Strength training is an important part of a comprehensive exercise program, especially as you get older. It not only builds muscle and strengthens bones, but it also protects your joints. In addition to using dumbbells or weight machines at the gym, strength training can be done at home with kettlebells, resistance bands or even your own body weight. But before you embark on a new strength-training program, it’s important to understand the modifications your bleeding disorder may require you to make.
Talk to Your Physical Therapist and Physician
Your doctor or physical therapist can help you design a workout that your joints can handle. Your PT also can teach you how to do each exercise properly. Correct form is key to avoiding injury. Finally, because your joint health can fluctuate from day to day, ask your PT to show you how to rate your joints before each workout.
“You have to honestly assess which are your stronger joints and which need a more conservative approach during exercise,” says Ruth Mulvany, PT, DPT, MS, retired associate professor of physical therapy and consultant to the University of Tennessee Hemophilia Treatment Center in Memphis.
Guided group workouts also offer the benefits of connecting with others and the potential to make new friends. Or bring a friend with you. “You can motivate each other and enjoy being out and socially engaged in a very healthy activity,” Mulvany says.
Use caution when picking a class, however. If you’re a beginner, select classes that emphasize gentle, low-impact routines. If necessary, talk with the instructor about modifying your workout to account for target joints, and ask if he or she would be willing to discuss your needs with your PT. If not, try elsewhere. Even if you’re a veteran of workout classes, you still want to talk to your PT before graduating to more intense classes.
“Group workouts are fun, energizing and beneficial if you have a good instructor who will modify instructions as needed,” Mulvany says. “If you feel intimidated at first, find a spot in the back so you can pause or stop when you need to.”
Exercise at Home
Turn on some music, a podcast, an audiobook or the TV as you lift or do body-weight exercises such as pushups and squats. Always warm up first for five to 10 minutes by stretching and marching in place while swinging your arms back and forth or pedaling on a stationary bike at a moderate pace.
If you use factor, protect your joints by timing your exercise session to coincide with the best period of factor coverage.
Don’t ruin the fun with exercises that cause you joint pain or stress your joints. And don’t attempt to lift weights so heavy that you can’t keep good, safe form. Plus, don’t forget to stay well hydrated. And remember: Exercise brings on soreness, which often starts 24 to 72 hours after your workout. That’s normal. But don’t ignore pain, swelling and tenderness that signal a muscle or joint bleed.
“Start off well informed, pack away your competitive edge, make good decisions, be patient and go slow until you can see how you and your body respond to the challenges of strength training,” Mulvany says. “Then enjoy the satisfaction of seeing your improvement.”
Visit the National Hemophilia Foundation’s Steps for Living website to find fitness videos and PT webinars, and to download the Playing It Safe: Bleeding Disorders, Sports and Exercise booklet.