Your child's physical or occupational therapist has recommended range-of-motion exercises for your child, but there never seems to be enough time to do them. Doing the exercises will be a lot easier if you make them a part of you-and your child's-daily routine.

What is joint range of motion?

Joint range of motion means moving a joint through its full available range of movement. Bones move and are connected to each other at a joint. When a joint is moved, the muscles, tendons, and ligaments that surround the joint are also moved and stretched.

Why are these exercises so important?

Children with disabilities may develop tightness in some muscles, which can lead to loss of active motion and possible permanent tightness or loss of movement. The child can't use tight muscles correctly, and the child's movement patterns can be impaired.

Range-of-motion exercises help to keep a joint and surrounding muscles, ligaments, tendons, and tissue from becoming tight or inflexible. The exercises also help improve blood circulation, promote bone growth, and improve the child's body awareness.

There are two types of range-of-motion exercises - passive and active. In passive range-of-motion exercises, someone else moves the joint. The child doesn't take an active part.

In active range-of-motion exercises, the child actively moves the arm, leg, or other joint. Someone else may help the child move the joint as much as possible.

How often should I do the exercise?

Range-of-motion exercises need to be done every day, but finding time is not always easy. You're much more likely to do the exercises if you include them as part of daily activities such as bathing, diapering, dressing, or carrying your child.

You'll do the exercises several times as they fit into your day, rather than in one specific "exercise session." The exercises will be more fun for you and your child, too.

How should I do the exercises?

The physical or occupational therapist will review the specific techniques for doing range-of-motion exercises with your child. Be sure to practice with the therapist present until you feel confident with the methods.

In general, give gentle support above and below the joint you are moving. Do not push on the joint. Do the exercise slowly. Use a gentle touch and hold the joint at its stretched range up to a count of five. Do each exercise three to five times.

The exercise time should be a nonstressful, relaxed time for both of you. Bathing and massaging your child before exercising may further relax the muscles. Make sure that you and your child are comfortably positioned and that your clothing is not tight.

What if my child becomes upset during the exercises?

The exercises should not be painful for the child, but can be uncomfortable to stretch tightened tissue. But without the exercises, the tightness, discomfort, and decreased function will get worse.

Start slowly and move the joint to the point where you begin to feel resistance. Do not force the joint. Move the joint only a short distance if your child begins to get fussy. Gradually increase the range in the joint, day by day. To distract the child, do the exercises as part of games.

How can I make the exercises part of my daily routine?

You can include range-of-motion exercises in almost every activity you share with your child. Here are some examples; ask your child's therapist for more.