Physical activity is as important to a child with JRA as are medications. In fact, exercise and movement are great medicine for your child’s physical, emotional and mental well-being.

The latest research shows that physical activity is essential for the strength, growth and well-being of your child, and that exercise protects bone density and tissues, improves sleep and increases energy.  

30 Minutes of Exercise/Physical Activity Every Day

• Builds strong muscles around the joints
• Gets swollen, painful joints moving again
• Helps your child lead a full, active life
• Improves coordination and balance 
• Increases flexibility
• Increases stamina and endurance
• Reduces joint pain and stiffness
• Slows down the effects of arthritis
• Strengthens weakened muscles  

Exercise is the key to getting fit for life

Juvenile rheumatoid arthritis is an illness that wants your child to sit still. But inactivity is detrimental to recovery and positive development, enabling pain and swelling to advance, making every day activities such as walking to the bus stop or playing with a pet painful. Your child needs to beat the tendency to sit still. He or she needs to be active.

Gently push your child to exercise. Make an exercise program part of their daily routine, as basic as brushing teeth or doing homework. Keep in mind that rhythmic exercises that are low in impact and use larger joints are among the safest.  

If you are concerned about any of the following exercises or about involvement in specific sports, such as football, consult with your child’s doctor. And keep in mind that if your child is in pain, he or she will know that it’s time to slow down.

Swimming and pool exercise

Swimming is the best exercise for your child with JRA, and is great for anyone who has joint problems. Working out in the pool, doing water exercises, can further boost your child’s strength. Here are three low impact water exercises that will help strengthen your child’s lower body.

High knees

In shallow water, begin to run in place, raising knees high and pumping arms. Then slowly move 10 yards down the swim lane. The key is to raise the knees to waist level quickly with every stride. Done properly, you’re almost running in place. After a little practice, your form will be like a sprinter’s, without the stress and impact on your ankles, knees and hips.

Butt kicks

Begin to run in place in shallow water, but kick your heels back toward your buttocks instead of bringing your knees up to waist level. Once you get used to the movement, you should do it in quick bursts. Focus on moving your legs and heels backward instead of trying to cover ground in front of you.

Power skipping

The motion is to move forward, hopping on one foot, then on the other. The goal is to rise as high up out of the pool as possible with each step. Correct arm action is also important. Your left arm moves with your right leg, and your right arm moves with your left leg.

Therapeutic exercises

Therapeutic exercises keep joints flexible and are especially important for children who have lost motion in joints, or whose joints have become fixed in a bent position. Before your child starts therapeutic exercises, suggest that he or she keep the following in mind:

• The exercise program should include a warm-up of the muscles through stretching and a cool-down at the end.
• Don’t exercise on a bed or soft surface.
• Do each exercise slowly and smoothly.
• Repeat each exercise two to four times, and move your body a little further each time.
• STOP if you feel intense pain. If you have a flare-up, take it easy for a day or two.
• Try moving to music or ask your parents or some friends to join you.
• Reward yourself – by playing a favorite game or eating a favorite bit of food - after you reach your exercise goal for the day.
• Make sure your doctor prescribes and/or approves the exercises you are doing.
• Keep a daily exercise diary to record how many of each exercise you do every day. At the end of the month, you will see how far you have come.
• ALWAYS focus on what you can do, NOT on what you cannot do.

Balance: Single Leg Stance

• Stand behind a chair.
• Hold onto the chair back with both hands.
• Slowly lift one leg off the ground.
• Maintain your balance, standing on one leg for 5 seconds.
• Return to starting position and repeat X 5.
• Perform with opposite leg.

Follow these steps as your balance improves:

• Hold onto chair back with only one hand.
• Stand near the chair for safety, but do not hold on.
• Progress finally to lifting your leg off the ground one inch higher.

 Hips

• Lie on your stomach and lift one leg, trying to keep your knee straight.
• Bring your leg back down and repeat a few times.
• Do the same thing with the other leg.
• Repeat a few times twice a day.

Hips and Knees

• Lie on your back.
• Bend one knee toward your chest, then bring it back down. Do this a few times.
• Repeat with your other leg.
• Repeat a few times twice a day.
  

Neck

• Turn your head sideways toward one shoulder.
• Now, turn your head toward the other shoulder.
• Repeat a few times twice a day

Neck and Chest

• Lie on your stomach with your arms at your sides.
• Lift your head and shoulders. Hold for three seconds, then bring your head back down.
• Repeat a few times twice a day.

