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Exercises 2 - How to do the exercises

A good video film called 'Physio for Kids' demonstrates how to do the main exercises and is available for a nominal fee from Arthritis Care, Children's Chronic Arthritis Association or Jointz (the Arthritis Care parent support group in Northern Ireland, who proposed the video). Your child's Physiotherapist will give you a leaflet about the routine, and should demonstrate how to do the exercises. You will need to practice while the therapist is present, and ask any questions. Consider the list above, and ask for both what to do if all goes well, and what to do if you hit problems. Also ask for the therapist's telephone number in case you have problems and need to ask for more guidance.

Alternatives to parents supervising exercises
Carefully supervising robust daily exercises is extremely demanding and can be distressing for everybody. It is entirely understandable if after trying, you find yourself unable to continue supervising the routine. Your child would still benefit from the routine so the task ahead is to find someone at school who will undertake them as part of meeting the child's needs.

There are too few therapists in the community who could do the routine although they may be able to help train a school staff member. Ask the specialist Physiotherapist to write a report for the school and local education authority explaining why the routine is crucial and how it could be conducted safely during the school day.

Parent tips about other ways to help your child undertake exercise

• Take your child swimming each week, either as a family or with a swimming club Exercise in water is an excellent way to maintain fitness, keep joints mobile and increase muscle strength and stamina.
• Involve your child in organisations like the Girls Brigade or Boys Brigade, Brownies/Scouts, Badgers (British Red Cross) or similar organisations that offer well supervised opportunities to try many different activities. Inform the organiser about arthritis and your child's needs and talk to your child about how much they want people to know about their abilities and limitations.
• If your child enjoys drama or art, find a local group that can support them and perhaps encourage them to develop their skills, have fun and express themselves.
• Use activities at home that encourage each child to share, take their turn, so that the child with arthritis learns how to take their part in team games, playful competition and collective efforts. Outside the family, other people may tend to let the child with arthritis always choose the game, or always go first which does not help the child fit in or learn the rules of 'give and take'.
• Borrow large versions of games from your local toy library, (for example a huge version of Snakes and Ladders, Chess, Connect 4, or Timber!) These are fun to play, and make your child stretch their arms and legs in order to reach parts of the game. This 'reaching' extends their joints, and provides exercise but during a fun game rather than just doing the movement on its own. Ask at your local library for the details of the nearest Toy library.
• Use foam or huge inflatable balls for throwing, catching and kicking games. Use boxes, hoops or marks with chalk on paper or walls to make targets or avenues down which the children have to steer their ball. These are far lighter than other footballs so that the impact does not jar the child's feet, or overpower the child's weaker leg muscles.