Hemophilia: Preventing Bleeding Episodes

Overview

Many people who have hemophilia know when they are bleeding even before there are many symptoms.

Work with your doctor to make a plan for what to do if you or your child has a bleed.

Bleeding in a joint

Bleeding into a joint (hemarthrosis), often without an injury, is the most common bleeding problem in people who have severe hemophilia. Bleeding usually occurs in one joint at a time. Bleeding may occur in any joint, but knees, elbows, and ankles are most commonly affected. Sometimes one particular joint, called a target joint, will tend to bleed most often.

Symptoms of bleeding into a joint include:

• Warmth or tingling in the joint during the early stages of hemarthrosis. This is called an aura. If bleeding isn't treated, mild discomfort can progress to severe pain.
• Swelling and inflammation in the joint. This is caused by repeated episodes of bleeding. If episodes continue, the swelling may lead to chronic pain and destruction of the joint.
• An infant or child not wanting to move an arm or leg because of bleeding into an affected joint. This is often first noticed when a child starts to walk.

Bleeding in a muscle

Another common symptom of hemophilia is bleeding into a muscle (hematoma). It can be mild or severe. There are many possible symptoms of bleeding into muscle, including:

• Bruising.
• Swelling.
• Muscle hardening.
• Tenderness.
• Pain, especially when large muscle groups are affected.

Can you play sports and be active if you have hemophilia?

People who have hemophilia can be active, but they need to prevent injuries and serious bleeding. But you can help prevent bleeding episodes by choosing the right exercises that keep the muscles and joints in good shape. Exercise helps keep muscles flexible and strong and helps control weight, making a bleeding episode less likely.

Doctors who specialize in hemophilia can help you figure out what sports are right for you or your child.

Keep the following in mind before you take part in a sport or activity:

• Know how to give clotting factors. Injuries can then be treated quickly. The sooner a bleeding episode is treated, the less damage bleeding will do to muscles and joints.
• Stretch and warm up with a few minutes of gentle exercise.

Some people who have hemophilia participate in any sport, regardless of the risk, because they infuse with clotting factors ahead of time.

Safer and riskier sports and activities

You are more likely to be injured and have a bleeding activity in some sports and activities than others. Sports and activities that are typically recommended for adults and children who have hemophilia include:

• Swimming.
• Walking.
• Hiking.
• Golf.

Sports that are possible but carry an increased risk of bleeding include:

• Baseball.
• Basketball.
• Bicycling.
• Bowling.
• Tennis.

Sports that have a high risk for bleeding include:

• Soccer.
• Football.
• Hockey.
• Weight lifting (with heavy weights).
• Wrestling.

What over-the-counter pain relievers are safe?

Doctors often recommend acetaminophen, such as Tylenol, for pain relief in people who have hemophilia. Don't take aspirin, ibuprofen (Advil or Motrin), Aleve, or other NSAIDs, or medicines that contain salicylate. These medicines can cause bleeding. Check the ingredient list.

What can you do to prevent falls?

Try to prevent falls by making your home safer. Keep walking paths free of rugs and other clutter. Install sturdy handrails in stairways. Train pets not to jump up or get underfoot, and keep them in one place at night. Keep your house and stairways well lit and free of clutter.