I have a client with Ankylosing Spondylitis. I have consulted with a therapist, and she suggested supported back extensions as well as maintaining overall muscular strength, with caution to lateral movements. Any recommendations?
Ankylosed spondylitis is a systemic inflammatory rheumatic disease involving spinal and sacral joints. Subjects will present with decreased range of flexion, extension, and rotation causing the risk of spinal fracture to dramatically increase. Disc injuries are also more prevalent. In the majority of individuals, back pain is self-limiting. Once a client has back pain they are more likely to decrease activity levels, which leads to compensations by other body structures and tissues. Finally poor, inefficient movement patterns lead to further injury cycles.
Exercise has shown in clinical studies to improve function, decrease pain and stiffness in subjects with anklosed spondylitis. Training programs should be focused on stability and strength of the core, and improving balance. This will allow for greater posture control in multiple planes of motion. It is important to condition your client through multiple planes of motion because simple every day activities do not occur in one plane of motion. Just remember that the rigidity through the spine limits range of motion and increases the risk of spinal fracture or disc injury. Exercise is not intended to correct this condition. Proper conditioning can make the symptoms less painful and, in most cases, help the client function in daily activity more efficiently. Do not force any range of motion with exercise and consult with your local physical therapist and/or physician for further contraindications of particular exercises.
Please refer to the article on Low Back Pain by Mike Clark. Also refer to the core stability exercises in the Exercise & Flexibility Library.
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