7 Physical Therapist-Approved Moves for Kids With JIAby Sheila M. Eldred Health Writer
Years ago, kids with juvenile idiopathic arthritis (JIA) were sent to bed with strict instructions not to move their joints. “They did horribly,” says Sangeeta Sule, M.D., division chief of rheumatology at Children’s National in Washington, D.C. “They ended up with more problems from bed rest than arthritis.” Now we know the opposite is true: “Encouraging kids to stay active is really important for their overall well-being,” she says. But when a child’s joints are swollen, they might not be jumping at the chance to work out. So, we tapped a few top physical therapists on the best moves to slip into your kid’s day.
But Wait! Are the Moves Safe?
Many parents haven’t heard of JIA—the kind of arthritis that typically strikes the under-18 set—before getting their child’s diagnosis, Dr. Sule says. “So, we reassure them it’s OK to stay active.” More than OK, in fact: It’s extra important to keep the muscles and bones that make up the joints strong because it decreases the possibility of contracture, or the shortening and hardening of muscle, Dr. Sule says. Exercise is also helpful in maintaining range of motion in joints. Not to mention the psychological boost that comes from the regular hops, skips and jumps of childhood, she adds.
The Move: Crane Arms
You may not equate “pilates” with “kids,” but it’s a perfect match for kids with JIA, says Christine Egan, a private practice pediatric physical therapist in San Quentin Village, CA “It focuses on elongation of the muscles, alignment and core strength,” she says—all helpful for kids with JIA since a strong core helps the limbs move better.
Start by taking a stuffed animal or rolled-up towel and putting it between your child’s knees. With flat feet and knees bent, have the child tuck their chin and reach for the stuffy with both arms. Slowly lower trunk to the floor, keeping the chin in the tucked position.
The Move: Bridge
Bridges are effective way to strengthen your child’s glutes and improve stability of the hips and lower body.
Start with both feet on the floor and have your kiddo raise his hips high enough that you can race toy cars underneath him. Once he can do that 10 times without wiggling, try a one-legged bridge. Start in the same position, but cross one leg so that the ankle rests on the opposite knee. Push down into the floor with both hands and raise the hips off the floor. Expect to help with this one, Egan advises--it’s extra challenging.
The Move: Squats
Joy Scott, a physical therapist at the Rehabilitation Center of Washington, D.C., suggests challenging kids to do as many squats as they can in one minute. The exercise is gentle enough on joints, plus it boosts strength and stability in the hips and lower back.
Help your child assume a squat stance by having them stand with their feet shoulder width apart. Next, they’ll bend their knees to lower down. Make sure your child keeps his hips pushed back and knees behind his toes. Press through heels to stand back up.
The Move: Sidesteps
One of the trademarks of JIA is inflammation in the joints that can make walking difficult for kids. This move is great because it supports the deep hip rotators that help stabilize the pelvis to make walking easier.
With a resistance band just above the ankles, have your kid take a wide step out, then a half step with the other foot in the same direction. Keep going across the room (or alternate directions when you’re in a small space).
The Move: Pull-downs
This exercise strengthens the core muscles on the back side of the body. Building up these muscles will help your kid combat rounded shoulders and maintain good posture.
Attach resistance bands to a closed door (some of them come with a hook). Have your kid grab the bands at or above eye level. Have her lift her arms to shoulder height, then pull them down by her sides. She should keep her elbows straight and her shoulder blades squeezed together. Aim for three sets of 10-15 reps.
The Move: Heel Raises
This simple move strengthens the calves, helping your kiddo maintain power through the lower leg and ankle to help in balance.
With legs straight, hold onto the back of a chair. Tell your child to raise both heels at the same time, so he’s standing on tip toes like he’s trying to reach something very high. Next, he’ll lower his heels so that his feet are flat on the ground. Repeat the move as many times as he can.
The Move: Chin Tucks
This neck-strengthening exercise stretches the suboccipital muscles at the base of the head while also strengthening the muscles on the front of the neck. It’ll help your kid (and you, if you do them together!) avoid a forward head posture as is seen with slouching.
Have your child start by tucking her chin towards her chest. Then she’ll stretch her mouth open, keeping the tongue on the roof of her mouth and keeping her head in the chin tuck (yes, it looks silly). Hold for three seconds and then release. Repeat this move six times a couple times a day.
Don’t Forget About Extra-Curriculars
If your kid loves music, encourage her to dance. If he’s a baseball buff, sign him up for Little League. Anything they find fun and enjoyable to keep themselves moving and that raises their heart rate will also help minimize JIA flares, Dr. Sule says.
The only limitations? If there’s a joint involved in a situation where they can’t support themselves, they may need a spotter, she says. Case in point: Think of a kid with hand or wrist arthritis on monkey bars. They should totally give it go (with adult back-up!).