Kids and motion go together like peanut butter and jelly. For many kids, involvement in sports offers an organized, fun way to satisfy their inherent need to move. Children with arthritis may face challenges in finding the right sports for them, but if they do, the physical and psychological payoffs can be huge.
“We teach families from very early on that exercise is essential to the management of their child’s arthritis,” says Kristin Houghton, MD, clinical assistant professor, division of rheumatology, department of pediatrics at the University of British Columbia. “In fact, we feel it’s equally important as medications.”
The benefits of physical activity and sport participation for the general population that Dr. Houghton cites include improved fitness, optimized body mass and bone density, improved cognition and concentration skills as well as possible prevention of future cardiovascular disease and some cancers. “In children with arthritis in particular, physical activity has been shown to improve mood, energy level, self esteem, pain and quality of life,” she says.
Yet children with arthritis have lower levels of sports participation and physical activity than healthy children their age. As you’d expect, many kids stop or decrease their physical activity when diagnosed due mainly to pain and fatigue.
First, Do No Harm
Kids and their parents may be worried about getting into sports for fear of damaging affected joints.
“Research so far suggests that children with well controlled arthritis can safely participate in exercise programs and sports without disease exacerbation,” says Dr. Houghton. What’s not known is the effect of weight bearing exercise on actively inflamed joints.
“Certainly children with impaired muscle and bone health around their active joints may be at an increased risk of injury,” says Dr. Houghton. That’s why kids need to work with their doctors to find a sport or activity they can safely participate in, given their condition.
“Most children can eventually participate in the sport of their choice but they may need to take time out while the disease is getting under better control,” says Dr. Houghton. “And they may require time to regain their physical fitness which can be really frustrating for kids. Missing a season is a long time to a 10-year-old.”
Kids who were active in sports before their diagnoses may perceive barriers to their return to sports even as their arthritis comes under control. They may feel they’re not able to perform as well as they once could. They may not want to go through physical therapy recommended by their medical team. Or they may not want to wear splints or other adaptive equipment sometimes necessary to protect joints.
A willingness to adapt or try something new can be key. Fifteen-year-old Sean Bartlett of East Stroudsburg, Pa., was 9 when his arthritis was identified. He’d been super active, playing baseball, basketball and soccer. Once his disease came under control, he continued playing these sports.
“But as he got older the games became more aggressive and Sean was getting hit harder and hurting more,” says his mother, Carol. Sean had always been a swimmer, so he decided to join a great YMCA swim team called the Pocono Piranhas when he was 11.
“Since I’ve started swimming my muscles have gotten stronger, I’m more flexible, and I’m noticing less pain,” says Sean. He continues to swim for the “Y” team and as a freshman in high school, he also made his varsity high school swim team.
Dealing With Flares
Sean’s coaches know he has arthritis and work with him when he’s having a bad day. Dr. Houghton feels it’s crucial to tell coaches and PE teachers of a child’s arthritis to prevent a common misunderstanding. Many people don’t realize that because of arthritis’s variable symptoms, a child can work out just as hard every day but not produce the same results due to the ebb and flow of the disease.
Following a flare, Dr. Houghton recommends that kids limit activity within pain boundaries, add some rest and gradually return to full speed. But if team players have alternate exercises they can do without pain, they can head to practice.
Team sports aren’t for everyone, but for Sean and many other kids, belonging to a sports team offers superb non-physical benefits. “I think being part of a team is a great motivator, it’s wonderful for kids’ self-esteem, they’re with people who have the same interests, and it gives them an instant group of friends,” says Carol Bartlett.
Whether your child plays on a travel soccer team, rides bikes with the neighborhood kids, practices tai chi or swims on your town’s recreation team, it’s all good. The main thing is that they’re moving and enjoying themselves, like kids should.