Sports and hemophilia : Antagonist or protagonist : Musculoskeletal problems in hemophilia

Until recent years the life for the person with hemophilia was dictated by the severity and frequency of bleeding episodes. Those with hemophilia tended to be overprotected and not allowed to participate in sporting activities normal to their peer group. The past 2 decades has seen a dramatic change in attitudes, mainly due to the introduction of factor replacement, home therapy, and comprehensive care programs. Those involved in the care of people with hemophilia now recognize that sport and exercise can reduce or prevent intraarticular hemorrhages. The arguments for and against sport as described in the literature from 1960 to 1990 are reviewed. Swimming, golf, and table tennis were recommended by doctors, whereas most contact sports, including football, were discouraged. The move toward more active pursuits brings with it an increase in sporting injuries, which is addressed in this article, but more importantly the prevention of injuries is highlighted.