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Stretching and strengthening exercises can help a child who has juvenile idiopathic arthritis (JIA) control pain and stiffness and maintain mobility. A physical therapist can help figure out how much exercise is appropriate for each child.

Stretching exercises are those in which the joints are moved through bent and straight positions without working the muscles against any resistance or weights, and the muscles are gently stretched. This type of exercise is designed to maintain the normal range of motion of a joint and can be done by a physical therapist or parent for infants or toddlers. Older children can do these exercises themselves. This type of exercise should be done even when a child has acute inflammation and pain, as it is essential to help prevent joint contractures.

Strengthening exercises are designed to keep or improve strength. Strength is important for preventing osteoporosis (loss of bone mass and strength) and for promoting good joint health. Muscle strength is an important part of your child's ability to exercise effectively. Children must do these exercises themselves. There are two types of strengthening exercises:

• Isometric exercises tighten the muscles without moving the joint. During an acute flare of arthritis, mild isometric exercises are helpful to attempt to maintain muscle strength.
• Isotonic exercises are those in which the child moves the joint through bent and straight positions. Isotonic exercises can be done with or without weights. When arthritis is less active, isotonic exercises can help regain or improve muscle strength.

When children with JIA have less active disease, they should be encouraged to maintain aerobic conditioning through swimming, bicycling, low-impact aerobics, walking, or dancing. Conditioning or aerobic exercises involve a level of intensity and duration to increase endurance and provide cardiovascular fitness.