When you hear the word sports you probably think basketball, baseball, or football. When you read fitness you may imagine intense daily workouts at a gym. As a person with a bleeding disorder you may not be able to participate in these activities.
The next time you hear the words sports and fitness, consider that physical activity—through safe sports and exercises—will strengthen your musculoskeletal system and reduce extra weight. The real benefit: your joints will become more stable and you’ll be less likely to have bleeds and pain.
A Center for Disease Control and Prevention (CDC) study showed that being overweight was strongly associated with limited joint range-of-motion. This was true regardless of the severity of the bleeding disorder. However, it’s not just about being overweight. Do you ever get tired just from climbing up a flight of stairs or does that walk down the hall feel like it keeps getting longer and longer?
Just a few of the benefits of being physically fit:
- It increases your energy level.
- It boosts your mood and attitude.
- It helps your body adjust to even routine activities that can cause a bleed and other complications, especially in joints and muscles weakened by lack of movement.
Some considerations when thinking about getting active:
- Your current fitness level and goals.
- Don’t compare yourself to others. This is about you and not your peers.
- How comfortable are you with physical activity? Just like a car, you can’t start off at 55 mph. You’ll need to work your way through the gears. Everyone has to start at zero and work up at different rates. You will get there! Do you have some limitations? An honest assessment of your fitness level will help you reach your goals quicker
- What do you want to accomplish by being active? Make a list: Is your goal overall health or weight management? A specific event (like a Hemophilia Walk)? Or do you just want to play sports with your friends? Just like in other areas of your life, setting goals (fitness goals in this case) gives you something to work toward; you can create a plan and chart your progress, so you know when you’ve accomplished your goals.
- Discuss your sports and fitness ideas with your Hemophilia Treatment Center (HTC) team before getting started.
- We’ve all heard the announcers on infomercials for exercise equipment and exercise videos say, “Speak to your doctor before beginning any exercise program fitness routine.” Heed this very good advice and talk to your treatment team before you start a sport or working out. Most likely you have been meeting with your bleeding disorder treatment team already, so they know you pretty well. They’ll have your health records, including information about bleeding episodes and other medical conditions, and will find your baseline and track your progress from that point.
- Your HTC team can:
- Discuss activities that will help and, more importantly, not hurt your body.
- Suggest ways to alter the activities you want to do to minimize the risk of injury and bleeding.
- Review your infusion or prophylaxis regimen and help you adjust it, if necessary, to fit your increased activity schedule.
- Help you make adjustments if you do get injured or have a bleed.
- Advocate for you. They can talk with your teachers, coaches, and even other medical staff to help promote your being physically active and help you avoid risks.
- Treating before and after specific activities decreases the odds of a bleed.
- While you may be treating prophylactically (which will make it easier and safer for you to take part in many activities), bleeding due to injury or overuse is still a possibility.
- Whether you’re on a regular prophylaxis routine or treat prior to your activity, discuss with your treatment team when you should treat based on your activity.
- Ideally, the activity should take place soon after treatment, when your clotting factor level is at its peak. Depending on the physical activity and any incidents that may have occurred, you may wish to treat afterwards.
- Don’t play through injuries!
- All injuries need adequate time to heal. If you don’t take the time needed to recover, you could end up with long-term or permanent joint and tissue damage.
- Use the R.I.C.E. protocol (Rest, Ice, Compress, and Elevate).
- Talk with your treatment team about your treatment options and to determine when you can continue certain physical activities.
So you’ve decided to get active, but now what?
For much of your life you may have been told you can’t do certain activities. That’s because the risk of injury or bleeding depends on the activity. Understanding these risks can help you make your own choices about what physical activities are right for you. Maybe you will choose to not participate in a contact or collision sport like football or hockey because you know the risk of serious injuries to the head, neck, and spine is high—and, of course, a neck brace (or head bleed) would put a serious damper on your social life.
When choosing a sport or exercise routine, it’s important to consider your body type, past bleeding history, and the condition of your joints. There’s no one-size-fits-all answer. Before you begin an activity, talk with your hematologist and physical therapist. They’ll go over all of this with you.
Your fitness plan doesn’t have to be an over-the-top routine. Having a fit body means you can participate in your daily activities and not injure or exhaust yourself.
Moderate aerobic activity for 30 minutes every day will give you better long-term results than exercising for a longer amount of time only once a week. You may wish to do a simple activity like walking, biking, or Pilates. Make your activity fun, so you’ll keep doing it. Consider how these activities affect different parts of your body. Are you developing your core muscles (abdominals, lower back, hips, and pelvis)? By developing your core, you build strength, balance, and stability, giving you better control over your body and potentially fewer bleeds. Even if your fitness plan is less strenuous, you should still decide how best to prepare for your routine by proper pre- and post-treatment and conditioning.
Whether you’re playing organized sports, pick-up games, or nontraditional sports like dance, you may want to keep in mind what could happen while you’re playing. Even the safest sporting activities have risks.
A few steps to lessen the risk of injury or bleed:
- Discuss with your bleeding disorder treatment team the best way to minimize any risk associated with the sport(s) you have chosen, and what to do if an injury or bleed occurs.
- Proper pre- and post-treatment. Treat close to the time of your activity so that your clotting factor level is at a peak during participation.
- Conditioning. When you know what joint or muscle may give you problems for your chosen sport you can work to improve that area. You can do this by:
- Stretching. Part of conditioning that makes your muscles more flexible and allows your joints to move more freely
- Strengthening. Part of conditioning that increases your muscle strength for greater joint support.