By: Sara Rau, DPT
In honor of National Arthritis Awareness Month, this week’s topic is on juvenile arthritis.
What is Juvenile Arthritis?
Juvenile Idiopathic Arthritis (JIA), formerly referred to as Juvenile Rheumatoid Arthritis (JRA), affects over 200,000 children in the United States. JIA encompasses various types of arthritis in children involving chronic inflammation of the joints causing pain, stiffness, swelling, and loss of motion. Children with JIA have at least a 45% chance of recovering from JIA with no recurrence of symptoms into adulthood. Studies are showing that exercise and sports participation can actually help improve symptoms of JIA.
What can exercise do for JIA?
There are many benefits of exercise in the management of arthritis. They include:
- Improve and maintain joint range of motion
- Improve strength and flexibility
- Optimize bone density
- Reduce cartilage damage
- Decrease risk of obesity
- Decrease pain
- Decrease risk for cardiovascular disease
- Improve energy levels
- Improve sleep patterns
- Improve mood and self-esteem
Is sports participation safe for kids with JIA?
Yes, in most cases sports participation is safe. It was once believed that kids with JIA should avoid any contact or high-impact sports. Studies have shown that kids with well controlled arthritis are able to participate in impact sports safely. Not only does this mean that they are able to stay more physically fit, but they reap the psychosocial benefits of group sports participation.
When should sports participation be avoided?
It is not recommended that kids with severe joint damage participate in high-impact or contact sports. For kids with moderate to severe arthritis or those who have actively inflamed joints, exercise needs to be reduced to within pain limits. In other words, exercise should not increase pain. Once the flare-up has subsided, these kids can gradually return to their previous activity level. If they return to full activity too quickly, they risk an exacerbation of symptoms and possible joint damage.
What are other possible risks to consider with this population?
Kids with JIA may have some gross motor delays that can affect their readiness to safely participate. Those who have had arthritis for a longer duration may have difficulty with endurance sports. Those with arthritis in the neck are at greater risk for a spinal cord injury while those with arthritis in the jaw have a greater risk for dental injury. Some recent studies have suggested that imbalances in muscle strength and muscular control with high impact activities, like jumping, can affect their technique. Taxter et al. “suggests that the child transition into a sport preparatory-conditioning program to address any underlying deficits. A pediatric exercise specialist who is sensitive to the needs of this population can work with a physical therapist to then appropriately integrate the child safely into sport.” CHKD has pediatric exercise specialists at all 3 of the Southside Sports Medicine Physical Therapy clinic locations. At this time, an exercise specialist is not available at our Oyster Point location in Newport News. For more information, please call (757)668-PLAY. And as always, it is important to talk with your doctor prior to starting any physical activity.
Ford KR, Myer GD, Melson PG, Darnell SC, Brunner HI, Hewett TE. Land-jump performance in patients with juvenile idiopathic arthritis (JIA): a comparison to matched controls. Int J Rheumatol 2009;2009:478526
Norgaard M, Herlin T. Sport and exercise habits in children with juvenile idiopathic arthritis (JIA). Pediatric Rheumatology 2011;9(Suppl 1):126.
Philpott J, Houghton K, Luke A. Physical activity recommendations for children with specific chronic health conditions: Juvenile idiopathic arthritis, hemophilia, asthma and cystic fibrosis. Paediatr Child Health 2010;15(4):213-218.
Taxter A, Foss KB, Melson P, Ford KR, Shaffer M, Myer GD. Juvenile idiopathic arthritis and athletic participation: are we adequately preparing for sports integration? Phys Sportsmed 2012;40(3):49-54.