Pilates for Ankylosing Spondylitis

Pilates for AS  

This is not suitable for anyone with osteoporosis – a different programme would apply

For a home programme suitable for healthy beginners which is similar to this please visit my other website www.pilatesshropshire.com

Please check with your doctor first before you start – show them this programme.

First have a look around this website and www.pilatesshropshire.com and read An Introduction to Pilates first and then read all the pages and posts on Pilates on both sites.

Programme Aim

Improve posture and mobility to the whole body

Restore balance to the spine in the three planes of movement i.e. flexion, lateral flexion and rotation

Stretch chest muscles, strengthen back muscles, stretch neck muscles, stretch muscles in between the ribs

Stretch and strengthen muscles around the hip joint.

Strengthen the core.

N.B. You may find this very uncomfortable and painful to start. If so just do one of each to the best of your ability.  Any small move you can make towards the actual exercise will help so don’t be discouraged, this is going to take time.  Remember Pilates is slow and controlled and should flow – aim for that. Don’t overdo it. It is OK for you to feel stiff and sore for a few days afterwards when you first start.

Optimum posture is the best that you can do.  Shoulders back and down, head in line with the spine, spine lengthened, pelvis* in neutral i.e. the two hip bones and the pubic bone should feel level.  Just keep trying and you will get it. Get the exercise first before you start the breathing.  Your breathing is probably inefficient at the moment as your ribs are inflamed.  Eventually your breathing will improve and that will mean your body will be getting more oxygen and nutrients and you will feel a whole load better. Engaging the core takes practice – you can practice this anywhere. Obviously this is slightly different for men!

It is a good idea to record your progress and discomfort levels.

You will need a mat to lie on, a rolled up hand towel or small pillow and wear unrestrictive clothing, I haven’t got photos for every exercise so just contact me if you are struggling.

Please do every day.  Once you have learned the exercises it won’t take long.


Warm Up (Spine flexion, rotation and lateral flexion) 3 – 5 repetition s

Standing in your optimum posture, feet straight and hip width apart, pelvis in neutral* with your shoulders back and down and relaxed, back of the neck long, chin parallel to the floor, lengthen through the spine lifting up out of your hips. With your arms down by your side and the palms facing back engage your core. Inhale to prepare, exhale and raise your arms up to the ceiling with your palms uppermost opening up the chest, inhale and bring your arms out to the side and lined up with your shoulders. Exhale and rotate to your right, keeping your hips facing forward, and inhale to return and repeat to the left. Exhale and take your right arm straight up to the ceiling, lifting out of the hips curve the arm over the head into a side bend.  Slide your other hand down the thigh. Inhale back and repeat to the other side.


Lying On Your Front

Deltoid Squeeze (Stretch the chest and neck, strengthen the back and shoulder) 3 – 5 repetitions

Lying on your front in your optimum posture with your arms down by your side with the palms up to the ceiling, lengthen through the back of neck.  Take your feet to hip width apart and drop the heels out to the side and relax the muscles in the legs. You may find it helpful to put a rolled up hand towel under your hip bones to increase the lumbar curve at the back of your waist. Pull up the pelvic floor and pull in your abdominal muscles, inhale and lift your head and chest up as far as you can and at the same time rotate the arms bringing the elbows towards each other. Exhale and return to your start position. Do not tilt the head back as you lift; keep the back of the neck long and in line with the rest of the spine.

The Cat (Stretch the muscles each side of the spine) 3 -5 repetitions

Cat StretchOn all fours in your optimum posture, wrists below the shoulders, knees and feet hip width apart with the knees directly below the hips, pelvis in neutral. Engage the core lengthen through the neck so you are looking directly down at your mat, inhale to prepare, exhale lengthen through the arms arching the back right up to the ceiling drop the head down and bring the tail bone forward without moving the legs, inhale deep into the ribs and the back in that top position and then exhale back to neutral working through the spine bringing the pelvis back into neutral last.

Lying On Your Side

chest opener bestThe Chest Opener (Stretch chest muscles, strengthen the back, improve upper body rotation) 3 – 5 repetitions

Lying on the side, hips and shoulders stacked, head must be supported with small cushion or rolled up hand towel under the ear, knees bent to 45 degrees.  Arms extended at shoulder height in front of you, hands together. Engage your core, inhale to prepare, exhale and take the top arm across the body and down towards the floor keeping the hips facing the front and following the movement of the arm with the eyes and head.  Inhale to return.


Spine Twist (Stretch and strengthen the muscles at the sides of the body. Spinal rotation)          4 – 8 repetitions

spine twistSeated in your optimum posture with your legs straight out in front of you, feet hip width apart and the toes up towards the knees. Take your arms straight out to the sides so they are lined up with your shoulders, lift up out of your hips and get your back as straight as you can with the pelvis in neutral.  Make sure your shoulders are back and down. Engage your core, inhale to prepare, exhale and rotate to one side as far as you can go keeping your hips firmly on the floor.  Inhale and return to your start position.  Check your posture again and then repeat to the other side. 

