Swimming provides equal parts fun and good-for-you physical activity. It is one of the safest ways to be active for people with bleeding disorders. “The beauty of water is that it is supportive. It decreases the weight on your joints, making it easier to move with less pain,” says physical therapist Nancy Durben, PT, of the Mountain States Hemophilia Center at Oregon Health and Science University in Portland.
Lap swimming
As with any new exercise, first consult your hemophilia treatment center (HTC) team and then start slowly. “If you plan to swim laps, start with just a few at a time to build up your endurance,” says Christine Rowell, MSPT, the physical therapist at Lucille Packard Children’s Hospital Hemophilia Treatment Center in Palo Alto, California.
What stroke you do is up to you, says Durben. But keep in mind that it will depend on what your joints can handle. “The breast stroke involves a kick/whip at the knee, and if someone has limited knee extension, this could aggravate it,” Durben says. “The butterfly is a particularly demanding stroke,” says Rowell. Save it until the others are perfected, she says. Be forewarned that some people cannot master this difficult stroke.
No matter what strokes you prefer, use the proper form. A swim coach can help you with that. Tell your coach about any joint problems and physical limitations, says Durben. If you have limited range of motion in your arms, try using a kickboard. Or if kicking is a problem, place a pull buoy, a squishy piece of foam, between your legs to give your arms a workout.
Swimming laps provides an excellent workout, but it’s not for everyone. Some people find them dull. Others lack the range of motion to perform all of the movements needed. For these folks, there are plenty of other options for pool workouts.
Walk it off
Water walking is a good exercise for everyone, and especially for beginners who don’t know how to swim. If you can’t swim, play it safe and wear a life vest while in the pool, Durben cautions.
To work different muscles, walk forward, backward and sideways, says Durben. “Even in water that is not deep, you get resistance to your muscles as you walk,” she says.
Safety first
While swimming in a pool is generally considered safe, there are some precautions that you should take. Ask your physical therapist to help you design a program for your specific needs. Find out if you should infuse before you swim. “It is a low-impact activity, but you are working hard,” says Durben. “Why risk a bleed?”
If you’re a lap swimmer, wear goggles so you can better judge the distance to the wall; otherwise, you risk colliding with it and causing a bleed. Further, goggles protect your eyes from chlorine, an irritant.
Other equipment to consider:
• Ear plugs, which reduce the risk of ear infections
• Swim caps, which protect your ears from water and your hair from chlorine
• Swim fins, which help you swim more efficiently
• Water shoes, which help prevent cuts and abrasions in and out of the pool
Finally, don’t forget to hydrate. You may be in water, but you still need to drink plenty to prevent dehydration. Durben recommends 20 ounces of water each hour that you are in the pool.