If your child has arthritis, asthma, diabetes or another chronic condition, you’ve probably felt torn more than once. You want them to play with friends, join a team or just be a normal kid on the playground. But you also worry.
What if they push themselves too hard? What if this causes a flare-up or a trip to the emergency room? That worry is normal and comes from a place of love.
Here’s the reassuring truth: Most kids with long-term conditions need few, if any, activity restrictions. The goal isn’t to avoid activity. It’s knowing what to watch for and building activity around your child’s specific needs.
For tips, we spoke with Deanna Haller, DO, a pediatrician with Banner Children's, on how to make that happen.
Know why activity matters so much for kids
Start with a mindset shift: Regular activity isn’t optional for kids with chronic conditions. It’s part of their care.
"As with all children, it is very important for children to get regular activity and exercise," Dr. Haller said. "Regular activity has many benefits. It helps kids stay fit and maintain a healthy weight. It can be fun, improve their self-image and give them opportunities to interact with other children."
According to the American Academy of Pediatrics, some of the benefits include:
- Stronger muscles and bones
- Better heart health
- Improved endurance
- Healthy blood pressure
- Healthy blood sugar levels
- Better attention and learning
- Improved mood
- Better sleep
- Lower risk of future health problems
Work with your child’s care team
Every child’s condition is unique. The activities suitable for one child might not be right for another. Your child’s pediatrician, specialist or physical therapist can help create a plan that’s both safe and enjoyable.
Factors that affect exercise recommendations include:
- Your child’s diagnosis
- Age and developmental stage
- Current symptoms
- Pain levels
- Fatigue
- Medications
- Whether they’re having a flare
- Recommendations from specialists
Depending on your child’s condition, you might get specific recommendations. For example:
- Asthma: Your child may be prescribed pre-activity medication to prevent exercise-induced asthma symptoms. With the right medication routine, most kids with asthma can fully participate in sports and play.
- Seizure disorders: Children with well-controlled seizures may need to avoid activities that could increase their risk of falls, such as high bars or high dives. If they swim, they will need an adult in the pool with them at all times for supervision.
- Heart conditions: If your child has hypertension or cardiovascular disease, a cardiologist can recommend safe activity levels. They will discuss activity modifications or restrictions that apply to your child’s specific condition.
- Arthritis or musculoskeletal conditions: Haller noted that children with juvenile idiopathic arthritis or musculoskeletal disease should not have any specific restrictions but may consider pediatric-friendly yoga or Pilates. These options build flexibility and joint support without high impact.
- Vision impairment: Protect what they have. If your child has limited vision, they should wear protective eyewear during sports and recreational activities, especially if they see well in one eye.
Focus on movement, not just organized sports
When people hear the word “exercise,” they often think of competitive sports. But physical activity means any movement that gets kids up and moving.
Your child might enjoy:
- Walking
- Bike rides
- Dancing
- Swimming (if safe for them)
- Playing in the park
- Hiking
- Yoga
- Pilates
- Backyard games
- Playing with friends
“Encourage your child to try activities they find fun and are suitable for their age and health," Dr. Haller said. Let them help choose activities they feel excited about.
If some activities aren’t safe, explain why in words your child understands. Helping them see the reason behind a rule can stop feelings of frustration or being left out. Focus on what they can do instead of what they can’t.
Teach your child to pace themselves
One of the most important skills children with chronic conditions can learn is pacing. Some children have a great day, feel full of energy and do too much, only to feel sore or exhausted afterward. Others avoid activity because they’re afraid it will hurt.
Help your child find a healthy balance by encouraging them to:
- Start slowly
- Warm up before activity
- Take breaks before becoming overly tired
- Drink plenty of water
- Increase activity gradually over time
- Listen to how their body feels
Adjust activity during flares or bad days
When your child is having a flare-up or a rough day with symptoms, they shouldn’t stop moving completely. Instead, it might be time to change their routine.
“Walking is one of the easiest and low impact exercises most kids can do if they are having a flare or pain,” Dr. Haller said. "They can slowly increase walking as they start to feel better.”
Once their symptoms improve, your child can slowly return to their usual activity level.
Know when it’s time to stop
Some muscle soreness after trying a new activity is normal. But certain symptoms mean your child should stop exercising and see their health care provider.
Call the provider if your child has:
- Sharp or severe pain
- Joint swelling
- Pain that doesn’t improve after resting
- A worsening limp
- Fever or feeling generally unwell
- Sudden drop in energy or unusual fatigue
- Any symptoms that feel different from your child’s normal pattern
Call 911 or go to the ER if your child develops:
- Chest pain
- Difficulty breathing
- Fainting
- Severe dizziness
- Confusion
- Signs of heat illness, such as hot, dry skin or chronic vomiting
Partner with your child’s school
Children spend a large part of their day at school, so it’s important that teachers and staff understand your child’s needs. Talk to your child’s teacher, physical education instructor and school nurse if symptoms interfere with participation.
Depending on your child’s condition, accommodations might include:
- Modified PE activities
- Extra rest breaks
- Access to water throughout the day
- Time to recover during flares
- Alternative activities when symptoms are worse
Learn more about setting up IEPs and 504s.
Make movement part of family life
Children often follow their parents’ example. Instead of making exercise feel like another task, build movement into your family’s daily routine. These opportunities help your child stay active with the bonus of creating family time.
Try:
- After-dinner walks
- Weekend hikes
- Bike rides
- Dance parties
- Trips to the playground
- Swimming together
- Stretching before bedtime
Bottom line
Children with arthritis or other chronic conditions can often stay active with the right support. The safest plan depends on the child’s diagnosis, symptoms and energy level. You can help by choosing fun, flexible activities, pacing movement, watching for warning signs and working with your child’s care team, school and coaches.
If your child has arthritis, chronic pain or another condition that makes activity harder, a Banner Health pediatric provider or specialist can help create a safe movement plan.
Learn more about Banner Children’s.
FAQs
Can kids with chronic conditions play sports?
Many can. The safest options depend on the child’s diagnosis, symptoms and care plan. Ask their doctor or provider before starting or changing sports.
What exercise is best for children with arthritis?
Low-impact activities like swimming, walking, biking, stretching and guided strengthening can help. However, the plan should be customized for each person.
Should kids exercise during a flare?
It depends on their symptoms and care plan. Many children get help from gentle activities like walking or moving their joints through exercise. They might need to do these activities less often or for shorter times. Talk to your child's health care team to find out what is best during a flare.
Can exercise replace my child's medication or treatment?
No. Physical activity is one part of staying healthy but it doesn't replace medications, physical therapy or other treatments recommended by your child's health care team.
Should I talk to my child's school about exercise?
Yes. If your child's condition affects physical education, recess or other activities, work with school staff to make arrangements that help your child stay active safely.
What if my child is afraid activity will hurt?
Start with simple activities they like and ask about physical therapy. Building confidence helps them stay active safely.
How do I know if my child is doing too much?
Watch for signs like more pain, swollen joints, limping or unusual tiredness. These symptoms could mean your child needs to rest or change their activity. If the symptoms last, however, contact their health care provider.
