Having a blood or bleeding disorder does not mean children and teens have to miss out on physical activity. It just means that they need to be careful about the types of activities they choose and use some precautions. This section of Steps for Living focuses on what parents, caregivers, children, and teens need to know about physical activity for children and teens with bleeding disorders, how to be safe when physically active, and what to know about exercising after a bleed.
This section of Physical Health covers:
Physical Activity and Bleeding Disorders
Treating Injuries From Physical Activity
Physical Activity and Bleeding Disorders
Being physically active supports a healthy body and gives kids a chance to socialize and set goals. Choosing the right activity is essential for people with bleeding disorders. With the right activity and precautions, children and teens can be safe, have fun, and enjoy the experience of individual and team activities. Physical activity leads to positive physical, psychological, and social benefits. For people with bleeding disorders, it also helps to protect joints and keep a person healthy.
Playing sports and being active helps children and teens with bleeding disorders feel good about themselves and their bodies. Sports and games are a part of growing up. Children and teens choose them for excitement, friendship, and competition. There is a wide range of physical activities to choose from, including team sports to other forms of exercise like yoga. No matter the choice, being active is good for everyone. Participating in physical activities can improve balance, muscle tone, sleep quality, and posture.
Most sports and physical activities have some level of risk. Before your child begins a new physical activity, talk with your Hemophilia Treatment Center (HTC) team or health care provider.
Here are some factors when choosing a physical activity:
- General body build
- Past bleeding history
- Cause of the bleeds
- Condition of the joints
Playing It Safe
Like most children and teens, kids with bleeding disorders want to have fun playing games and sports. When it comes to choosing a sport, there's no standard answer. Based on your child's health needs, a physical therapist can help you select the best sport and how to reduce physical activity risks. Contact sports such as football and hockey are not recommended for people with bleeding disorders. Even if your child has no specific problems, starting a training program before joining a sport can help. It is important to plan if your child has specific muscles that are weak or problem joints.
The animated video Playing it Safe With Hemophilia shows how two brothers and their friends with bleeding disorders feel about staying physically active while staying safe.
This video was developed by the Centers for Disease Control and Prevention (CDC), Division of Blood Disorders in collaboration with NBDF's HANDI and ICF International.
The National Bleeding Disorders Foundation has published Playing It Safe, a brochure that rates the risks of a wide range of sports and activities. It has a useful graph to help you and your child decide which activity and sport to join. You will also want to consider the severity and bleeding history of your child and evaluate the risk of bleeding for each activity. Your Hemophilia Treatment Center (HTC) team or health care provider can help you make informed decisions about which activities are best. A child with a bleeding disorder should never ignore pain and always listen to their bodies.
- Physical therapist. Before beginning a new sport, talk with your physical therapist and health care provider about the risk of having a bleed in a target joint.
- A physical therapist can help you with a conditioning plan to get you ready for a sport or exercise.
- Protective gear. This includes helmets, knee pads, and mouth guards.
- Protective gear helps prevent serious head, mouth, and joint bleeds.
- Helmets can protect you from head injuries. Bleeding in or around the brain can be life threatening or result in permanent nerve damage.
- Protective gear helps prevent serious head, mouth, and joint bleeds.
- Position. Play a position in a sport or game that's less likely to lead to an injury.
- For example, outfielder rather than catcher or shortstop in baseball; a point guard rather than a center in basketball.
Honest and open communication is important. Include your child in discussions about sports so that they can learn how to play safely, reduce the risk of injury, and respond to an injury. Remind your child that it's very important to let you know if they have a bleed. Hiding a bleed or an injury can be very dangerous.
Communicate with your child's coaches, physical education teachers, and exercise instructors so they understand your child's condition, the risks, and how to assist your child if a problem occurs. As you talk with your child and their coach or instructor, stress the importance of inclusion. Your child has a right to participate in physical education classes. Sometimes modifications might be necessary, but a child with a bleeding disorder can still join in and have fun!
Here are some tips while encouraging your child to participate in sports, exercise, and other physical activities:
- Play a position in which the likelihood of injury is lowest (for example, outfielder rather than catcher or short-stop in baseball)
- Wear supportive shoes
- Use mouth guards and helmets if necessary
- Protect joints with supports, such as wrist/knee/elbow guards, tape, and padding
- Make sure to warm-up before playing and cool-down and stretch after the sport or activity is over
If you want more information about safe activities, please go to NBDF Publications.
Treating Injuries From Physical Activity
If your child has a mild bleeding disorder or is on prophylactic therapy, they may never have experienced a bleeding episode. Your child may not know the warning signs of a bleed. Children and teens with a bleeding disorder should know the signs and symptoms of a bleed, such as a tingling, bubbling, or a warm, aching sensation.
You should stress that an injury can cause a bleed whether or not blood is visible. Be sure your child knows to tell an adult right away in the case of an injury or possible bleed. Remember P.R.I.C.E. (Protect, Rest, Ice, Compress, and Elevate) in case of injury and to treat early and adequately. If you want more information about recognizing a bleed, go to Identifying Different Types of Bleeds. For more information about P.R.I.C.E. treatment, go to the Steps for Living pdf P.R.I.C.E.
A Heads-Up on Head Injuries
Bleeding in or around the brain can be life-threatening or result in permanent brain damage. Any significant head, neck, or spine injury requires factor replacement immediately. These injuries need a CT scan and evaluation by a health care provider.
Signs and symptoms of a head bleed include:
- Repeated vomiting
- Irritability
- Drowsiness
- Headache
- Confusion
Remember these signs and symptoms may not appear until several days after the injury.
Exercising After a Bleed
After your child has had a bleed, you may be unsure about when to start playing sports or be physically active. Injuries need time to heal. Your child should not participate in vigorous activity while the injured joint or muscle is healing. Major injuries can occur in children or teens who return to sports too soon after minor injuries.
Your Hemophilia Treatment Center (HTC) or health care provider can help determine when it's safe for your child to go back to full activities. A physical therapist can help with regaining function and protecting joints and muscles from further injury. Your child can exercise other parts of the body while the injured joint or muscle is healing.