Facts & Fallacies about training with A.S

I get a lot of questions from folks who don't quite know what they can or can't do when training with A.S. Here's my opinion, gained from my personal experience and from my knowledge as a strength coach and kinesiologist.

FAQ about training with A.S

1) I shouldn't train because I risk making my condition worse.
False. You should train to the level that you can tolerate without increasing your inflammatory response. Any movement that you can do will maintain your mobility in the long term and help limit the range-limiting ankylosis effects.

2) When I’m feeling pain I should avoid moving to let the flare-up pass
False. If you are feeling a flare-up, keep your training mild and avoid doing movements that directly target the inflamed areas, but don't stop moving.

3) Running is dangerous for my spine
False: Although I agree that those with segmental fusion should not run for risking stress fractures, I believe that a low volume running program is beneficial for those with spondylitis. Running stress must be increased progressively (remember that you will have between 170 and 185 impacts per minute when jogging - even more when sprinting) by upping the training volume by one or two minutes per workout. Start your volume extremely low (2-3 minutes per workout) and use short intervals (30 to 60 seconds) at the beginning in order to maintain proper running form. Your foot strikes should be light on the ground - if you feel your feet landing hard - your workout is over. Those who cannot maintain an efficient head-level posture or who are limited in range in the hip joints should chose another activity.

4) Training will help alleviate my chronic pain & fatigue
True: Training will allow you to increase your pain threshold and can have a positive effect on management of inflammation. As long as the mechanical stresses (loads lifted, number of impacts per session etc...) are increased progressively and the threshold of inflammation is respected, training will only make you more resilient.

5) I should not load my back during a squat or deadlift
False: It is very important to learn proper technique prior to increasing the workload. Making sure that you are able to maintain a neutral back and keeping proper bracing during these exercises. Once this is attained, a slow progression can be integrated. There are several variations that can help beginners attain good posture (wide stance, trap bar, partial range etc...) and progressively increase range of motion until full variations can be done.

6) I should still go to the gym even when I feel horrible
True: While it's not my favorite time to train it’s the most important time to go the gym. You will always leave the gym feeling better than when you walked in. Just going for 20 minutes is enough to increase dopamine and endorphin levels in the brain. Why stay home and feel victimized by your pain? Get out there and sweat it out!

7) I should only do stretching to make sure I get more range of motion
False: Although stretching has its benefits, it won’t increase your strength or muscle endurance. Many weight training variations can be seen as assisted flexibility training - the weights can help you reach range of motion that you could not get to on your own. For example, it's not unusual to see someone improve their hip flexibility by training squats and deadlifts.

8) Now that I’m training and feeling great, I can stop taking my meds
False: The medication is absolutely necessary to slow down the process of A.S. The medication will also help inhibit conditions such as muscle spasms and joint pain and inflammation. The training is a tool used along side your medications to allow you to live an active and pain free life.

9) I should do my weight training early in the morning to relieve muscle tension
False: Training in the morning with load may not be a very good idea if you are, like me, very stiff in the morning. I like to do mobility work in the morning after the stiffness dissipates and keep my heavy workouts for the afternoon or night. Also, the disks in your spine are more hydrated in the morning, making your spine less mobile - doing mobility work first helps balance these fluids and return your spine to a more mobile state before loading with weights.

10) Squatting is dangerous for my back
False: There are no inherently dangerous exercises, as long as you are able to correctly execute the proper technique and respect a conservative progressive loading program, you can do any exercise. In fact many exercises that were proscribed in the past are now being used as rehabilitation choices. In some cases, A.S. can limit the range of certain joints so that certain exercises such as squats might be a poor choice - in which case other variations can be prescribed. Remember - there are no bad exercises, only exercises that are not appropriate for an individual at a given time in their training.
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