A physiotherapist is there to help your child with the physical problems caused by their JIA and lead a normal active life.
Painful and stiff joints caused by JIA may mean that your child becomes less active and so there may be some muscle wasting and they become weaker.
As a key member of the rheumatology multi-disciplinary team, your child’s physiotherapist may have some knowledge of working with children with JIA if not, they will be are able to speak with physiotherapists from specialist centres who have expert knowledge of JIA. They are able to assess your child’s joints, muscles and range of movements and they will work out the best plan to keep your child mobile. They will also be able to show you some simple exercises to do at home and also give you some handy tips 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
- ice or heat packs to help reduce swelling.
Your child may not always routinely see a physiotherapist but children are often referred to the physiotherapist because their joint movements are restricted and, also if they have had a steroid injection into their inflamed joint(s).
Your child’s physiotherapist may also encourage her/him to go swimming or cycling because these sports are low impact on joints. The physiotherapist may also refer your child to the nearest hydrotherapy pool where the hydrotherapist can show you exercises that you can do at the local swimming pool especially if they are having a flare-up. These exercises may help to increase the range of movements in joints and/or increase their stamina. Exercises in water are great because the water allows movement to be more comfortable than on land.
Some children with JIA can't always take part in sport at school because they may tire easily and run out of steam before the end of the session 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 so that they do not pressurise them too much. It is possible that she/he may be fine for most of the time with just occasional flare-ups which is difficult to understand for the non-medical staff.
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.
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. They are all very keen to help so if any of you have any worries or questions don’t be afraid to ask. No question is trivial to them so ask and you will probably find another parent has already asked them the same question!
By Mrs Alison Cohen (Physiotherapist)
Original article: 27/12/2014
Next review due: 27/12/2017