Talk with your physiotherapist or doctor about the best types of exercise for you. Doing the wrong kind of exercise can actually cause more pain or problems! There should be no restrictions on the types of sports and leisure activities you can do. The one exception would be if you have severe joint damage or neck problems. Talk to your doctor to find out if you have any activity restrictions. At times when your arthritis is very active and a joint is swollen, you may need to restrict some activities temporarily.
Types of exercises
There are several different types of exercises that you can do to help keep your joints healthy.
These can help to reduce some of the symptoms you are having.
• Range of motion exercises
• Stretching, including yoga
• Strengthening exercises
• Cardiovascular fitness.
Range of motion exercises
Your range of motion is the amount your joints can be moved in certain directions. When a joint has active arthritis, you tend to hold it in a ‘position of comfort.’ This position is usually bent. This can quickly lead to a loss of joint motion and a flexion contracture. A flexion contracture is when the joint has persistent limitation in joint movements with the joint stuck in a bent position.
Range of motion exercises help to reduce stiffness and improve joint motion. These are gentle exercises that can be performed safely. They can be done even when your joints are painful and swollen. Range of motion exercises are important since most daily activities do not move your joints through their full range of motion.
These exercises are most effective if they are done daily. However, most people find this hard to do. Choose the range of motion exercises that work on your stiffest joints and do them as regularly as possible. You may find it easier to do these exercises while taking a shower. Or try doing them by taking a quick break from homework or computer time.
You don’t need to do range of motion exercises for ALL of your joints ALL of the time. A physiotherapist can help you with this.
Stretching can reduce your stiffness and help keep your joints and muscles flexible. This can make everyday activities much easier. Stretching gradually expands your range of motion by improving muscle flexibility. Stretching can also help you to move more comfortably.
In order to help improve muscle flexibility, these exercises need to be done regularly.
Make sure to warm up before you start stretching. Move around for five to 10 minutes first. You might like to do these stretches after having a hot shower or bath. Stretches should be done slowly and held for at least 20 seconds. No bouncing! Ideally, you should stretch at least three to five times per week to see improvements in your flexibility. Talk to your physiotherapist about some stretches you can do.
Why not try out yoga or pilates? They are activities that focus on muscle flexibility and stretching exercises. This may be a way to incorporate stretching in a more fun way. Maybe some of your friends would like to do this too!
For more information, see the page on “Yoga.”
Strengthening exercises can help to maintain or improve muscle strength. Strong muscles help to support joints, which is especially important for people with JIA. There are different types of strengthening exercises. Your physiotherapist or doctor can help you determine which type is right for you.
In these exercises, you tighten your muscle without moving your joint. This is safe. Because your joint does not move during these exercises, they are more comfortable to do when your joint is painful and swollen.
In these exercises, you use your muscles while moving your joint(s) through some range of motion. Isotonic exercises can be done with or without resistance added. Resistance can be added with the use of your own body weight. You can also add external weights such as ankle or wrist weights, or elastic exercise bands. A general rule of thumb is, if you can complete two sets of 10 repetitions of an exercise easily, you can add some resistance. Start with a low weight (1 lb to 5 lbs) or low-resistance band. Build up slowly as you are able.
It is important to be in the correct position when doing these exercises. A little bit of muscle soreness the next day is okay. However, these exercises should NOT make your joints more sore or swollen.
Talk to your physiotherapist or another exercise expert before starting a strengthening regime. Generally speaking, people with JIA will use the principles of low weight and higher repetitions. A good starting point may be 10 repetitions of an exercise, a brief rest, and then a repeat set of 10. Do this three to five times per week. This is the type of routine that we know will help improve your muscle strength and endurance. However, anything that you are able to do is better than nothing!
You may be feeling overwhelmed by all of the exercises that you have been given. Talk to your physiotherapist about how to make this more realistic. You may want to rotate your exercises so you are not doing all exercises every day. Or you might focus on one or two of the most important exercises for a period of time and then focus on others later. Look at what your goals are and what exercises can help you to meet these goals.
Cardiovascular fitness is the ability of your lungs to provide oxygen to your blood and heart, and to transport that oxygen to the cells in your body. It is also the ability of your body to do an activity like swimming or walking for an extended period of time.
Cardiovascular fitness is extremely important for everyone, including young people with JIA. It can help you maintain a healthy weight, help control your pain, and improve your sleep and mood.
In order to improve cardiovascular fitness, an exercise must be intense enough to raise your heart rate and maintain it for a period of time. Any continuous activity will help. Swimming, water aerobics, brisk walking, in-line skating, dancing and cycling may be easier for you to do if you have JIA.
If you are interested in learning more about your heart rate, target heart rate and how to monitor the intensity of your exercise, check out this link: https://www.health.gov.au/health-topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians
For suggestions on how to become more physically active, visit the BetterHealth website: https://www.betterhealth.vic.gov.au/health/healthyliving/sports-and-physical-activity#tips-to-get-physically-active
Tips for becoming physically active
• Start slow, build up gradually, and have fun!
• Recruit a friend or family member to exercise with. This will help to keep you motivated.
• Set goals and work toward them.
• For additional advice or support, speak to your physiotherapist or other health care provider.
Check out the article “Staying active” for more tips.
A story of hope
“It’s difficult for children that have JIA to do everyday things like healthy children. I know because I have had JIA for 10 years. I was four years old when I was diagnosed with JIA. I don’t remember much about the early years but I do know that it involved many years of treatments, operations, physiotherapy and occupational therapies. I’ve learned to deal with JIA in my everyday life. I start off with my stretches and exercise schedule. At times I don’t feel like doing them, but if I don’t, I pay for it later on during the day. My joints and muscles hurt. I always push myself to the maximum. I know I can’t compete in sports with other children my age because they are stronger and faster than me. However, I never give up and I work very hard. My parents motivate me to do the best that I can.
To all those children who have been diagnosed with JIA, I suggest to them to always take their medications, exercise, enjoy themselves, and never give up. Even though the day ahead doesn’t look too bright because you are having a hard a time, there is always light at the end of the tunnel! Keep your chin up and don’t give up. I’ve had a very difficult time throughout the years, but I never let it bring me down.”
-Daniele, age 14