Physical Activity

Physical Activity

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Having a bleeding disorder does not mean children and teens have to miss out on sporting activities or exercise. It just means that they need to be careful about the types of activities they choose and use some precautions. Being physically active not only helps maintain a healthy body, but also provides an opportunity for kids to socialize and set goals.

Choosing the right sport is essential for individuals with bleeding disorders. Parents and children should follow the National Hemophilia Foundation's guidelines for safe activities and speak with their Hemophilia Treatment Center (HTC) team if they have any questions.

And, of course, parents and children must know how to recognize and treat a bleed that may occur as a result of physical activity, as well as when the activity can be resumed. With the right activity and precautions, children and teens can be safe, have fun, and enjoy the experience of individual and team activities.

This section of Next Step provides important information on:

  • Bleeding Disorders and Sports
  • Choosing the Right Sport and Exercise
  • Communication and Precautions
  • Treating Injuries Promptly
  • Exercising After a Bleed

Keeping Physically Active and Safe

In First Step, you learned that physical activity is important for everyone—especially for people with bleeding disorders. Overall, it produces positive physical, psychological, and social benefits; and for people with bleeding disorders, it helps to reduce weight and protect joints.

For more information, go to Physical Activity.

This section of Next Step will cover:

Can People With Bleeding Disorders Play Sports?

Yes! Playing sports helps children, particularly those with bleeding disorders, feel good about themselves and their bodies. Sports and games are a part of childhood. Children choose them for excitement, friendship, and competition. The physical, social, and emotional benefits your child will gain for participating in these activities should relieve any concerns you may have. There is a wide range of physical activities, from traditional sports, like tennis, to other forms of exercise, like yoga. No matter the choice, being active is good for everyone. Participating in sports can improve balance, muscle tone, sleep quality, and posture.

What Are the Right Sports and Exercises for My Child?

Most sports and other physical activities have some level of risk. So, before your child begins a sport, talk with your Hemophilia Treatment Center (HTC) team.

Here are some considerations when choosing a sport or exercise:

  • General body build
  • Past bleeding history
  • Cause of the bleeds
  • Condition of the joints

Playing It Safe with Hemophilia

Like most children, kids with bleeding disorders want to have fun playing games and sports. Share this animated video with your child, and see how two brothers and their friends, all of whom have hemophilia, 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 NHF's HANDI and ICF International.

When it comes to choosing a sport, there's no one-size-fits-all answer.

Based on your child's specific health status, the HTC physical therapist can help you chose the best sport and determine how to reduce risks associated with the activity. (However, contact sports such as football and hockey are not recommended for people with bleeding disorders.) Even if your child has no specific problems, a training program prior to engaging in a sport can help. It's especially important to plan in advance if your child has specific muscles or joints that are weak. Eliminating those weaknesses can take time.

Picking the Right Sport

The National Hemophilia Foundation has published Playing It Safe, a brochure that rates the risks of a wide range of sports and activities. It contains 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 can help you make informed decisions about which activities are best.

A child with a bleeding disorder should never follow the no pain, no gain philosophy.

Honest Communication Is Key

Honest and open communication is important. It is helpful to include your child in discussions about sports so that he or she can learn how to play safely, reduce the risk of injury, and respond to an injury. Remind your son or daughter that it's very important to let you know if he or she has a bleed. Hiding a bleed or an injury can be very dangerous.

Communicate with your child's coaches, PE 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 his or her coach or PE teacher, stress the importance of inclusion—your child has a right to participate in PE classes. Sometimes modifications might be necessary, but a child with a bleeding disorder can still join in and have fun!

For more information on safe activities, go to NHF Publications.

Here are some tips to keep in mind while encouraging your child to participate in sports, exercise, and other physical activities:

  • Play a position in the sport or game in which the likelihood of injury is lowest (for instance, 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 do warm-up exercises before playing, followed by cool-down and stretching exercises
  • Remember: R.I.C.E. (Rest, Ice, Compress, and Elevate) in case of injury and to treat early and adequately!
To learn more, go to R.I.C.E.
Play smart! It's the wise way to reduce the risk of injury.

Prompt Treatment of Injuries Is Important!

Teach your child early on how to recognize a bleed. You should stress that an injury can cause a bleed whether or not blood is visible.

For more information, go to Identifying Different Types of Bleeds.

A Heads-Up on Head Injuries

Bleeding in or around the brain can be life-threatening or result in permanent brain damage. This is why any significant head, neck, or spine injury requires factor replacement immediately, as well as a CT scan and evaluation by a health care professional.


Signs and symptoms of a head bleed include:


  • Repeated vomiting
  • Irritability
  • Drowsiness
  • Headache
  • Confusion

These signs and symptoms may not appear until several days after the injury.

For more information, go to Identifying Different Types of Bleeds.

If your child has a mild bleeding disorder or is on prophylactic therapy, he or she may never have experienced a bleeding episode and may not know the warning signs of a bleed. Nevertheless, all children with a bleeding disorder should know the signs and symptoms of a bleed, such as a tingling, bubbling, or a warm, aching sensation. Be sure your child knows to tell an adult right away if he or she gets hurt or thinks he or she is having a bleed.

Exercising After a Bleed

After your child has had a bleed, you may be unsure about when he or she can resume playing sports or exercising. 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 who return to sports too soon after minor injuries.

Your Hemophilia Treatment Center (HTC) 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. In the meantime, your child can exercise other parts of the body while the injured joint or muscle is healing.