.png?format=original){kind=spacer}
I’m a Personal Trainer, and These Are the Exercises That Help Me Manage My Chronic Back Pain
Ten years ago Alex Levine, now 36, was diagnosed with ankylosing spondylitis, a form of axial spondyloarthritis. At that point he had already been experiencing symptoms like sciatica and back soreness for about five years. Until his diagnosis he pushed through his pain as much as he could, playing sports like basketball and soccer and lifting weights to stay fit. As time went on, though, he couldn’t continue his usual routine because of ongoing discomfort. Still, he vowed to remain as active as possible. He knew it would help him maintain his mobility in the long run. Levine eventually became a personal trainer specializing in arthritis and joint pain. Here’s how he manages his pain, stays strong, and helps others do the same—and why he thinks exercise is key to managing his condition—as told to fitness writer Jenny McCoy.
Staying active when you have axial spondyloarthritis can be really challenging—both mentally and physically. If you’re living with axSpA, you already know it’s a form of chronic arthritis that causes pain and swelling in the spine and sacroiliac joints (a.k.a. SI joints, which connect your spine to your pelvis).
The damage the condition causes can seriously limit your mobility, making it tough to maintain a fitness routine. Plus, some exercises can make axSpA symptoms worse. So if you lack the confidence to start an exercise routine because you don’t want to feel pain or get injured, I get it—I have ankylosing spondylitis (AS), a severe form of axSpA.
But as a personal trainer who specializes in arthritis and joint pain, I also know this: The right type of movement can help you manage your condition. In the years since my diagnosis at age 26, I’ve learned a lot about how to strike that delicate balance. Here’s how exercise can help you manage this condition—plus what stretches and strength moves I recommend adding to your routine.
How exercise can help manage axSpA
Because axSpA can cause debilitating stiffness, retaining flexibility and mobility is key. That way, as time goes on, you’re still able to go about everyday activities like working, cooking dinner, and playing with your kids.
Strength training is also essential, since the tightness axSpA causes can weaken muscles. Working on your strength is great for boosting mobility too. Since axSpA can create strength and mobility imbalances, I prioritize unilateral exercises, where I work one side at a time. These moves—like a single-leg glute bridge, for example—help correct those discrepancies.
I’m also a big proponent of doing full-body training rather than just homing in on a few areas. That’s because the tightness you experience with axSpA can sometimes lead to secondary issues like pain in the shoulders, feet, and Achilles tendons. In my case, low back tightness caused by AS led to calf and foot pain, which triggered tight hamstrings. By doing workouts designed for your entire body, you can help mitigate the impact of these secondary issues.
Exercising safely with axSpA
A fitness routine doesn’t need to be high-intensity to be impactful. While that can be part of your routine if it’s something you enjoy (and your doctor says it’s safe), in many cases, for folks with axSpA, it’s about adapting movements and activities to work for you.
For example, getting on the ground when you have arthritis can be challenging, especially first thing in the morning, so doing stretches from a standing position and using support items like a wall or chair can make these moves more accessible. When it comes to strength training, dumbbells may be too much, which is where tools like resistance bands can come into play. Opting for strength modifications—like, say, performing a bench press from the floor, which provides more support for your body—can also be helpful.
Due to the inflammatory aspect of this disease, symptoms can change daily, and you have to adjust your workouts accordingly. That’s why a flexible mindset is key. Instead of focusing on what you can’t do, ask yourself: How can I tweak my fitness routine to keep the consistency going?
The workout
Below are some of my go-to moves for folks with axSpA. Keep in mind that these exercises aren’t one-size-fits-all. Some moves may feel great for your body, and others…not so much. To suss out the difference, pay attention to how you feel during and after exercise. You shouldn’t feel pain at any point, so if you do, back off. Experiencing intense soreness post-workout is another sign to ease up. If that happens, reduce the number of reps, use lighter resistance, or add a longer warm-up or cooldown.
What you need: Grab a resistance band for the banded pull-apart and a set of light dumbbells for the floor dumbbell chest press. You may also want an exercise mat for comfort and access to a wall you can lean on for modified stretches.
Exercises
- Standing Chest Opener Against a Wall
- Downward Facing Dog Against a Wall
- Wall-Supported Overhead Reach
- Bird Dog
- Dead Bug Heel Taps
- Single-Leg Glute Bridge
- Floor Seated Straight Leg Raise
- Banded Pull-Apart
- Floor Dumbbell Chest Press
- Prone W Reach
Directions
- Pick three or four moves to combine as a workout, ideally selecting a mix that hits your whole body.
- For each stretch perform 1 set of 6 to 15 reps. For the strength moves perform each for 2 to 4 sets of 6 to 15 reps. For single-sided moves, do the prescribed number of reps on each side. Beginner exercisers should start with 2 sets.
- As you do these moves, focus on maintaining good form and working through a range of motion that feels comfortable and controlled.
- Start by doing the strength moves just once or twice a week. If that feels good, add another day. Pay close attention to how your body responds, and back off if you feel overly sore or low on energy afterward. The stretches can be done more frequently.
Trainer tip: At first keep your exertion level mild and stop performing reps before you’re gassed—the goal is to finish feeling like you could still bust out a few more reps with perfect form. Once you get comfortable with the exercises, you can work closer to ending your workout feeling fatigued, but make sure you keep good form throughout.
Demoing the moves is Alex Levine, a certified personal trainer and senior fitness specialist through the National Academy of Sports Medicine. Alex owns and operates a virtual personal training business that specializes in one-on-one personal training for people with arthritis, joint pain, and axial spondyloarthritis.
Get more of SELF's great service journalism delivered right to your inbox.
Related:
SELF does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice, and you should not take any action before consulting with a healthcare professional.