Spondylarthritis is an illness from the rheumatic form. Frequently occurring inflammation occurs, primarily in the vertebral joints (facet joints), and the resulting degenerative changes in the joints, up to deformity and loss of mobility. Respiration may also be restricted, since increased hunchback formation reduces the mobility of the rib cage and ribs.
Exercises
Physiotherapeutic exercises against spondylarthritis are mainly mobilizing exercises. It is important that the joints should never be subjected to additional stress during the acute inflammatory period. The exercises then take place in the pain-free area and should be pleasant and produce a pain-relieving effect.
In acute inflammatory phases, cold application can be pain-relieving; heat should not be applied in acute inflammation. Exercises for spondylarthritis in the cervical spine (cervical spine) serve to mobilize the upper vertebral joints. The cervical spine is the most delicate section of the spine and should be gently mobilized.
The mobility of the cervical spine can be severely restricted, especially by the arthrotic changes (joint wear and tear). The mobilizing exercises are performed slowly and in a controlled manner. All directions of movement can be practiced, but combined exercises should be avoided, i.e. if turning the head is practiced, the inclination should be avoided at the same time.
The article Mobility of the cervical spine might also be of interest to you in this regard. 1st Exercise In the rotation movement, one side is first practiced. For example by looking over the shoulder several times, the thorax remains still in the room, only the head and the cervical spine move.
After 15-20 repetitions the exercise is repeated on the other side. 2nd exercise The lateral inclination can be trained in the same way. The right ear approaches the right shoulder, the gaze remains straight ahead, the chest straight in the room.
Then the head is raised again, until it is in the normal position, i.e. until it is aligned over the spine. The retreating movement (pulling back) straightens the cervical spine. This direction of movement is particularly important to train, since the frequently occurring increased flexion of the thoracic spine can lead to compensatory malpositioning of the cervical spine.
Retraction counteracts this straining incorrect posture. In cases of severe malpositioning of the thoracic spine, the compensation of the cervical spine cannot be corrected so that the patient can straighten his or her field of vision and gaze. 3rd Exercise In the retraction, the chin is pushed backwards in a straight line, the back of the head straightens and moves upwards, the neck becomes long.
When the position is released, the chin should only be brought back to the normal position and not pushed forward. Further mobilization exercises for the cervical spine can be found in the articles:
- Mobilization exercises cervical spine
- Physiotherapy Mobilization exercises
Exercises for BWS in spondylarthritis are particularly important because the frequently occurring kyphosis (hunchback) can lead to severe limitations in mobility, statics, breathing and abdominal organ functions. Due to its curvature, poor posture of the thoracic spine favors poor posture of the cervical spine.
The head has to be placed in the neck in a forced position to ensure a forward view. As a result, the nerve channel between the 3rd and 4th cervical vertebrae is constricted and tensions in the shoulder-neck area are the result. 1st ExerciseIn the first place the straightening of the thoracic spine is trained.
Exercises can easily be performed without any aids, either standing or sitting. By moving the arms, the thoracic spine can be mobilized in a straight line. The exercises against spondylarthritis should always be combined with breathing for the area of thoracic spinal column.
When the patient straightens up, the thorax widens, when he bends down, he breathes out, and the ribs sink. When stretching the spine, the arms are led far back. This can be done at shoulder height or next to the body if there are movement restrictions in the shoulder joints.
2nd ExerciseTo add a rotatory component the exercise can be performed with one arm. When lifting the right arm the view over the right shoulder follows the hand, the patient breathes in, the pelvis remains straight, the exercise is best performed in a sitting position. The left hand can hold on to the stool or chair to act as a light counter support.
After 15-20 repetitions the exercise is performed on the other side.Other exercises for mobility of the thoracic spine, for example from the exercise program of the FBL (Functional Movement Leaning) or PNF (Proprioceptive Neuromuscular Faciliation) are to be worked out with the therapist. Therapy bands can be used to strengthen muscles that are too weak. Gymnastic balls are also suitable for exercises in BWS in cases of spondylarthritis.
Exercises from the yoga/pilates area are ideal, as they incorporate both mobility and breathing into their concept. Spondylarthritis usually begins in the lumbar or sacroiliac spine. Exercises for this section of the spine are also of great importance, since changes in the lower spinal sections influence the upper ones and vice versa.
The mobility of the pelvis and lumbar spine can be influenced by hip movements, but pelvic tilting and circling also mobilize the lowermost section of our spine. 1. exercisePelvic mobility can be practiced very well on a stool. The patient can easily feel his ischial tuberosities on the hard surface and can therefore follow the perhaps unfamiliar and difficult to control movements more easily.
From the upright position the pelvis is tilted forward, the ischial tuberosities roll backwards, then the pelvis is tilted backwards, the abdomen becomes short, the back rounder, the ischial tuberosities roll forward. The movements are carried out alternately. The thorax remains still, the movement only takes place up to navel height.
2. exerciseThe lateral pelvic movement can also be trained. It serves to mobilize lateral flexion (lateral inclination) in the lumbar spine. From the supine position, the stretched legs are alternately pushed down so that the two protruding pelvic bones are pushed down and up.
The movement also takes place only in the lower spine, the thorax remains firmly on the ground, the movement is not great, the pelvic bones move in one plane. Many repetitions can be done, the exercise should be pleasantly loosening. In addition, stretching exercises for the hip flexor muscles can be useful.
Strengthening the hip extensors can also serve to straighten the pelvis. However, the focus in spondylarthritis is usually on mobilizing exercises. Further exercises for the lumbar spine can be found in the article Physiotherapy Mobilisation exercises and Physiotherapy exercises back.
