Best Exercises for Children With JA

By Mary Anne Dunkin

For children, as with adults, regular physical activity is an important part of managing arthritis. These days, physical activity is even more important to staying healthy, physically and emotionally. But when joints are stiff, painful or inflamed, physical activity can be difficult, and some activities may be inadvisable.

Fortunately, there are many forms of exercise that are both safe and beneficial for kids with arthritis, even when arthritis is flaring. Though the pandemic may limit your child's ability to participate in group sports, here are some activities that your child can do solo.

Here are experts’ top picks:

Aquatic exercise. If you have access to a pool, aquatic exercise may be one of the best things your child can do for his joints, says physical therapist Chris Bertani, sports medicine physical therapy manager at Children’s Hospital of the King’s Daughters in Norfolk, Virginia. The water’s buoyancy supports the weight of the body, reducing stress on weight-bearing joints. Water’s resistance helps build strong muscles. Exercising in a heated pool adds the benefit of soothing relief, which can make exercise easier. It can also help kids maintain activity even when joints are flaring.

Swimming. Like other forms of aquatic exercise, swimming is generally an excellent form of exercise for children and adolescents with arthritis, says Bertani. Swimming improves cardiovascular health, muscle strength and range of motion and is safe for most joints.

Cycling. Bertani recommends cycling as a low-impact exercise that improves cardiovascular fitness as well as muscle strength and balance. To minimize the impact on the joints, have your child ride on paved paths rather than rough terrains – and always be sure she wears a helmet. Stationary cycling is also a safe choice and appropriate for any kind of weather.

Yoga. Although research on yoga in children with arthritis is lacking, yoga’s benefits for adults with arthritis – reducing pain over time, improving flexibility, relieving stress – are well documented. A 2007 study of 129 children with chronic pain syndromes found that yoga was among the most popular complementary therapies for pain.

If your child wants to try yoga, use a padded mat to cushion the joints, says Greg Canty, MD, medical director of the Center for Sports Medicine at Children’s Mercy Kansas City, who was also diagnosed with JIA at age 3.  And be sure to work with an instructor who has been trained to teach people with arthritis to modify certain poses and avoid stress on joints.

Tai chi. With its slow graceful movement, tai chi has been shown to improve balance, reduce stress and relieve arthritis pain while providing a low-intensity cardiovascular workout. Research shows that in children with JIA, a tai chi-like martial art can improve physical function.

In a 2007 study published in Arthritis Care & Research , Canadian researchers examined the effectiveness of cardio-karate (a high-intensity martial art) compared to qigong, which is similar to tai chi. The study found that both forms of exercise resulted in improved physical function. The authors noted that higher adherence in the qigong program may suggest that less intensive regimens are easier for children with JIA to comply with and provide a degree of benefit equivalent to more intensive programs.

Finding the Right Fit

If arthritis is well controlled, few if any forms of exercise are completely off limits. However, the involvement of certain joints may make some activities more difficult or less advisable than others. For example, soccer is probably not the best sport for children with ankle or knee involvement, says Bertani. Likewise, he says, children with shoulder involvement may want to choose a sport other than tennis.

An older child will likely know what activities are available and gravitate toward one that suits his interests and skills, says Dr. Canty, who chose swimming as a teenager, even though his father, a basketball coach, encouraged him to play the sport. For younger children, he recommends introducing them to four or five appropriate activities or sports and letting them make the choice.

The main goal is to get kids active, says Bertani. “I think exercise is just as important as any other therapeutic arm of treatment. It improves quality of life.”