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Spondylosis: The 3 Types of Exercise and Why Most People Miss One
This article covers three types of exercise used to manage sponsylosis including one type that can easily be missed. It follows on from the video What Is Spondylosis? (& What Actually Helps)
Living with spondylosis is challenging, and one of the the biggest questions I get is: 'What type of exercise should I actually be doing? Understanding the different types of exercise and what each is designed to achieve can make it much easier to build a balanced exercise program.
A reminder that this content is for general educational purposes only. It is not a substitute for individual physiotherapy assessment, diagnosis or treatment. Always consult a qualified health professional for advice specific to your situation.
Type one: pain management exercises
The first category is pain-management exercise. These are generally gentle movements that can be useful when symptoms are more irritable, such as during a flare up of pain or stiffness. As the name suggests, the aim is to help manage symptoms while allowing movement within a comfortable range. For this reason, pain-management exercises can often be a useful starting point when beginning to exercise with spondylosis.
A simple program might include one to three pain-management exercises that can be performed regularly, depending on symptoms. A few examples include:
For the neck and upper back, relaxed breathing, shoulder rolls or gentle chin tucks.
For the mid or lower back, cat-cow, knee-to-chest movements, lying rotations or gentle extension.
Importantly, the same exercise will not suit everybody. A movement that feels comfortable or easing for one person may irritate symptoms for another, so exercises should be selected according to individual response. Movement should stay within a comfortable range and should not cause sharp, sudden or progressively worsening pain.
Type two: range of motion exercises
The second category is range of motion exercise. Spondylosis can be associated with stiffness and reduced mobility, and pain itself can also lead us to move less. Range of motion exercises aim to maintain or improve comfortable movement through the spine. The main movements of the spine include flexion, extension, lateral flexion (or side bending) and rotation.
For the neck, examples include looking up and then down, turning to look over each shoulder, and gently bringing your ear towards your shoulder.
For the thoracic or lower spine, exercises may include bending forward and extending back, rotating through the trunk and gently bending from side to side.
Range of motion exercises might be included two or three times within a program and varied throughout the week. The aim is not to become as flexible as possible. The goal is to maintain or improve the movement needed for everyday activities, like checking traffic when driving, getting dressed, reaching for something or simply moving more comfortably after sitting. When completing range-of-motion exercises, some mild tightness can be normal but the movement should not be forced into sharp or worsening pain.
Type three: strength training
The third category is strength training which is often the part that gets missed. When pain is the main concern, it is very natural to focus on exercises that make the area feel more comfortable. Once the pain begins to settle, continuing with stretching and mobility exercises makes sense because those are the exercises already known. However, this raises an important question: What helps build physical capacity in the longer term?
That is where strength training comes in. Resistance exercise helps build strength and endurance in the muscles that support movement and helps maintain the ability to complete everyday physical activities.
For neck symptoms, this might include neck isometric exercises, chin-tuck progressions, rows or other exercises for the muscles around the neck, shoulders and upper back.
For thoracic or lower-back symptoms, examples might include band pull-aparts, bird dogs, bridges or other abdominal and trunk-strengthening exercises.
Strength training does not have to mean lifting heavy weights. It is about choosing an appropriate level of resistance and gradually progressing as our body adapts. This might include a small number of strength exercises two or three times per week. Over time, this can progress towards two to three sets of around eight to twelve repetitions, depending on individual tolerance.
As confidence and capacity improve, strength training can also progress beyond exercises specifically for the neck or back and become part of a more general full-body strengthening program. The key message is that strength training does not need to be avoided simply because you have spondylosis. It is about finding an appropriate starting point and progressing gradually. Just like the other categories, strength exercises should not cause sharp or sudden pain.
How the three types work together
So, think of the three categories like this:
Pain management exercises help to manage symptoms and keep moving.
Range of motion exercises help maintain or improve mobility.
Strength exercises build longer term strength and physical capacity.
These categories do not have to be completely separate. For example, an exercise such as a chin tuck might initially be used as a pain management exercise and also a strength exercise.
A program might include one to three pain management exercises, two or three mobility exercises, and then gradually build towards several strength exercises performed across two or three weekly sessions. During a flare up, the program can also be modified. For example resistance, repetitions, range of movement or overall exercise volume can be adjusted rather than stopping activity completely.
A good exercise program should be individualised, progressive and realistic enough to maintain. Small amounts of exercise performed consistently are generally much more useful than an overly complicated routine that you struggle to continue.
In summary, rather than asking, “What is the best stretch for spondylosis?”, a better question is: Does my exercise program help me manage symptoms, maintain movement and build strength over time?
The three key categories covered are:
pain management exercises
range of motion exercises
and strength training
And strength training is often the missing piece. It helps move an exercise program beyond simply managing symptoms towards building the strength and capacity needed for everyday life.
For additional guidance, the accompanying A Practical Guide to Exercising with Spondylosis can be found on the Age Fit with Tess website. It includes:
· Exercise planning
· Flare-up management strategies
· A comprehensive exercise library
Tess Halbauer
Physiotherapist
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