Keeping Fit

Keeping Fit During the College Years

Although maintaining fitness is important throughout the lifetime of a person with a bleeding disorder, doing so while in college can be especially critical. The physical benefits of exercising while in college are the same; strong muscles, protected joints and prevented bleeds but the behavioural ramifications run much deeper. For students with haemophilia, college is the beginning of an era of freedom, one without parents hassling them to stay in shape or making sure they infuse before going to play tennis. From making new friends, to studying, to staying healthy, college poses many challenges in terms of exercise. It also offers people with bleeding disorders an excellent opportunity to develop lifelong fitness habits. The college lifestyle has many aspects that facilitate staying in shape.

The most beneficial type of peer pressure college students encounter is to exercise. College, unfortunately, is likely the last time a person with a bleeding disorder will be surrounded by a large number of peers who are serious about fitness. For most college students, it is easy to find a roommate or classmate to be a work-out partner or make new friends while exercising.

“I had to adjust my exercise habits significantly once I reached college. I have severe haemophilia A and over the past two years, have developed tendonitis in my left ankle, which was a target joint for most of the eight years I played soccer as a child. As a child, I could be physically inactive for extended periods of time and then go out and play soccer for two hours with no consequences. Now, if I fail to keep my joints strong and flexible by swimming or working out in the gym and I try to participate in sports (tennis, soccer, basketball), I will usually have a bleed (often in my left ankle). I have learned that although I enjoy basketball more than swimming, it is too hard on my joints to play basketball if I haven’t built a solid muscle foundation through swimming. Surprisingly, I’ve also discovered that when I am stressed out with schoolwork, that I exercise the most (in order to relieve tension and take a break from studying). Maintaining fitness is a learning experience, and the ultimate goal of adopting life-long fitness habits will require trial and error, combined with lots of hard work. ”

With all these factors that promote exercise, college serves as a key test as to whether or not an individual will be an active adult. An individual with a bleeding disorder who finds a physical activity in college that he enjoys and is motivated to do on a regular basis, will be healthier in the short term and likely in the long term. “College is a good time to explore and develop exercise habits that can last a lifetime”, says Marc Gilgannon, a physical therapist at the University of Virginia’s Haemophilia Treatment Centre. Unfortunately, this trend works both ways. A recent study at Ohio State found that students who left college as sedentary individuals were highly unlikely to adopt a physical active lifestyle. For people with bleeding disorders the choice is clear; get into the habit of exercising while in college or face a lifetime of increased bleeds and more severe joint damage. What kind of physical activity should students with bleeding disorders pursue in college? Aerobic activities such as biking, swimming, hiking and low impact workout machine are safe for most people with haemophilia and should be an integral part of their fitness routine. These activities build muscles to protect joints and decrease the amount of joint bleeds with activity. Prior to participating in sports it is important to first gain flexibility and solid muscle foundation through aerobic activities.

Taking part in sports is inherently riskier for a person with a bleeding disorder, but the benefits of these activities generally outweigh the risk. Only time will tell if a particular activity is going to provoke unacceptable bleeding and the chances of this happening will be reduced by careful attention to warm-ups, stretching exercises and cool downs.

These activities provide social and psychological benefits that range from strengthening relationships with friends to improved self-confidence to valuable experiences of competency and success. An important part of college is exploring and engaging in relationships with a diverse group of peers and participating in these sports can vastly improve one’s ability to function in a team environment. Engaging in sport can also change the perception others have about haemophilia and dispel the myth that ‘haemophilia is the disease where you will die if you get a paper cut’. The same is not true for participating in dangerous contact sport like rugby or hurling and these activities should be avoided by people with haemophilia.

Weightlifting, one of the more popular physical activities in college, is convenient for college students. Rather than working the biceps and triceps in front of the mirror, Gilgannon recommends low impact workouts (lower weights, more repetitions) that strengthen the knees, ankles and elbows – three of the most frequent sites of joint bleeds in people with haemophilia. Certain practices such as ‘maxing out’, that are common in college weight rooms, should be avoided. “When you’re doing overly strenuous free weight lifting, you’re causing micro tears in your muscles. This happens to everyone but obviously, has more severe consequences for the haemophilia population”, Gilgannon says.

Before beginning an exercise programme, a college student with haemophilia should consult with a haematologist or physical therapist to develop a fitness routine, complete with pre and post work out stretches. College students with bleeding disorders must take responsibility for prophylaxis before physical activity if a haematologist advises it. For many people with bleeding disorders, college will be the first time they will assume ‘ownership’ of their disease. This ranges from ensuring that sufficient factor is always on hand and in case of emergency to properly disposing of sharps, to locating a sanitary place to infuse in dirty dormitories and apartments.