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Precautions

Are there any drugs a person with hemophilia should not take?

Yes. Certain drugs affect the way platelets plug holes in blood vessels. Since hemophiliacs already have a bleeding problem, taking these drugs will only make their bleeding worse. Anybody with hemophilia should never take drugs containing:
  • aspirin (ASA) and other drugs containing aspirin (Alka-Seltzer, Anacin, Aspirin, Bufferin, Dristan, Midol, 222, to name just a few);
  • non-steroidal anti-inflammatory drugs (indomethacin and naproxen);
  • blood thinners such as warfarin or heparin.

Drugs containing acetaminophen can be used for fever, headaches and minor aches and pains.

Can a person with hemophilia play sports?

Yes. It is important that all people with hemophilia engage in regular exercise to keep their muscles and joints strong and their health good. Being in good physical condition can actually reduce the number of bleeding episodes a person has.

A person with hemophilia will have to find out for himself / herself what physical activities he / she can or cannot do. Many people with mild forms of hemophilia participate in all kinds of sports including active sports like soccer and high-risk sports like skiing. People with more severe forms of hemophilia may find these activities lead to serious bleeding.

Specialists at the hemophilia / bleeding disorder clinic can advise people of the risks based on an evaluation of each person's condition.

People with severe hemophilia should take prophylactic concentrate treatment just before taking part in sports and some with mild hemophilia should do so as well.

Table 2 below gives information on sporting activities for the person with hemophilia.


Scale *
Low degree of stress

**
Moderate degree of stress

***
High degree of stress

SportRisk of SportJoints Involved (ranked in descending order of involvement)Degree of Stress to Joints

Recommended Equipment


Additional Comments
SwimmingVery LowShoulders *
NoneSwimming is a low risk sport assuming no diving is involved. Stress to joints is directly related to intensity and duration of swimming. Whipkick may irritate knees.
WaterskiingHighKnees
Shoulders
Elbows
***
**
**
LifejacketVery stressful on muscles. The overall risk is high due to outside forces over which skier has no control (examples: speed at which he hits the water, being hit by a ski).
WindsurfingMediumSpine
Shoulders
Elbows
**
**
*
LifejacketLessons useful initially to learn proper technique. High winds increase risk especially if inexperienced.
GolfLowShoulders
Elbows
Knees
*
*
*
Appropriate footwear
TennisLowKnees
Ankles
Elbows
**
**
*
Tennis shoes
Squash / RaquetballMediumKnees
Ankles
Elbows
Shoulders
***
***
**
**
Appropriate footwear, protective eyeglassesContact with ball/ raquet could be harmful.
VolleyballLow/ MediumKnees
Hands (fingers/ wrists)
Ankles
**
**

*
Kneepads,
high-top running shoes
Increased risks with higher level of competition.
BasketballLow/ MediumKnees
Ankles
Fingers
***
***
**



High-top running shoes,
knee pads
High-top running shoes may prevent ankle sprains. Knee pads provide some form of cushioning when falling on knees.
BaseballMediumShoulders
Knees
Elbows
Ankles
**
**
**
**
Kneepads,
appropriate footwear
helmet (batting)
Higher risk of soft tissue injuries
SoccerMediumAnkles
Knees
Hips
***
**
**
Appropriate footwear,
shin pads
Higher risk of soft tissue injuries.
Football (tackle)HighKnees
Ankles
Shoulders
***
***
***
Helmet,
protective pads
High risk of head injuries and traumatic bleeds due to repeated heavy physical contact in tackle football.
RugbyHighKnees
Ankles
Shoulders
***
***
***
Generally not used in this sportHarmful due to high risk of physical contact. Increased risk of head injury and jarring injury to the spine.
Weight liftingMediumElbows
Shoulders
Back
***
***
***

Proper lifting techniques can lessen risk of injury. Recommended lifting through mid-range only. Increase number of repetitions rather than weight. Train regularly. Not recommended for young children.
SkatingLowKnees
Ankles
**
**
Proper fitting skates with good ankle support.Helmet is advisable during initial learning period. Knee pads or snow pants.
SkateboardingHighKnees
Ankles
***
***
Helmet,
knee and elbow pads
Risk of fracture and of head injury due to falling.
Rollerskating/ RollerbladingHighSpineStress on joints related to falling.Helmet,
knee, elbow & shin pads.
Risk of injury is high due to risk of falling on hard surfaces. Rough surfaces, hills and ramps increase risk.
Road hockeyMediumKnees
Ankles
**
**
Helmet and knee pads may be beneficial.Contact with stick and other players could be harmful.
Ice hockeyHighKnees
Shoulders
Ankles
***
***
**
Proper fitting skates with good ankle support. Protective padding (shoulder, elbows, knees). Helmet.Contact with puck, stick, boards, other players, could be harmful.
Nordic skiing (cross-country)Low/ Medium Knees
Ankles
Shoulders
**
**
*
Skis and poles of appropriate length. Boots with good support.The difficulty of the course will directly affect the degree of stress on joints and overall risk such as risk of falling.
Alpine skiing (downhill)HighKnees ***
Helmet, ski bootsAppropriate length of skis and poles The risk of head injury and traumatic bleed is high due to the inherent risk of falling at high speeds
Horseback ridingHighSpine **
HelmetThe risk of head injury and serious muscle or joint injury is high due to the possibility of falling off or being thrown from the horse. Jumping should be avoided.
BicyclingLowKnees *
Properly adjusted bike with seat at proper height.
Bicycle helmet.
Toe straps.
To minimize stress on knees: 1. Keep seat high 2. Avoid hills 3. Stay in lower gears 4. Pedal at high revolution (80-100 per minute.)
RunningLow/ MediumAnkles
Knees
**
Appropriate footwear (need good shock absorption, firm heel-counter, arch support).Running surface (example: concrete or uneven ground) will affect risk. Intensity of running (such as distance, speed, frequency) will also affect risk.
Karate/JudoMedium/ HighKnees
Elbow
Ankles
**
**
*
None If there is contact, the risk of injury is high. Without contact, the training can be good for improving muscle flexibility, coordination and balance.

Are there any vaccines a person with hemophilia should take?

Yes, there are. Hepatitis B can still be transmitted by certain blood products. The vaccine against hepatitis B is recommended for all people who routinely receive blood or blood products.

In very rare cases, hepatitis A has been transmitted by blood products. Therefore, doctors recommend vaccination against hepatitis A for people who receive blood or blood products. This is especially important for people who are infected with hepatitis C. This is because hepatitis A can be a serious, even fatal, disease for people who have hepatitis C.

There is no vaccine for hepatitis C.

What other precautions should a person with hemophilia take?

Every person with hemophilia should wear a Medic Alert bracelet or necklace. Hemophilia is not well known and not easily diagnosed. In the case of an accident, the Medic Alert bracelet will be very helpful to medical personnel.

People with hemophilia should carry a FactorFirst wallet card. These are distributed by Hemophilia Treatment Centres. Treatment information contained in this card is detailed and up to date.

PDF OF FACTOR FIRST CARD


Every person should be knowledgeable about his bleeding disorder, know what treatment he should receive in an emergency, and carry the information with him.

Before traveling, he should obtain a sufficient supply of treatment products and the addresses of hemophilia clinics in the areas which he will be visiting. The World Federation of Hemophilia provides information with addresses of clinics in most countries around the world.