How to Broaden Your Sporting Horizons

For a lot of people, it's hardly a revelation that they key to staying healthy is regular exercise. The problem isn't that they don't know this—it's that workouts can seem a lot like, well, work.

The solution? Make physical activity fun. Sure, swimming, cycling and golf have their place as safer sports for people with hemophilia, but too much of a good thing can backfire, resulting in boredom—and avoidance.

The good news is that, with access to sufficient factor, people with bleeding disorders are in a position to take advantage of a wide range of sports.

Be Prepared

Before beginning any physical activity, it pays to do your homework. "Choosing a sport comes down to a combination of a lot of factors, one of which being the sport itself," says George R. Buchanan, M.D., medical director at the Center for Cancer and Blood Disorders at the Children's Medical Center in Dallas, Texas. "Consider the level of activity, the trauma and stress it puts on the joints and the likelihood of injury."

To help accomplish this Dr. Buchanan recommends getting hold of a copy of the U.S. National Hemophilia Foundation's booklet "Playing It Safe: Bleeding Disorders, Sports and Exercise." In addition to discussing topics like conditioning, stretching and flexibility, it lists approximately 50 sports and places them into one of five rankings depending on their risk level. (To order the booklet, call the U.S. National Hemophilia Foundation at (+1) 800-42-HANDI. Cost is $5 (U.S.) for non-members and free for members.)

Having the right gear is also important. "Having proper equipment is one of the keys to success," says Bruce Evatt, M.D., retired chief of the Hematologic Diseases Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia. Wear that bicycle helmet, those protective pads, proper fitting shoes and any other available accessories that can help keep you safe. Keep with you a medic alert necklace or bracelet, or documentation in your wallet, and put a plan in place in case of emergency.

Also, discuss any new sports or workout plans with your treatment team. "Physical therapists can get you trained in terms of proper exercise form and good muscle tone to help prevent injuries," says Dr. Evatt.

The final reality check, of course, is simple: if it hurts, don't do it!

Game On

While steering clear of contact sports like American football, rugby, hockey and boxing is an obvious no-brainer, many other opportunities still exist for exercise. Nothing is 100 percent risk-free but here is a list of sports you might consider trying:

• Rowing/Crew. Whether on a machine or as part of the team on a river, rowing can provide an excellent non-impact aerobic workout for the whole body. Be sure to learn proper form to prevent injury. Adjustments in movement can also be made to work around injured joints. (Canoeing and kayaking in calm water also make for good exercise. However, avoid fast white water, which can cause capsizing, head injuries and drowning. Always wear an approved life vest and helmet.)
• Baseball/Softball. With the proper equipment and in the right position, baseball and softball can be great team sports to play. Possible injuries include being hit in the head, eye area and chest by a ball, and joint problems from sliding, running into other players and pitching. However, risk can be minimized by using certified helmets with ear flaps on both sides, a chin strap and eye protection. Padded chest protection and using a softer ball can make the game even safer. Other precautions include not playing pitcher or catcher, and avoiding those spectacular slides into base.
• Martial Arts. Tai Chi, with its slower movements, breathing and meditation, is a terrific activity for anyone. More strenuous martial arts such as Karate, Kung Fu and Tae Kwon Do may be possible with a qualified instructor and can provide great physical conditioning. With your treatment team's permission, practicing moves like strikes, punches, blocks and kicks under careful supervision can often be done. Competitive fighting, high contact and breaking objects, obviously, make less sense.
• Circuit Training/Weight Lifting. This type of strength training uses machines, free weights and/or exercise bands in a specific order with little rest in between to build strength, increase flexibility and give you an aerobic boost. With the proper technique there is little risk if you have hemophilia. Lifting lighter weights with more repetitions is also generally safe and helps to increase strength and endurance. Power lifting should always be avoided.
• Cross Country Skiing. While downhill skiing is discouraged, cross country skiing over flat terrain carries less risk of injury and can be a great aerobic workout. Proper-fitting equipment and a helmet are a must. Indoor cross-country machines are another fun variation.

Ultimately, when choosing a new activity, use your heart as a guide as well as your head. You have to take not only the sport itself and your physical status into consideration, says Dr. Buchanan but also your personal happiness—within reason, of course.

Bottom line, if you're feeling bored or burned out with your current workout, climb out of the rut and check out some new sports. There is a whole wide world of options out there. And—newsflash—exercising can actually be fun. Here's to good health and a happy heart!