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Pilates

Spine-extension Pilates for ankylosing spondylitis: a 25-minute class for posture, rotation and breathing

NICE (the National Institute for Health and Care Excellence) recommends a programme of posture exercises, deep breathing, spinal extension and movement through the whole spine for axial spondyloarthritis (axial SpA), and in small trials Pilates improved function and disease activity. This class follows that list: breathing and neck work sitting, posture at a wall, back extension face down, rotation and hip work, and a balance finish. Everything stays smooth and within your range, with no rolling or legs-overhead moves, so it suits a stiff spine. Add aerobic exercise on other days, and keep up your medicines and your physiotherapist's programme.

25 minBeginner20 movesA wallAbs · Neck · Back · Shoulders · Chest · Glutes
Follow along: a timer, a cue and the next move, one step at a time.

Breathe and neck, sitting

  1. Lateral breathing (Pilates breathing)5 to 8 breaths
    Beginner · Abs · 3D demoBreathe wide into the sides and back of your ribsHarder: Roll-up (Pilates)
  2. Breath reach5 breaths
    Beginner · 3D demoBreathe in as you reachHarder: Slow breathing (6 breaths a minute)
  3. Chin tuck10 holds of 5 s
    Beginner · Neck · 3D demoSlide the chin back; don't force a stiff neckEasier: Lying chin tuckHarder: Isometric neck holds (four-way)
  4. Thoracic rotation6 each side
    Beginner · 3D demoTurn from your upper backEasier: Side-lying open bookHarder: World's greatest stretch

Posture at the wall

  1. Wall angel8 slow
    Beginner · Back, Shoulders · 3D demoFeet a step forward if your back can't reach the wallEasier: Table slide (seated forward reach)Harder: Prone Y-T-W raises
  2. Doorway chest opener2 holds of 30 s each side
    Beginner · Chest, Shoulders · 3D demoGentleEasier: Elbows backHarder: Fish pose (Matsyasana)

Face down

  1. Swan (Pilates swan dive)5
    Intermediate · Back, Glutes, Triceps · 3D demoLift the chest a little; a forearms version if that's easierEasier: Mermaid (Pilates seated side bend)Harder: Double-leg kick (Pilates double kick)
  2. Swimming (Pilates)2 sets of 20 s
    Intermediate · Back, Glutes, Shoulders · 3D demoSmall, smooth liftsEasier: Mermaid (Pilates seated side bend)Harder: Leg pull back (Pilates leg pull up)
  3. Prone Y-T-W raises5 of each letter
    Beginner · Back, Shoulders, Neck · 3D demoForehead on a folded towelEasier: Wall angelHarder: Bent-over reverse fly

All fours and side-lying

  1. Cat-cow8 slow waves
    Beginner · Back, Abs · 3D demoSeated if kneeling is hardHarder: Half lord of the fishes (Ardha Matsyendrasana)
  2. Bird dog5 each side, 3 s hold
    Beginner · Back, Abs, Glutes · 3D demoFists if your wrists hurtEasier: Bird dog, one limb at a timeHarder: Bear crawl
  3. Side-lying open book8 each side
    Beginner · Back, Chest, Shoulders · 3D demoPillow under your headHarder: Thoracic rotation
  4. Side kick (Pilates side kick series)8 each side
    Beginner · Hip flexors, Glutes, Hip abductors · 3D demoGlide the leg forward and backHarder: Side-lying leg circles (Pilates side kick series)

On your back

  1. Pelvic tilt into bridge6 to 8 slow
    Beginner · Glutes, Abs, Hamstrings · 3D demoPillow under your head if your upper back is stiffHarder: Glute bridge
  2. Single-leg circle (Pilates one leg circle)5 each direction, each leg
    Beginner · Abs, Hip flexors, Adductors · 3D demoSmall circles, pelvis stillHarder: Corkscrew (Pilates)
  3. Dead bug heel taps6 each side
    Beginner · Abs, Hip flexors · 3D demoLow back restingEasier: Bent-knee fall-outHarder: Forearm plank

Kneel, sit and stand

  1. Half-kneeling hip flexor stretch2 holds of 30 s each side
    Beginner · Quads, Glutes · 3D demoPad the kneeHarder: Couch stretch
  2. Mermaid (Pilates seated side bend)3 each direction, each side
    Beginner · Back, Abs, Shoulders · 3D demoOn a chair if side-sitting is hardHarder: Side bend (Pilates)
  3. Spine twist (Pilates)3 each side
    Beginner · Abs, Back, Shoulders · 3D demoSit tall on a cushion or chairHarder: Saw (Pilates)
  4. Single-leg stand2 holds of 20 s each leg
    Beginner · Hip abductors, Calves, Glutes · 3D demoBeside a counterEasier: Tandem stance and heel-to-toe walkHarder: Single-leg reach matrix

Tips

  • Two or three times a week, and the breathing and spine moves for a few minutes on other days. Add aerobic exercise: the National Axial Spondyloarthritis Society (NASS) suggests 30 minutes, 5 times a week.
  • In a flare, keep moving with a smaller range and fewer repetitions.
  • With a fused spine or osteoporosis, keep every move smooth and within range, and get any new neck or back pain after a fall checked the same day.
  • Exercise later in the day if your mornings are stiff.
  • A painful red eye, light sensitivity or blurred vision needs an eye check the same day.

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

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Questions people ask

How long does the spine-extension pilates for ankylosing spondylitis: a 25-minute class for posture, rotation and breathing take?

About 25 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. 10 of its 20 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.