Pediatric arthritis is a life-altering diagnosis, but it’s not often in the public eye. While people typically associate arthritis with aging, the CDC estimates that more than 220,000 children and teens in the U.S. are currently living with the condition. For young people with juvenile arthritis, everyday activities and playing can trigger debilitating pain and fatigue. This is deeply concerning, as play is essential for brain development and stress relief for children. In a world built for healthy, high-energy kids, chronic joint pain can isolate those with juvenile arthritis, limiting their ability to express themselves.
Physical therapists are uniquely positioned to help, not just by optimizing movement, but by preserving the joy of childhood. With innovative, patient-centered strategies, we can make therapeutic exercise feel less like a chore and more like play. For example, instead of asking a child to stand on one foot for a full minute, we might have them balance a stack of beanbags on the other foot or volley a balloon back and forth. The therapeutic goal is the same, but the laughter and engagement can transform the experience.
Effective physical therapy always starts with people. A core principle of physical therapy education should emphasize that practitioners must approach care not just with clinical expertise, but also with curiosity, creativity, and compassion. I believe that the best therapy for a child living with arthritis is therapy they enjoy so much they forget it’s therapy. That joy can be as healing as any exercise.
Observances like Juvenile Arthritis Day demonstrate a larger truth: when therapy is approached with play, creativity, and inclusivity, it can shift from clinical to empowering. These experiences remind us that pediatric rehabilitation is most effective when children feel seen and supported – physically, emotionally and socially. By creating environments that adapt to the child rather than the other way around, physical therapists can turn exercise into connection, belonging and joy.
Ages 3-6: Emotional Support and Comfort
Creating calming spaces and allowing children to ease in at their own pace builds trust and confidence. At this age, therapy is less about structured exercise and more about fostering safety, comfort, and curiosity. Sensory corners, quiet zones, or favorite toys can make a clinical environment feel welcoming instead of intimidating. These elements give children permission to regulate their emotions before being asked to move their bodies.
Sometimes the simplest moments of connection, like a therapist sitting on the floor to play alongside a child – can be just as powerful as formal interventions. For young children, feeling understood is often the first step toward meaningful participation. Once that trust is built, even small activities – rolling a ball back and forth, stacking blocks, or walking across a soft mat – can create opportunities to strengthen coordination, balance, and confidence without the child realizing they’re “in therapy.”
Ages 7-11: Gamified Movement
For kids ages 7–11, therapy works best when it feels like play with a purpose. Activities often take the shape of a carnival, with obstacle courses that include balance beams, crawling through hoops, and jumping off small trampolines, each designed to strengthen different skills while still sparking excitement.
An example is setting up “skee ball” and ring toss games just like you’d find at a fair, but modifying them as needed – for instance, using larger targets for skee ball or removing balance challenges during ring toss for those who need it. By weaving therapeutic goals such as balance, strength, or flexibility into games disguised as fun, children are motivated by curiosity and competition rather than obligation.
This age group is also deeply social, which means peer involvement is critical. Team elements, relay races, or cooperative challenges allow kids to cheer each other on while rediscovering what their bodies can do. It shifts the focus away from what arthritis has taken from them and toward what they can still achieve, an emotional reframing that can be just as therapeutic as the physical movements themselves.
Ages 12 and Up: Authenticity and Belonging
For teens, therapy needs to feel relevant and respectful of their identity. Traditional exercises can feel “uncool,” which risks disengagement. Sometimes the most effective approach is stepping away from drills and creating space for music, movement, and peer connection.
An example is turning on a “Just Dance” video, like the One Direction track that once had a hesitant group of teens laughing and joining in. What began as resistance quickly shifted into participation, showing that therapy doesn’t always need to look like therapy to be meaningful.
When sessions meet teens where they are – emotionally and socially – engagement follows. A song, a playlist, or even casual peer banter can transform the room, delivering endurance, flexibility, and strength while preserving dignity and belonging.
The Student Experience: Practicing Adaptability in Real Time
For future physical therapists, this approach to therapy highlights the importance of adaptability: reading a child’s mood, adjusting to flare-ups, and modifying activities without losing therapeutic value. These lessons extend beyond the clinic and remind practitioners that therapy is about inclusion, confidence, and joy.
Keeping a pediatric patient engaged often means disguising exercise as play. The most effective way to do this is by focusing on challenges that are fun and achievable, while avoiding anything that causes unnecessary discomfort. A balancing task for one child might need to be broken into smaller parts for another. A strengthening activity might work best when turned into a game with points or friendly competition.
Observances like Juvenile Arthritis Day give students the chance to “read the room” in real time, choosing when to ramp up the energy, when to step back, and how to build trust in the moment. More than anything, it reminds them that physical therapy is about more than muscles and joints; it is about helping kids feel included, capable, and joyful, even if only for a day. Seeing this impact on families reinforces the idea that physical therapy extends beyond the treatment space and shapes entire support networks.
Creating Inclusive Spaces for Families
Supporting children with juvenile arthritis also means supporting their families. Parents and caregivers benefit from opportunities to connect with professionals across physical therapy, occupational therapy, nursing, and psychology, where both practical strategies and emotional guidance are shared. Conversations often focus on stress relief techniques such as mindfulness, psychotherapy, and exercise; the value of local support groups and community partners; leaning on family and friends when needed; and the importance of building trust with a pediatric rheumatologist.
For many families, simply having a few uninterrupted hours knowing their children are engaged, supported, and safe can be transformative. That sense of respite and community connection is not an accessory to care – it is a core part of holistic treatment for both the child and the family.
Preparing the Next Generation of Pediatric PTs
As a profession, physical therapy must continue to prioritize human connection and hands-on creativity. Innovation isn’t only about technology – it’s also about how we make therapy feel less like work and more like play. For children living with arthritis, even a single moment of joy, freedom, and play can be deeply therapeutic and long-lasting. That’s the gift physical therapists have the power to give.
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Joe Johnson
Joe Johnson, PTA is the Physical Therapist Assistant Program Director at Bryant & Stratton College. With a focus on pediatric interventions and gamified care strategies, Joe is passionate about shaping empathetic, adaptable clinicians who can meet young patients where they are both physically and emotionally.