Shoulders

• Lie on the floor with both arms at your sides.
• Raise one arm over your head, keeping your elbows straight, until the back of your hand reaches the floor.
• Return your arm slowly to your side.
• Repeat with other arm.
• Repeat a few times twice a day

Stretch: Hamstrings

• Sit on firm surface with one leg out front.
• Slowly lean forward, trying to touch toes.
• Hold for 30 seconds.
• Repeat with other leg.
• Repeat a few times, twice a day.

Stretch: Hamstrings with towel

• Sit, looping towel around ball of foot.
• Gently and steadily pull on towel, keeping knee straight.
• Hold exercise for 30 seconds.
• Repeat with other leg.
• Repeat a few times, twice a day.

Stretch: Standing

• Stand facing wall, hands on wall.
• Stretch forward with foot of one leg, leaning hips toward wall.
• Keep rear leg straight with heel on floor.
• Hold for 30 seconds.
• Repeat with other leg.
• Repeat a few times, twice a day.

Stretch: Standing on Stairs

• Stand with balls of both feet on a step, using banister to steady yourself.
• Keeping knees slightly bent, gently lower heels.
• Hold for 20 seconds.
• Progress to performing twice a day.
• Repeat two to four times, twice a day

Stretch: Supine

• Lie on back with knees bent.
• Cross one leg over the other.
• Grasp knee and ankle.
• Pull knee across chest to opposite shoulder.
• Hold exercise for 20 seconds.
• Repeat with other leg.
• Repeat one to four times, twice a day.

Body Strengthening Activities

Chores can be exercise. Washing dishes helps with bending and stretching. Studies show that kids with childhood illnesses who do chores tend to grow up to be successful adults.

Dance.  Put on a favorite song and move with friends.

Frisbee. This is a great way to exercise the arms and legs.

Go to the park, go to the playground, play tag, or have a scavenger hunt. Climb, run, play and keep moving.

Hula hoop. This is a fun way to exercise, while it increases the mobility in the legs and low back.

Jump rope. It’s great exercise, while no studies have found that it causes joint damage.

Martial arts. Yes, kids with JRA can do these. They strengthen the body, improve balance, coordination and confidence.

Play ball. Any kind of ball, beach ball, basketball, tennis, volleyball, dodge ball or tetherball. Just play, catch or kick it around.

Play-Dough. Playing with play dough, squeezing, pinching and pulling, is great exercise for the hands.

Play-Dough Recipe

¼ cup water
½ tablespoon vegetable oil
2 drops food coloring
½ cup flour
¼ cup salt

Instructions

• Mix water, oil and food coloring in a quart size zipper bag.
• Mix flour and salt in a bowl.
• Add flour/salt mix to the wet ingredients in the bag.
• Seal bag, shake and squish until mixed well and holding together as dough.
• Remove from bag and knead until smooth.

Play-dough will last about 1 week. Keep refrigerated for longer-lasting dough.

Ride a bike. Or if the weather is bad, use a stationary bike indoors. It’s great for overall conditioning.

Soccer is good for endurance, coordination and teamwork.

Trampoline. Kids love to jump on them.

Walking. The whole family can do this together.

Water, Water, Water! Swimming is one of the best exercises for children who have arthritis. Swimming uses nearly all joints and muscles in the body, without putting weight on those joints. Swimming strengthens, stretches and rehabilitates the entire body.

Yoga is great for overall body stretching and strengthening. It also relaxes the mind. Even young kids can do yoga.

Hand Strengthening Activities

Chores. Washing windows, sweeping, mopping, scrubbing are all good.

Climb ropes, ladder poles, using the hands.

Craft activities. Mold clay, weave cords for necklaces or other items.

Garden. Dig, rake, and pull weeds.

Jump rope. Jump by yourself or hold onto the rope while another person jumps.

Legos/duplos. Pull these apart and push them together.

Mix in a Ziploc bag. Mix and squish any ingredients you can think of.

Monkey bars. Assist your child until able to hold on independently.

Open and close containers. This includes jars and plastic containers.

Play-Dough.

Pop beads. Pull the beads apart and push them together.

Prepare food. Mixing and kneading is great hand exercise.

Sidewalk chalk. This requires force in the hands and arms.

Squeeze sponges. Play with sponges and water, squeezing the water out.

Squirt guns, super soakers, spray bottles. Great hand exercisers.

Swing. Holding onto ropes and chains helps build hand strength.

Tug-of-War. Play with anyone, even with the dog.

Wash dishes. Warm water is good for the hands, while scrubbing builds strength.

Push your child to be active. Be positive. Tell your child that it’s great to play and, “If you put your mind to it, you can do it.” Teach your child that by exercising, he or she is taking a major step toward a stronger, healthier and happier self.