Run Further, Faster

Who doesn't feel the need for speed? Whether it's a kick-ass roller coaster or a sports car with the top down, there's something exhilarating about the rush of wind and the jolt of adrenaline that comes with going fast. And the feeling isn't limited to motorized vehicles.

While walking has always been a highly recommended form of exercise, running can also be a viable option for many people with mild and possibly even moderate hemophilia—with the proper preparation.

Start with a Tune Up

In its "Playing It Safe: Bleeding Disorders, Sports and Exercise" booklet, the U.S. National Hemophilia Foundation ranks jogging/running as a 2 (or "moderate risk") on a scale of 1 to 3, so don't start running on a whim.

"Outside of any trauma from a fall, the biggest worry is bleeding in the joints and muscles," says Joe Meschi, M.D., a doctor in the Department of Hematology and Oncology at the Rush-Copley Cancer Care Center in Aurora, Illinois. "Ankles, especially in younger people, are one of the joints most affected."

Therefore, prior to beginning any exercise program, always check in with your treatment team. With knowledge of your factor levels, possible treatment regimens and health history, they are in the best position to help decide if running is right for you.

Yellow Means Slow

Once you receive the green light, don't put the pedal to the metal right away. Instead, play it smart and do your homework. Specifically:

• Consider starting with a conditioning program to help prevent injuries.
• Include stretching for improved flexibility.
• Don't forget to use resistance equipment or weight training to increase strength, which will help support your joints and can give you more power and speed. Leg muscles to focus on include hamstrings, calves, quadriceps and glutes, while a strong core (abdominals and back) can help with proper form.

Green Means Go

Now that your body is in shape, make sure everything else is too.

• Choose your gear carefully. Sure you want stylish clothes and cool kicks but make them practical as well. Clothes should be comfortable, loose fitting and weather-appropriate. "The whole issue is we want to avoid stress on the joints and muscles, so running shoes with more padding and cushion support are key," says Dr. Meschi. Also, remember to replace them at regular intervals.
• Consider where you will run. As with shoes, the softer the surface, the easier on the joints. For example, an indoor cushioned track—or a treadmill—would be preferable to hard concrete outside. If you want to catch some rays while you run, grass is probably still better than pavement though be sure to watch out for obstacles and hidden holes that can cause a twisted ankle.
• Plan your workout in advance. If you're new to running, start slow to increase your endurance. Alternate a minute of jogging with two minutes of walking for about 30 minutes if your body can tolerate it (if it feels like too much, do more walking and less jogging). As this becomes easier, increase the jogging time while decreasing the walking time. Always stop if you feel any pain.
• Warming up is key. Do some walking and/or very light running to increase your heart rate gradually. As you start to feel your muscles loosening up, do stretching exercises as well. Stretch slowly for at least 30 seconds and do not bounce, because this can increase the risk of hurting your muscles. You should feel a pulling sensation but no pain.
• Practice proper posture. "Look up at the horizon with your shoulders pulled back, abs engaged and a short stride to start," suggests Stephanie Ramones, a personal trainer and group exercise instructor at the Boston University Fitness and Recreation Center. "When your foot lands it should lead with the heel and mid sole. And don't allow your arms and torso to swing too dramatically."
• Track your heart rate. To get the most benefit to your heart and lungs, exercising in your target heart rate range is key. To determine your maximum heart rate, take the number 220 and then subtract your age from it. Next figure 60 percent of the number after subtraction and that's the low end of your target zone. Take the same number and get 85 percent of it and that's the high end. For example, if you are 20 years old your maximum heart rate would be 200 (220 minus 20) with the low end of the target zone being 120 (200 x .6) and the high end 170 (200 x .85).
• Don't forget to cool down. As with the warm up, you should allow approximately 10 minutes for cooling down after your workout. The idea is to bring your heart rate down slowly so don't go from a full on run to standing still. Instead, slow your pace and exertion level gradually.
• Be safe. Always stop if anything hurts and begin appropriate treatment if you experience a bleed. Remember RICE (rest, ice, compression and elevation) to help reduce swelling and increase your comfort level.
• Enjoy yourself. There's no doubt running is a workout but with the proper preparation, training and supervision, many people with hemophilia can attack the track with great success.