Playing With Children When You Have Chronic Pain

From a swoosh down a slide to countless rounds of tag, kids love to play, and they love it when the adults in their lives play with them.

Just think of the times when you’ve been beckoned with, “Mom, can you push me on the swings?” or “Grandad, will you give me a piggyback ride?”

But as much fun as child’s play can be, there are some days when arthritis threatens to take all of the fun out of play. Luckily, it doesn’t have to be that way! With planning, a willingness to be flexible, and a bit of creativity, you can let the good times roll.

What do you say?

When it comes to dealing with the ups and downs of arthritis, you already know that some days are better than others. But how do you get a child to understand that? It may be easier than you think.

“Kids understand the concept of pain, whether they call it a boo-boo, owie, or hurt. Telling them that grandma has pain today, so we’ll need to play more quietly — kids can understand that,” says Teresa J. Brady, PhD, OT, senior behavioral scientist with the Arthritis Program for the Centers for Disease Control and Prevention. “Some children may be worried that they are causing grandma more pain; or because grandma has arthritis they will get it, too, so it is helpful to add some reassurance in the explanation,” Brady says.

If you need some help in offering an explanation or need some support, self-management education programs, such as the Chronic Disease Self-Management Program, can help you develop communication skills for talking with family, friends, and health-care providers, and problem-solving skills such as how to deal with commitments to grandchildren and others when you are having a bad day. (The Chronic Disease Self-Management Program is a six-week program taught at senior centers, churches, libraries, and hospitals throughout the United States and online at www.restartliving.org.)

What do you do?

Both indoors and out, opportunities abound for play, many of them offering the added benefit of exercise. However, before you jump into any type of physical activity, a little preparation makes a big difference. “Being physically active regularly, such as 30 minutes of moderate physical activity at least five days each week, can help build exercise tolerance and raise the pain threshold so people can be more active with their grandchildren without paying the price in pain and fatigue later,” says Dr. Brady.

Activities for younger children

Interacting with younger children is about finding ways to connect one-on-one. No matter what level of physical activity you feel comfortable with on a given day, the most important thing is that you and your child or grandchild enjoy a shared experience. And there are so many ways to do that.

Grow some fun plants with kids. Maybe they’ll be more inclined to eat their fruits and veggies if they had a hand in growing them. No guarantees, but it’s worth a shot. Try radishes, which produce quickly, or cherry tomatoes — they’re small, sweet, and fast growers, too. Impatient budding gardeners may appreciate the rapid growth and size of sunflowers. Four O’Clocks, sometimes called Marvels of Peru, are also a good choice for kids to plant. When in bloom, the flowers open in the late afternoon like clockwork, as their name implies.

Container gardening offers the benefits of planning and planting a garden, as well as seeing (and eating) what comes up. It also eases the tedious chore of weeding. Most kids naturally love to water, so put them in charge of watering the plants. And since kids typically don’t mind getting dirty, allow them to play an integral part in putting the soil into the containers before planting.

Get crafty. If it’s time to host a playdate with a grandchild or if you were hoping for some physical activity with your child but a flare-up has prevented it, try your hand at a craft project, instead. The options for crafts are limitless. Scrapbooking and painting are just a couple of ideas. Crafting is a great way for you to share your special skills or interests with a child, and it also provides a great avenue for you to learn something new together.

Have a ball. Strike up a game of toss with a soft, fabric or foam ball, or roll a ball back and forth. If you have arthritis in your hands, Sandra McGee, a physical therapist and pediatric certified specialist at the Children’s Hospital of Philadelphia, suggests in the book Juvenile Arthritis: The Ultimate Teen Guide (Scarecrow Press, 2009) to play “with Play-Doh to loosen up wrists.”

Game on. Most young kids find it hard to resist a simple round of Simon Says (in which you’re Simon) or hide-and-seek. Classic board games are another option for interacting with a child or grandchild on days when physical activity is not the best option.

Pretend play. Tea parties, a pretend grocery store, or even a puppet show are just a few of the imaginative ways to engage a young child’s creativity for some fun playtime. Round out special play events with dress-up clothes or accessories.

Keep your options open. “In terms of selecting an activity, think ‘low impact’ on the joints that hurt. Also, look for activities where you can stop in the middle or find alternatives if pain or fatigue begins to interfere. For example, a trip to the zoo, where there are plenty of benches to sit on and a train to ride, may be better than a long hike in the woods with no natural resting places,” Dr. Brady suggests.

Activities for older children

Interacting with older children is also about finding ways to connect one-on-one. In lieu of a playdate, you just might find yourself embracing some new physical activities and making some memories, too. Here are a few ideas:
Go for a swim. Swimming is good for arthritis, because the water provides support and reduces stress on your joints. You don’t have to be a good swimmer to reap these benefits: You can focus on range-of-motion activities rather than swimming laps.

