Week 3: Hemophilia and Sports/Fitness — What is safe and what is not?
Pick a weekly goal and track your progress.
Last week we learned about exercise recommendations and the benefits that exercise can bring. This week we are going to focus on safe sport and fitness activities.
Instruction:
Being active is really important for children and adults with a bleeding disorder. Getting regular exercise can make muscles stronger and joints more flexible. People with hemophilia that exercise regularly can actually experience less bleeds because their muscles are strong and their joints are more stable.
How to Choose an Activity or Sport:
When you speak to your child’s hematologist or physical therapist about which sports or activities they should do, think about if they have any target joints, muscle problems, or recent bleeds.
Sports and activities should generally be low impact. High collision sports, such as football, lacrosse, rugby, ice hockey, and wrestling should be avoided.
Don’t just pick 1 sport or activity. It is good to have a variety of interests in sports or activities for your child in case 1 sport or activity becomes unsafe because of injuries or becomes riskier because of older levels of play.
Playing It Safe:
For more information on the risks and safety of specific sports and activities, please read the National Hemophilia Foundation’s Playing it Safe manual. This manual has great information about strengthening, conditioning, and safety ratings for many sports and activities.
Prevention and Protection:
If your child is on prophy, or preventative treatment, you should speak to your child’s hematologist about possibly scheduling the treatment before sports activities to make sure that factor levels are in a safe range for the activity.
If your child has target joints, talk to their physical therapist about whether they should use braces or splints during activities.
Before playing a sport or exercising, always warm up (to avoid injury) and cool down (to stretch when muscles are warm).
Signs and Symptoms of a Joint Bleed:
Stiffness and pain, unable to straighten out the arm or leg all the way
A feeling of bubbling, tingling, or warmth in the joint
Swelling of, or around, the joint
Difficulty walking or standing
Refusing to use their arm or leg
Younger children may be fussy, limp, or have behavior changes
Signs and Symptoms of a Muscle Bleed:
Pain or trouble moving the muscle
Small children may refuse to move an arm or a leg
Warmth or tightness
Numbness or tingling, which may be described as feeling “asleep”
Treating Sports Injuries:
It is really important that you and your child learn to recognize a bleed so that it can be treated as soon as possible.
Coaches, gym teachers, and school staff who supervise recess need to be aware of your child’s condition. Your child should tell an adult immediately if they are injured.
You should be present at your child’s sports activities in case an injury occurs. Take your child’s emergency or travel factor dose when traveling for tournament play.
Children should not keep playing in a game or a practice when injured. Doing so can lead to permanent joint damage.
Use P.R.I.C.E.
P: Protect the injury by doing such things as using a sling, crutches (for children over 10 years old), or a brace if recommended by your child’s doctor.
R: Rest the area that is injured. Continued use of an injured area can worsen the injury and increase the chance for bleeding into the tissues and the joint.
I: Ice the area to reduce pain and limit bleeding. Use a towel or a cloth instead of placing ice right on the skin for 10-15 minutes every 2 hours. Do not use for more than 15 minutes at a time.
C: Compress the injured area with an elastic bandage to help decrease swelling and limit bleeding. Wrap snugly from low to high, but do not wrap too tightly, as you don’t want to restrict the blood supply.
E: Elevate the injured area. Place an injured arm or leg on a pillow or a stool at above the level of the heart. This can help decrease swelling and help with healing.
Getting injured during sports or exercise:
Contact your child’s hemophilia treatment center after an injury to see if treatment is needed and if they need to be seen by their hematologist.
Talk to your child’s hematologist or physical therapist about when they can return back to their regular physical activities. Returning too soon can put them at risk for another injury.
Children should be pain free when they return to their activity and have good strength in the area that was injured.
Returning to physical activity can be done in small steps; for example, doing half of their practice instead of all of it.
Resources to download:
Physical Therapist Weekly Tip
“It is healthy for kids to do heart pumping exercise for at least 1 hour a day. It is okay to start at 20 minutes and build-up. It is also good to try different activities on different days to keep things interesting and let some of the muscles rest. Sports teams can be very fun, but walking the dog, riding a bike with a helmet, hiking, dancing, or swimming are other ways to have a lifelong way to being fit without needing a team. ”
— Molly Mays, Hemophilia Physical Therapist