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 (we’ve all seen the ads for the P90X® or Insanity® fitness programs). 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?
Here
are 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.
Here
are a few considerations when thinking about getting up and getting active:
If you do injure
yourself or if you feel a bleed coming on, treat within one hour to help
minimize joint and tissue damage!
·
Your current fitness level and goals.
Don’t compare yourself to others. This is about you and not your
peers.
o 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.
o 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.
Here are other ways your HTC can help you
start exercising:
o 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.
§ They can discuss
activities that will help and, more importantly, not hurt your body.
§ They can suggest ways to
alter the activities you want to do to minimize the risk of injury and
bleeding.
§ They can review your
infusion or prophylaxis regimen and help you adjust it, if necessary, to fit
your increased activity schedule.
§ Because they were
involved in helping plan your activity program and know your treatment history,
they’ll be better able to help you make adjustments if you do get injured or
have a bleed.
§ Your treatment team can
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.
o You may be treating
prophylactically, and that has made it easier and safer for you to take part in
many activities; but 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! You’ve all heard the adage No pain, no gain, but 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.
Activities
So you’ve decided to do something, but 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.
Exercise
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.
Consistency and
continuity are the keys to keeping fit.
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.
Sports
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.
Here
are 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:
o Stretching. Part of
conditioning that makes your muscles more flexible and allows your joints to
move more freely
o Strengthening. Part of
conditioning that increases your muscle strength for greater joint support.
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