If it increases your comfort and confidence level, consider taking a course specifically for individuals with arthritis before heading to the pool with your child or grandchild. Many YMCAs offer an aquatics program with the goal of building flexibility and increasing strength and endurance while gently exercising joints and muscles. The program is typically six to eight weeks but is ongoing in some places. Swimming is not required for these classes.

If you opt for some type of pool activity, check the water temperature before you begin. According to the Arthritis Foundation, the ideal range is between 83˚F and 88˚F. Water that is too cold may cause you to become stiff and tense. Warm water, however, allows blood vessels to dilate and increase circulation.

If you are new to water exercise, you may also find it helpful to wear a pair of water shoes; the nonskid soles reduce the likelihood of slipping, and they protect your feet from injury.

Take a walk. It’s hard to find anything easier or more economical, and it’s an ideal activity to enjoy with a child or grandchild, giving you an opportunity to connect while enjoying your surroundings. Just as important as the physical benefits of walking are the psychological benefits: Walking regularly gives your spirits a boost. Your local park, neighborhood, or even an indoor track are all good places to get up and get moving.

Try tai chi or yoga. Tai chi is an ancient Chinese martial art, in which a person performs slow, whole-body movements. It offers such benefits as improved balance, reduced stress, and decreased pain associated with arthritis. Yoga, which originated in ancient India, involves holding a series of poses, focusing on one’s breathing, and sometimes chanting or meditating. It can also improve balance and reduce stress, and yoga modified for people with arthritis has been shown to be effective in lessening the occurrence of swollen and tender joints.

Learn a hobby. Find out what interests your preteen or teen, and take a course together or read up on the subject. It’s an ideal way to do something together, and it gives you both an opportunity to grow.

Go for a spin. Take a bike ride together. When choosing a two-wheeler for outdoor riding, select one that fits you comfortably. If braking or shifting gears is difficult, ask at your local bike shop about components that may be easier to use. If you have balance issues, an adult tricycle may be the answer.

If foul weather prevents outdoor bicycling, pedaling a stationary bike can help keep you in shape. If you don’t have enough stationary bikes for you and your child or grandchild to ride together, consider going to a local gym.

Start a collection. From stamps to baseball cards, it’s possible to make a collection of anything. Choose something that interests and excites your child or grandchild. Enjoy researching and displaying a new treasured item.

Exercise precautions

Before beginning any type of physical activity, exercise a bit of caution. In its publication Questions and Answers about Arthritis and Exercise, the National Institute of Arthritis and Musculoskeletal and Skin Diseases recommends that people with arthritis check with their doctor first, and then slowly begin physical activity. Physical activity should involve stretching and a warm-up, range-of-motion exercises, strengthening exercises with small weights (one or two pounds), and the gradual addition of aerobic exercise, the institute says.

And whether you’re planning play activities with a young child or an older one, make sure to get a sense of how much energy you will need before trying to go “all out.” “Selecting the right physical activity is key — look for those low-impact activities. Start slow — don’t be a ‘weekend warrior’ who overdoes it on the weekend and can’t get out of bed on Monday — and progress gradually. Remember that many activities can be modified rather than eliminate the activity entirely,” Dr. Brady says.

When you’re not up for playing

A day may come when you just won’t feel like following through with your plans. Even then, “the key is to adapt, not abandon,” Dr. Brady says.

“On a day where grandpa planned to take the grandkids on a hike up the mountain, but wakes up with a lot of pain, rather than cancel the trip, change the itinerary — rather than hike the mountain, go to the park where there are benches for grandpa to sit on and swings for his grandchild to play on,” Dr. Brady suggests. “Activities can also be adapted by reducing the amount you do, walking around the block rather than all the way to the store, and by interspersing rest breaks: Walk a block, take a rest, then walk another block,” she says.

If you need to hold off on an exercise class for a day, reflect on the progress you’ve made. Talk to your child or grandchild about what you’re enjoying in the class and ask him to share his feelings, too. You may find the exchange gives you a mental boost in making a return to class. Attending the class to watch your child or grandchild participate and to root for him is also a good way to share in an activity, even if you can’t take part in it yourself.

Good for every body

On days when aches and pains are intense or stiffness is overwhelming, it may seem counterintuitive that being active is a good idea. Yet numerous studies show that individuals with arthritis benefit from regular, safe, physical activity. In fact, physical activity will help to give you more pain-free days. Movement is good for preteens and teens, too.

According to a Physical Activity and Health report released by the Surgeon General, kids and young adults stand to benefit from physical activity, as nearly half of young people ages 12 to 21 are not vigorously active on a regular basis, and more than 60% of adults achieve less than the recommended amount of regular physical activity. In fact, according to the report, 25% of all adults are not active at all.

Whatever activity you choose, remember to be as active as your body allows — have all of the fun that you and your child or grandchild can stand!

Stephanie Green is a freelance writer in Augusta, Georgia.

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