Benefits of Exercise
Exercise has been shown to optimize physical and mental health in everybody. In addition to directly increasing strength, endurance, balance, and flexibility, some of the other physical benefits of exercise include improving cardiovascular endurance), maximizing bone density, helping weight management, and possibly even enhancing response to medications. The mental health benefits of exercise include reducing stress, improving self-esteem, and improving productivity.
In addition to the general benefits of exercise noted above, those with JSpA can benefit from exercise in other ways. Regular exercise can help improve posture, stiffness, pain, fatigue, breathing capacity, and therefore overall function. Through these physical effects, youth with JSpA also report that exercise increases their quality of life, self-esteem, and decreases the impact of living with a chronic illness.
Recommendations for Different Types of Exercise
There are 4 main types of exercise recommended for all people with spondyloarthritis (including JSpA):
Range of Motion or Stretching
Aerobic or Cardiovascular
Range of Motion or Stretching Exercises
These exercises are done without weights to move the muscles and joints through their full range of motion. Range of motion exercises improve flexibility and reduce stiffness, swelling, and pain, as well as minimize the risk of fusion. These are often done as warm up exercises before sports. Range of motion or stretching exercises are critical for everyone with spondyloarthritis because people tend to limit movement and use of an area when there is pain, swelling, and/or stiffness around a joint. Lack of movement can lead to loss of mobility and increase the risk of fusion of the joints. In addition, when a joint is inflamed, surrounding muscles tighten to control motion, resulting in even more stiffness and pain. Therefore, it is recommended that range of motion or stretching exercises be done daily for all joints that are stiff or that have the potential for becoming stiff.
Aerobic or Cardiovascular Exercise
These consists of activities performed for a sustained period of time that increase the heart rate, and blood flow through the heart. Aerobic exercise improves heart and lung function and overall health. Studies show that all people with spondyloarthritis who do aerobic exercise have better breathing function, endurance, and mood, and less disease activity, pain and fatigue than people who don’t. Aerobic exercise releases endorphins that can help with mood and energy, and help fight fatigue. The current aerobic exercise recommendations include performing aerobic exercise between 3 to 5 times per week, for a total of 75 to 150 minutes per week.
These exercises use muscles to move or hold against a weight or resistance. Strengthening exercises improve the performance of muscles that help you move efficiently and safely and support good posture. Some of the most important muscles to strengthen in spondyloarthritis are the “core muscles,” which are the abdominal and back muscles that act like a “corset” to support the spine. Having strong core muscles has been shown to reduce stress in the spine and therefore can minimize back pain. It is common for a person who has back pain from spondyloarthritis to change their posture to ease the pain. Over time, these postural changes may lead to stiffness and weakness of the muscles and joints, and more pain. As such, “core strengthening” is key to managing back pain in spondyloarthritis. Strengthening exercises should be done 2 to 4 times per week for best results.
These exercises focus on improving stability when still or moving. Balance exercises can help reduce the chances of falling, which is especially important for people with lower bone density, or those who have fusion, and are at greater risk for fracture during a fall. Balance exercises should be done 3 to 5 times per week for best results.
An ideal exercise program will include each of the types of exercise noted above. In addition, experts recommend that all people with spondyloarthritis work toward exercising as often and as long as people without spondyloarthritis. However, it is also recommended to discuss specific needs with a physical therapist, and rheumatologist regarding the best frequency, intensity, and duration of exercise for each person. SAA recommends visiting a knowledgeable physical therapist to evaluate each person’s needs, and help craft the most effective exercise program.