As recently as the early 1960s, people with hemophilia routinely confined themselves to their homes, not because they were too ill to go out, but for their own safety. Many doctors prohibited physical activity of any kind. Kids couldn't walk to school and adults couldn't work, all because experts believed physical activity could damage joints and cause uncontrolled bleeding. This approach made many hemophiliacs into virtual hermits. It was also completely wrong.

Today, doctors know that being active can be extremely helpful for people with hemophilia. Far from posing a grave danger, exercise can actually prevent or reduce bleeding by strengthening muscles and vulnerable joints. The National Hemophilia Foundation strongly encourages regular exercise for hemophiliacs of all ages.

Of course, people with hemophilia have to know their limits, just like everyone else. According to a report published in Clinical Orthopaedics and Related Research, some sports -- including boxing and rugby -- are generally considered too risky for anyone with hemophilia. Experts also recommend that those with severe hemophilia should avoid contact sports like football, wrestling, and other sports that are more likely to cause an injury. Some of the most widely recommended activities include swimming, jogging, tennis, fishing, and bicycling.

Decisions about sports and exercise can be especially tricky for parents of children with hemophilia. On one hand, parents want to protect their children at all costs. At the same time, they want their children to enjoy the benefits of sports. In her review in Clinical Orthopaedics and Related Research, Brenda Buzzard urges parents to err on the side of fun and fitness. "The only way children with hemophilia learn their limits is to be allowed to do things," she writes. "If a child is forbidden to participate in a sport he or she wants to play, there is a good chance that he or she will play it anyway without the parent's knowledge."

Both children and adults with hemophilia should talk to their personal doctor before starting a new sport or exercise program. A doctor can help determine if particular activities might be too risky. For instance, patients who already have damaged joints may have to avoid jarring activities such as basketball or jogging and stick with gentler exercises such as swimming or walking. In some cases, a doctor may also recommend factor treatments before activities to lower the risk of bleeding.

In addition, if you have hemophilia, it's important to choose playing fields that will minimize injury whenever possible and to use protective equipment. When bicycling, for example, wearing shin guards, face masks, and helmets will provide maximum protection. Good footwear can also help curb injuries, as will warning up before exercising. Even stretching exercises should be done with the muscles warm to reduce the risk of injury, according to Buzzard. Strength training is a controversial area, she adds, and notes that experts recommend careful supervision, stretching beforehand, and doing a high number of repetitions with a low weight.

Attitudes about hemophilia have come a long way in the last 40 years. Today, most people with the condition can lead active -- even adventurous -- lives. It's still a serious disease, but it doesn't always have to put a person on the sidelines.

-- Chris Woolston, M.S., is a health and medical writer with a master's degree in biology. He is a contributing editor at Consumer Health Interactive, and was the staff writer at Hippocrates, a magazine for physicians. He has also covered science issues for Time Inc. Health, WebMD, and the Chronicle of Higher Education.

References

First published July 22, 2003
Last updated September 14, 2007
Copyright © 2003 Consumer Health Interactive

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