Physical activity and juvenile idiopathic arthritis (JIA) – advice for teachers

Juvenile idiopathic arthritis and physical activity

Our aim is to support all our children and young people with juvenile idiopathic arthritis (JIA) to enable them to regularly take part in physical activity. This may be PE (physical education) or extracurricular sport and includes contact sport. We do not limit which sports a child can do unless they have active JIA or are unwell. Below is advice relating to PE, sport and physical activity for children and young people who have JIA that is controlled with medication or is in remission, and for those who are ‘flaring’ with their arthritis.

Please be aware that children and young people with JIA that is not fully controlled may experience some variability in their condition day-to-day. This is why it’s important to check in with the child or young person to establish their abilities for that day.

Our aim with medical management is to control a child’s JIA so that they can fulfil a normal life. However, sometimes this process does take some time (until we find the correct drug regime for that person) and so they may experience symptoms of active JIA during this time.

Active juvenile idiopathic arthritis

Active JIA can cause swollen, painful, stiff and restricted joints. If controlled quickly these symptoms are not long lasting and should not lead to long term joint damage in most cases.

During a ‘flare’ children should try and protect the inflamed joints. If it is a lower limb (leg) joint they should avoid high impact activities (such as running, jumping) or contact sport. They may find other lower impact activities such as swimming more comfortable. Equally they may still be able to join in with PE but maybe in more of a refereeing or supervisory role.

It is good to keep active during a flare but within limits of a child’s comfort.

Controlled juvenile idiopathic arthritis

During these periods, children and young people should hopefully experience minimal symptoms. Being as active as possible is important for a child’s general muscle strength and joint mobility, as well as their health. We do not put a limit on what activities or sports a child is allowed to do (unless they have specific ongoing problems with a specific joint).

Considerations and suggestions for pupils with juvenile idiopathic arthritis

Time of activity

Pupils may experience some morning stiffness if their JIA is active and so PE early on in the day maybe more difficult than a later period.

Have a go

It is important pupils try and take part in PE but they may find it helpful to do a slightly shorter session, have short rest periods during the session or take part in the warm up session.

Otherwise there may be another PE activity they could do, possibly with another class. A child may have been provided with a home exercise programme by the physiotherapist and it may be appropriate for this to be completed within the PE session, especially at times of a flare.

Suitable footwear

If a child has been particularly affected by arthritis in their feet or ankles they may have poor foot posture that can cause them some discomfort. In this case wearing good, supportive running type trainers rather than pumps or barefoot may be better for PE.

Keeping warm

Children and adults with arthritis report that they can be affected by the cold weather. It can make their joints feel stiff and achy. It may be helpful to wear tracksuit bottoms outside for PE in colder weather or consider indoor options if the weather is especially bad.

Inclusion not exclusion

We would not want any child to feel excluded from physical activity in or out of school because of their arthritis. Measures can be taken (as above) to make PE and sport more achievable when a child has active arthritis.