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#270824 - 03/29/15 02:14 AM New to AS and looking for exercise options
mm1832 Offline
Registered Visitor

Registered: 03/27/15
Posts: 8
Hi All,

I don't yet have a diagnosis of AS but have been told this week that it is "likely". I'm waiting for my first appointment with the rheumatologist. I'm 38 years old and prior to this time last year I had no back problems and was very active. I used to lift weights, cycle, do pilates, archery and ballroom dancing. The problems started as pain in the left groin area (I now understand this was from the SI joint) and have gradually progressed so that both SI joints are really inflamed and painful and I also have pain in parts of my lumbar spine. Due to the pain and the advice from the doctors to "not do it if it hurts" I have gone from being really active to extremely inactive. Now I understand what the problem is, I realise this has probably made things worse.

I really enjoy exercise and am looking for the best way back into it. I live in the UK and the National Ankylosing Spondylitis Society have a "Back To Action" guide to different exercises. It covers "Mobility", "Cardiovascular", "Strength", "Flexibility" and "Breathing". I have already tried the Mobility and Breathing exercises and they actually felt really good. I'm looking for advice around Cardiovascular and Strength exercise.

For Cardiovascular I have been thinking of:
1. Cycling. I used to do this quite a lot and would definitely enjoy getting back into it.
2. Swimming. I only really know breaststroke, which I believe is not the best option for AS. So, I'd probably get some lessons on front crawl / backstroke.
3. Walking. I have tried this already but I find that it causes really bad swelling / inflammation in the SI joints even after only 5 minutes

Questions:
1. What have you found to be the best types of cardiovascular exercise?
2. Are there certain types of exercise that are "best" or is it a matter of trying each out to find what works on an individual level?
3. Do any of you do exercise classes? If so, which ones and do you do them in the standard way or make some modifications?

I'd also like advice on strengthening exercises. I've been considering:
1. Pilates
2. Weights machines in the gym
3. Exercise in the water

Which types of strengthening exercises have you found to be the best? Which would be the best starting point for someone who used to be really active but has become very inactive?

I'd appreciate any advice and suggestions you have.

Many thanks

Matt

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#271098 - 04/22/15 05:57 AM Re: New to AS and looking for exercise options [Re: mm1832]
60Driver Offline
Registered Visitor

Registered: 05/11/10
Posts: 25
My exercise philosophy ever since my symptoms showed up about 9 years ago has been to work around whatever pain I had on a given day. For example, if I am feeling particularly good, I run. If I am feeling stiff or having a flare, I'll get on a bike (real or stationary) and start slow/low resistance to loosen up and just feel out how much I can push myself. Swimming is another great way to get cardio. If my lower body just doesn't want to cooperate, things like speed bag work are another way to get cardio with upper body movement.

For weights, I use the same philosophy. I find that weight machines are more forgiving than free weights in terms of mitigating risk of injury. However, I do like using dumb bells and barbells and occasionally kettle bells. I personally like focusing on my core strength because I feel like that helps me get through a bad day a little bit better. Basically, in my mind a stronger core can compensate for joint weakness and pain.

Since I started humira, my ability to exercise has improved greatly. I rarely have to skip a run day.

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#271116 - 04/23/15 07:03 AM Re: New to AS and looking for exercise options [Re: mm1832]
mm1832 Offline
Registered Visitor

Registered: 03/27/15
Posts: 8
Thanks, that's very good advice. Since my original post, I have been experimenting a little with some gentle exercise and am focusing on cycling for now in addition to some stretching / mobilising. Like you say, it seems best to adjust based on how you feel on a given day. I'm starting to better understand what I can and can't do at any given point. I'm also finding that I can't necessarily tell at the time of doing the exercise how much I can manage. I generally feel better once I start exercise and it's only later the same day or the next day when I can really tell if I've done too much. Is that normal or can you tell at the time of doing the exercise when you've done enough?

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#271139 - 04/23/15 01:58 PM Re: New to AS and looking for exercise options [Re: mm1832]
60Driver Offline
Registered Visitor

Registered: 05/11/10
Posts: 25
There are times when I get the sense that I'm pushing myself too hard. Sometimes I continue anyways and usually end up regretting it afterwards. Other times, I reduce intensity and it works out.

I think I've gotten to the point where I know what a certain pain or stiffness means and whether or not I should work through it and keep going or play it safe. Trial and error is really the only way I know of to get to that point.

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