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Stretching & mobility

Daily exercises for ankylosing spondylitis

The National Institute for Health and Care Excellence (NICE) recommends a physiotherapist's programme for ankylosing spondylitis and axial spondyloarthritis (axial SpA) that includes stretching, strengthening and posture exercises, deep breathing, spinal extension, movement for the whole spine and aerobic exercise. This routine covers the stretching, posture, breathing and spine parts in about 20 minutes. Do it every day, later in the day if your mornings are stiff, and add cardio and strength sessions through the week. A programme from your own physiotherapist comes first; the doses here are our editorial starting point.

20 minBeginner15 movesA wallHip flexors · Abs · Neck · Back · Shoulders · Chest
Follow along: a timer, a cue and the next move, one step at a time.

Warm-up and breathing

  1. Standing march2 min
    Beginner · Hip flexors, Abs, Glutes · 3D demoEasy pace, arms swingingHarder: Standing band hip flexion
  2. Lateral breathing (Pilates breathing)5 breaths
    Beginner · Abs · 3D demoSitting or standing, hands on your lower ribs: breathe into themHarder: Roll-up (Pilates)
  3. Breath reach5 breaths
    Beginner · 3D demoArms rise as you breathe in and lower as you breathe out

Neck and upper back

  1. Chin tuck10 holds of 5 s
    Beginner · Neck · 3D demoGlide your head straight back, eyes levelEasier: Lying chin tuckHarder: Isometric neck holds (four-way)
  2. Side neck stretch3 holds of 5 to 10 s each side
    Beginner · Neck, Shoulders · 3D demoLet the weight of your head do the workHarder: Sleeper stretch
  3. Thoracic rotation6 each side
    Beginner · 3D demoKeep your hips stillHarder: Reverse lunge with rotation
  4. Wall angel8 slow slides
    Beginner · Back, Shoulders · 3D demoA small range is fineHarder: Prone Y-T-W raises
  5. Doorway chest opener2 holds of 30 s each side
    Beginner · Chest, Shoulders · 3D demoElbow at or below shoulder heightEasier: Elbows backHarder: Fish Pose (Matsyasana)

On the floor

  1. Cat-cow8 slow waves
    Beginner · Back, Abs · 3D demoDo it seated if getting down to the floor is hardHarder: Half lord of the fishes (Ardha Matsyendrasana)
  2. Side-lying Open Book Rotation8 each side
    Beginner · 3D demoA cushion under your head if your neck is stiffHarder: Reverse lunge with rotation
  3. Prone press-up (McKenzie press-up)10 slow reps
    Beginner · Back, Triceps, Chest · 3D demoOr rest on your forearms (the sphinx) for 3 slow breaths at a time. Skip it if it sends pain down a legEasier: Sphinx pose (Salamba Bhujangasana)
  4. Prone Y-T-W raises5 of each letter
    Beginner · Back, Shoulders, Neck · 3D demoForehead on a folded towelEasier: Wall angelHarder: Bent-over reverse fly

Hips and finish

  1. Half-kneeling hip flexor stretch2 holds of 30 s each side
    Beginner · Quads, Glutes · 3D demoPad your knee and tuck your tailbone underHarder: Couch stretch
  2. Supine hamstring stretch with a strap2 holds of 30 s each leg
    Beginner · Hamstrings, Calves · 3D demoBack flat on the floorEasier: Leg-up hamstring stretchHarder: Contract-relax hamstring stretch (PNF)
  3. Overhead side bend3 each side
    Beginner · 3D demoStand tall with your feet plantedHarder: Overhead lat stretch at a bench

Tips

  • Move within a comfortable range. Mild aches are normal and should ease once you finish; get advice if more than mild aches follow (the National Axial Spondyloarthritis Society's safety advice, as archived in October 2025).
  • If your mornings are stiff, do it later in the day.
  • This routine keeps you moving but isn't the whole plan: add about 150 minutes of cardio a week and strength exercises on at least 2 days.
  • A physiotherapist's programme comes first if you can get one: ask your rheumatology team.
  • In a flare, keep going at a smaller range (our suggestion).
  • With a fused spine or osteoporosis, skip any floor move you can't get down for and up from safely, and do the cat-cow seated.

The doses are suggested starting points, not a prescription. Choose a range you can control and stop for sharp or increasing pain, numbness or tingling. Get individual advice after an injury or surgery, or if you are pregnant or managing a health condition.

Guides that recommend it

Find more moves like these

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10-minute morning stretch

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Full-body stretch routine

A 15-minute head-to-toe stretch for the neck, shoulders, back, hips, hamstrings and calves.

15 minBeginner11 movesA wall

Lower back stretch routine

Seven gentle stretches and mobility moves for a stiff lower back, done lying and kneeling.

12 minBeginner7 movesA wall

Questions people ask

How long does the daily exercises for ankylosing spondylitis take?

About 20 minutes, including any warm-up and cool-down listed. Shorten it by doing fewer rounds; lengthen it by adding one.

What equipment do I need?

You need: A wall. Each move links to its guide, where you can find an alternative if you are missing something.

Is it suitable for beginners?

It is written for beginners. 5 of its 15 moves have an easier option listed beside them if you need one.

How do I make it easier or harder?

Use the easier or harder option listed under each move, change the number of rounds, or adjust the rest. Progress one change at a time.