Some people practice Pilates to help manage ankylosing spondylitis (AS). Pilates may help improve aspects of physical function, such as strength, flexibility, and balance.

AS is a form of inflammatory arthritis that affects the ligaments and joints of the spine. Over time, this inflammation can lead to pain and stiffness. Symptoms can also spread to other parts of the body, such as the hips or shoulders.

Experts consider Pilates to be a safe and effective way for people to help manage their AS symptoms.

This article explores how Pilates can help people with AS, including the benefits, risks, and moves to try.

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Pilates classes focus on exercises to help strengthen the muscles that support the spine. In particular, Pilates may help a person with AS improve or maintain their:

  • strength
  • flexibility
  • mobility
  • balance
  • coordination
  • posture

Often, people with AS feel better when they move than when they stay still. Exercise is more helpful for managing AS than any other form of arthritis.

What is AS?

AS is a type of arthritis that presents with inflammation of the spinal joints and ligaments. These joints and ligaments help a person move and bend their body. The inflammation of AS can make these actions more difficult over time.

Some people with AS may experience mild flare-ups of pain and stiffness. Others may experience severe ongoing pain. Some also develop spinal fusion, which is the vertebrae of the spine joining together, causing spinal rigidity.

Additionally, other people may develop symptoms in their hips, ribs, shoulders, knees, ankles, and feet.

Learn more about AS here.

A randomized controlled trial from 2023 split 42 people with AS equally into a Pilates group and a control group. The Pilates group did Pilates three times a week for 8 weeks. The control group did a home exercise program for 8 weeks.

The people following the Pilates program showed statistically significant improvements in:

  • disease activity
  • function
  • spinal mobility
  • quality of life
  • core muscle endurance
  • stability

The control group only showed improvements in flexor muscle endurance and limits of stability tests.

A randomized controlled trial from 2022 found that aqua Pilates, which is Pilates practiced in water, such as a swimming pool, significantly improved scores for pain, function, walking, quality of life, and spinal range of motion in people with AS.

Additionally, a 2019 pilot study with 11 people with AS found that doing Pilates twice a week over 1 year helped improve AS symptoms.

Pilates is a safe and effective method for managing AS.

Pilates is a low impact form of physical activity. The Centers for Disease Control and Prevention (CDC) recommends that adults with arthritis take part in low impact exercise, which puts less stress on the body and reduces the risk of injury.

The CDC suggests starting slow and monitoring how the body tolerates new exercise or increased activity.

The following Pilates moves may help people with AS.

Pilates breathing

  1. Lie on the floor, facing upward.
  2. Breathe in through the mouth without using the neck muscles.
  3. Inhale deeply, trying to get the ribs to expand as much as possible.

This exercise may help relieve tightness in the chest.

Shoulder bridge

  1. Lie on the floor, facing upward.
  2. Place the soles of the feet on the floor with the knees together.
  3. Place the shoulders and arms flat on the floor, with the palms facing down.
  4. Keep the heels just out of reach of the fingertips.
  5. Slowly lift the pelvis up and then lower it down.

This exercise may help improve spinal mobility.

The swan

  1. Lie facing down.
  2. Bend the elbows to 90 degrees and tuck them into the sides of the body.
  3. Keep the wrists next to the ribs.
  4. Press the pelvis into the floor and slowly lift the face, breastbone, and ribs upward.
  5. Keep the eyes gazing forward.
  6. Draw the shoulders back and down.
  7. Slowly roll back down in the reverse order.

This exercise can help counteract the tendency of people with AS to bend forward.

Kneeling hip flexor stretch

  1. Start on the knees, with the upper body straight.
  2. Bring one foot forward so the knee and ankle align.
  3. Rotate the pelvis as if tucking a tail between the legs.
  4. Draw in at the navel.
  5. Place the hands on the hips and keep the hips aligned forward while shifting the weight slightly forward.
  6. Hold for 30–45 seconds before easing back to the starting position.
  7. Repeat 2–3 times.
  8. Switch to the other knee and repeat.

This exercise can help stretch the front of the hips and improve posture.

People with AS experience inflammation in the joints and ligaments of the spine. Over time, this can cause pain and stiffness, which can be severe in some people.

Pilates is a low impact form of exercise. It minimizes stress on the body while improving strength, coordination, mobility, and balance.

Experts consider Pilates a safe and effective exercise for people with AS.

A person can try moves like Pilates breathing to decrease chest tightness and the shoulder bridge to improve spinal mobility.