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This website is intended for carers and patients living with haemophilia.
How is physiotherapy used in haemophilia?
Exercise plays an important role for anyone in maintaining a strong and supple body and, for people with haemophilia, when this is combined with specialist physiotherapy it can help prevent chronic joint and muscle problems.
This is vital to anyone with haemophilia, as they are more likely to have periods of enforced rest or immobilisation due to bleeds. Therefore, there is an emphasis on the need to recover well, not just from the bleed but from the loss of muscle tone, which in some muscles will start to break down after only 24 hours of bed rest.
And it doesn’t matter at what age you decide to consider exercising. Many people feel that they should have done more about their health and fitness when they were younger, but everyone can make improvements in their health, wellbeing and even happiness by taking control in this aspect of life. The key for those with haemophilia is to make sure they get good, individualised advice from an expert.
A physiotherapist who specialises in haemophilia can give advice on what to do to maintain or improve health and fitness regardless of a person’s age or their joint problems. They can tailor an exercise programme that will maximise activity without doing damage to problem joints or muscles.
Specialist physiotherapists also play an essential role in giving advice and prescribing exercises or specific treatment, such as a hydrotherapy pool or gym, to speed up recovery from bleeds and to help protect the joints and muscle from the effects of a bleed.
If you do have a bleeding episode, the PRICE or RICE regime is very useful. The letters stand for:
Protection – try to take the weight off your joints, perhaps by using a sling or crutches
Rest – this helps the healing process. Try not to use the injured joint or muscle too much
Ice – ice can help with pain and reduce swelling and bleeding. Wrap an icepack in a towel and place over the affected area for 10 to 15 minutes. Do not leave the ice pack on for more than 20 minutes, or repeat it more often than every two hours, or put the ice pack directly on your skin.
Compression – sometimes an elasticated bandage can help reduce swelling
Elevation – this can help reduce swelling by draining the blood away from the affected joint or muscle. If it is your ankle or knee, you could lie on the sofa with your leg on some cushions. If it is your elbow or hand, you could rest it along the back of the sofa or put it in a sling.
But these techniques are really only first aid in preventing a bleed from progressing too quickly, by slowing down or reducing the amount of blood that leaks into a joint or muscle and need to be used alongside factor replacement or other treatment to stop the actual bleeding.
After the acute phase of the bleed has ended, getting the joint or muscle moving again is critical. Especially important is striking the right balance of doing enough to restore physical movement and not overdoing it and risk re-bleeding. This is best achieved with advice from a specialist at your Centre and ideally a specialist physiotherapist - they have a very good understanding of body movement and the healing process.