person implementing different stretching methods into their routine

Getting out of Bed with Spondyloarthritis, Part II

Motivation to begin exercising is a major problem for me. I'm just tired - mentally and physically - from family drama, a bad diet, a wonky-doodle work schedule, and yes, the lack of exercise. Throw in spondyloarthritis and I feel defeated. You would think finding time to exercise would be easy to do, especially during a pandemic, more time stretching for flexibility, on mobility exercises, and strength routines, but I haven't done it - not at all.

The way back to exercise

The quotes "motion is lotion" or "movement is medicine" are used incessantly throughout the AS community; sacred knowledge in the chronic illness world, if there ever was any. This alone should motivate me somehow. But lately, all I want to do is grab the blanket and dive back under the realm of sleep where I supposedly won't feel a thing. As I come to in the morning, exhausted after a night of broken and interrupted sleep, I really hesitate… to get moving. The motivation isn't there.

I know moving will help the pain and discomfort I have from SpA, inflammatory arthritis. But, excuses pile up when faced with taking on exercise. I tell myself the stationary bicycle has been packed away in the closet or the yoga mat is not worth taking out for only a half-hour. I mentally convince myself starting is just not worth it, that it will hurt more than be helpful. I recognize the mental deceit and defeat. I need to change my way of thinking, find a better way to motivate myself or it'll come back to bite me in the end.

Finding motivation

Positive thinking is one way to start. Focus on seeing results. I would walk better, have more energy, less stiffness, and possibly lose unwanted pounds. With this reasoning, I am able to start and keep the momentum. I ask myself what's holding me back from beginning. Should I pull my bike out of the closet, for easier access? Possibly leave out my mat and yoga blocks in front of the mirror instead of tucked away? By doing this, it would be easier for me to initiate the act of exercising. Placing these items in plain sight could be motivation to begin when I can't find the energy. What is an obstacle for you? What is an end result you look forward to if you began a movement plan?

Secondly, find your "tribe." It's very important. Understanding what works is salient. I have never been a person to head out to a gym. I like my place, my space. Mentally it works better for me. I could buy a gym membership, but I know I won't go. I recently looked into a yoga class for those with ankylosing spondylitis on Facebook to start at home. Instructors consult with you individually and devise personalized exercises to keep you motivated. It will be easier for me to head to my mat if I have a plan in place. My tribe supports me and my condition, yielding positive results. Who is included in your "tribe"? A walking buddy? Fur babies running in the yard? Where do you feel most comfortable stretching and moving?

Lastly, reward yourself. Many find that rewarding themselves is effective motivation. Should I continue daily to stretch and move in different ways for at least one month, I reward myself by heading to the museum for a day. After two months on my plan, I will buy that concert ticket to see my favorite band in the fall. Reward equals motivation and motivation equals continued activity. I really like this idea. Feeling better makes travel and exploration easier in the future. What is your reward to get you moving? (Incorporated and inspired from these tips.)

Devising a plan

My exercise routine begins the moment I open my eyes. Having gone through physical therapy too numerous times to count, I have built on those experiences. I asked myself what I really need. Can I go without balancing until I strengthen my core? I start small: 5 minutes for 3 times a day, or 3 exercises for 1-2 weeks, then increase activity by 2-3 minutes more a day in weeks 3-4, or add 2 more exercises next week. I ask myself how am I handling the movement plan this week, and remind myself that I am to take a break when my body messages me to stop.

Below is my exercise plan upon awakening. Each is done for about 1-2 mins or until you feel the joint loosen up a bit, extending the time for those really stiff joints or muscles. Please avoid any movement that feels awkward or causes pain. And, as always, speak with your physician before starting any exercise plan.

I hope this inspires someone who is struggling with a chronic illness to get back into the swing of life.

Stretches that help with getting out of bed

Under-cover stretches (lying flat on back)

  • Toe scrunches/stretches/wiggles
  • Foot flex/point
  • Foot/ankle circles
  • Internal/external leg rotation from hip (turn in/turn out)
  • Knee bends parallel legs/knee bends turned out legs (soles of feet together - frog legs)
  • Knee hug at chest (draw legs up to hug knees, bring head up off bed)
  • Pelvis bridge (with arms at sides, bend knees, plant feet, push pelvis off bed)

Rising isolations
Swing legs over side of bed, with feet on the floor, sit up straight at edge of mattress.

  • Head tilt (ear to right shoulder/ear to left shoulder)
  • Head twists right/left (chin over right/left shoulder)
  • Head circles (chin to chest, ear to right shoulder, chin up and look to ceiling, left ear to shoulder - reverse)
  • Shoulder wiggles (right shoulder forward/left shoulder back - left shoulder forward/right shoulder back - alternate)
  • Shoulder circles (both shoulders forward, up to ears, back squeezing scapular wings together, drop)
  • Rib/abdominal expansions (deep breath into lungs for count of 7, hold count of 4, breath out count of 8 alternating with deep breath into abdomen count of 7, hold count of 4, breath out count of 8)
  • Rib isolations side to side (rib cage to the right, rib cage to the left)
  • Rib isolations forward and back (rib cage forward arching upper back, rib cage rounding upper back)
  • Rib cage circles (ribs forward, ribs right, ribs backward, ribs left - reverse)
  • Hip/pelvis tilts (arch lower back hips forward, round lower back hips backward)
  • Hip/pelvis rocks (lift left buttock off the bed, rock left lifting right buttock off bed)
  • Hip/pelvis circles (tilt hips forward, right, left, and round lower back - reverse)

Mobility and balancing
Stand at side of bed.

  • Rotate spine and swing arms (right across abdomen/left behind back and left across abdomen/right behind back)
  • Bend both knees (gentle bouncing while swinging arms forward and back)
  • Knee lift/leg balance (lift right knee up to 90 degrees - balance, left leg up to 90 degrees - balance)
  • Knee/toe touch (slowly roll/reach down toward knees/toes - roll back up and return to standing)
  • Slowly begin walking (take notice of placing each part of foot on floor - expand toes, lift arches, balance on full foot - a slight swing of the arms)

I just need to start moving that little toe

This 20-minute rising routine helps me be a little more presentable to the world. Eventually, at the dresser, I reach for fresh underclothes, a crisp tee, warm socks, and cozy warm-up pants. A warm-water sponge bath wakes my senses a little more. Fixing my hair and sliding on my socks is less painful and I have better balance.

Remaining inactive and planted under the sheets, all day on some occasions, is detrimental to my mental and physical health. If I just start moving that little toe, circle the ankle, and bend that knee - I am motivated toward getting out of bed. One little step in the right direction means moving forward in my day, toward a more productive life with spondyloarthritis.

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