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.