Physiotherapist

If JIA causes your child’s joints to become painful and stiff, they may become less active and so reduce their muscle strength, this can cause them to get fatigued when exercising.

The physiotherapist is a key member of the rheumatology multi-disciplinary team. Physiotherapists meet regularly with the other members of the team caring for your child and will be up to date with their treatment and any problems that they may be experiencing.  

The role of the physiotherapist includes assessment of your child’s muscles and joints so they can provide an individual program of exercises, and give you advice on how to manage their pain.  These may include:

• Stretching exercises to increase their range of movements
• Exercises to improve muscle strength
• Exercises to build up their stamina
• Application of ice or heat to help reduce pain

Your child may not always routinely see a physiotherapist, but children are often referred to the physiotherapist if their joint movements are restricted or painful. They may also be referred following a steroid injection into their inflamed joint(s). Your physiotherapist should also be able to advise you how to manage your child’s symptoms if they have a flare up. Symptoms during a flare up may include:

• Worsening of symptoms
• Inflamed or painful joints
• Joints may feel hot to touch or look red

Your child’s physiotherapist may also encourage her/him to go swimming or cycling because these sports are low impact on joints.  Some areas may have access to a hydrotherapy pool that the physiotherapist may refer your child to if needed. The hydrotherapist can show you exercises that you can do at a local swimming pool; these can be especially useful if your child is having a flare-up.  These exercises may help to increase the range of movements in joints and/or increase their stamina.  Exercising in water is usually more comfortable than on land. 

Some children with JIA can’t always take part in sport at school because they may tire easily, or they may be advised not to do contact sport e.g. netball/football/rugby when they have swollen joints.  It is helpful for P.E. teachers to understand how your child can be affected and that JIA can be very changeable, ensuring that they do not pressurise them too much but still encourage them to stay fit and join in if able. It is possible that she/he may be fine for most of the time and be able to participate fully, with just occasional flare-ups. 

Your child’s physiotherapist will always encourage your child to do sports or dance even if they don’t manage to do a full lesson.  They can also liaise with the P.E. teachers at school and help them to work out an exercise plan which your child will be able to do and which will help them feel included in the P.E. lessons.  It’s very important though to follow the physiotherapist’s advice on what type of exercises to do and how much. 

Sometimes families find planning and going for days out can be difficult because of the impact of JIA on your child.  It is always worth discussing with your child’s physiotherapist which activities you can all do as a family because they may have some suggestions that you haven’t thought of. Pacing and balancing activities through the day/week will help you to manage any symptoms of pain and fatigue by spreading out your child’s activity into manageable chunks. This will also help you to avoid periods of over and under activity. Your physiotherapist can discuss pacing with you and help you to establish some pacing strategies.

Updated: 04/10/2019

Next review: 04/07/2022