Mermaid (Stretch the sides of the body and the hamstrings at the back of the legs. Lateral flexion of the spine) 4 – 8 repetitions

Seated in your optimum posture as above with both legs straight out in front of you with your feet hip width apart and the toes up.  Place your left hand on the floor beside you for support.   Inhale to prepare, exhale and lift your right hand up towards the ceiling lifting up out of the hips and curve the arm over your head. Taking care to keep the knees down and the hips on the floor. Inhale to return. Stay on one side for your reps and then repeat on the other side.

Lying On Your Side

The Chest Opener  As above on your other side.

Lying On Your Back

Shoulder Bridge (Segmental control of the spine, stretching and strengthening spinal muscles, strengthening the legs and hips) 3 – 5 repetitions

Shoulder Bridge 1Lying on your back, knees bent, feet hip width apart and straight, pelvis in neutral, arms down by your side with the palms down, shoulders back and down. Lengthen through the back of your neck and bring your chin down.  Engage your core, inhale to prepare, exhale and pushing your feet into the floor lift up your pelvis, without tucking it, and peel your spine off the mat bone by bone until you are at your highest position.  Inhale here, exhale and start your return journey visualizing your spine as you return to your start position. Never support your head on this one.

Knee Circles (Stretch and strengthen the muscles around the hip joint, strengthen the core) 3 – 5 repetitions in each direction.

knee circlesThe picture is to show you the alignment of the working leg, the other foot must be on the floor with the knee bent. Lie on your back in optimum posture with your arms down by the side palms down, both knees bent. Engage your core and lift one foot bringing the knee directly above the hip socket and the foot lined up with the knee with the shin parallel to the floor. Inhale and circle the knee letting the movement come from the hip. In breath on the inside of the circle out breath on the outside (imagine a clock, in breath 12 – 12.30, out breath 12.30 – 1.00). Repeat in the other direction and then on the other leg taking care with the set up. Focus on keeping the pelvis and the non working leg stable.  Breathing takes a while to get the hang of!

Hip Roll (Stretch and strengthen the sides of the body) 3 – 5 repetitions

hip roll low levelLying on your back with your knees bent and both feet flat on the floor. Take your arms out to the side so they are lined up with your shoulders.  Bring your feet in together and then bring them in towards your hips taking care not to lose your neutral spine. Make sure your shoulders are back and down and the back of your neck is long with the chin down.  Inhale to prepare, exhale and take your knees to the right at the same time turn your head to the left.  Only take the knees over as far as you can keep the opposite shoulder blade on the floor.  Inhale in this position. Exhale to return to your start position. Inhale here and repeat to the other side.

STRETCHES  Hold for 20 seconds, the hamstrings for 30 seconds.  Each One Twice

 Hamstrings (back of thigh)

hamstring stretchLying on your back with both legs extended along the floor.  If more comfortable this stretch can be done with the knee(s) bent.  Relax the shoulders down and bring one leg in towards the chest keeping the hips on the floor where possible.  Support the leg with both hands either below or above the knee and keep it straight if comfortable to do so.  Flex the foot by bringing the big toe down towards the knee to take the stretch into the calf. Hold the stretch there for 30 seconds.  Now breathe in, breathe out and ease the leg in a little further to encourage increased flexibility. You can use a towel or a resistance band to help you. Replace the leg on the floor and repeat on the other leg. 

Quadriceps (front of thigh)

quad stretchLying on your front, take one arm above your head bend the elbow and place it on the floor. Take the other hand and reach down and pick up your foot and bring it in towards your hips until you feel a stretch at the front of the thigh. If you can’t reach the foot grab your sock or your trousers or you can use a towel or a resistance band to help you.  Repeat on the other side. Can be done lying on your side with knees bent and bottom arm going straight up from the shoulder and your head on the arm.

Outer thigh 

Seated in your optimum posture with both legs extended, take the right bent leg over the straight left leg and place the right foot on the floor.. Hold the right shin with your hands and ease that leg over until you feel the stretch on the outside of the right thigh keeping both hips on the floor.  Repeat on the other side.

Inner Thigh with Spine Stretch 

Seated in your optimum posture with both legs extended, slide the legs apart until you can feel a stretch on the inside of the thighs.  Keep both hips on the floor and put both hands on the floor in front of you and then walk them away taking your spine into a stretch and increasing the stretch in the inner thighs.  Hold at your furthermost point and see if you can lower your elbows further down towards the floor.  


Seated in your optimum posture with both legs extended, take both hands out to the sides of your body so that the elbows are lined up with your shoulders and the hands are directly above the elbows. Squeeze the elbows back together stretching out the muscles in the chest and bringing the shoulder blades in together.

Now say to yourself well done!

For more information about Pilates please click www.pilatesshropshire.com