Frequent sports participation boosts bleeding risk in new hemophilia study
Episodes most common during junior high school years, researchers report
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Youth with hemophilia who play sports frequently may face a higher risk of bleeding.
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Bleeding episodes were most common among junior high school students who played sports more than three times per week.
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Researchers say patients should consult their doctors to adjust prophylaxis based on activity levels.
Many boys and young men with hemophilia regularly participate in sports. However, doing so frequently — particularly three or more times a week — may raise the risk of sports-related bleeding, especially during early adolescence, a Japanese study reports.
“Regardless of sports type, most bleeding episodes happened during junior high school years, when physical growth, new sports participation, and intense physical activity are common,” researchers wrote, “highlighting the importance of tailoring treatment plans to individual activity patterns.”
The findings come from the study, “Factors Influencing Sport-Induced Bleeding in Patients with Haemophilia Without Inhibitors: A Single Centre Retrospective Study of People Born in the 2000s,” published in Haemophilia.
Study explored sports participation and bleeding risk in hemophilia
Hemophilia is a genetic disorder in which the blood does not clot properly because certain clotting factors — proteins needed to stop bleeding — are missing or reduced. Treatments that replace these factors can help prevent bleeding episodes and improve quality of life, allowing many people with hemophilia to safely take part in physical activities that were once considered too risky.
“In the past, [people with hemophilia] were often told to avoid exercise because even normal activities could cause serious bleeding. However, modern treatments that prevent bleeding episodes (prophylaxis) enable [people with hemophilia] to participate in sports,” the researchers wrote. Even with these treatments, however, sports-related bleeding can still occur.
For this study, the researchers reviewed medical records from 23 boys and young men with hemophilia, ages 14 to 23. Most (91.3%) had hemophilia type A, while two participants (8.7%) had hemophilia type B. None had inhibitors, antibodies that can reduce the effectiveness of clotting-factor replacement treatments.
Most participants (91.3%) were receiving prophylaxis to prevent bleeding episodes. Fourteen patients with severe hemophilia had started prophylaxis by age 4. Some with moderate hemophilia began preventive treatment later, between ages 8 and 16, while those with mild hemophilia typically received treatment only when bleeding occurred.
Of the 23 participants, 20 regularly took part in sports. Eighteen played sports at least three times per week, while two participated once or twice weekly. Three patients did not regularly play sports. The most common activities were baseball, swimming, and soccer, and 13 patients played at least one higher-risk sport at least once a week.
“The proportion of children participating in sports closely mirrors that of the general Japanese population,” the researchers wrote. Similar patterns have been reported in other countries, where “the proportion of [people with hemophilia] participating in sports was not lower than that in the general population.”
Bleeding episodes linked to frequent sports participation
Overall, 15 participants experienced 57 episodes of sports-induced bleeding, meaning bleeding that started during or shortly after physical activity. These episodes occurred in several parts of the body: 20 in the joints (intra-articular bleeding), 24 in muscles (intramuscular bleeding), and 13 under the skin (subcutaneous bleeding).
Most bleeding episodes occurred during sports involving greater physical contact or intense movement, such as baseball, soccer, and basketball (84.2%). They were also most common among junior high school–age participants, ages 13 to 15 (82.5%). Patients who played sports at least three times per week had about 2.2 times higher odds of experiencing bleeding than those who played less often.
In contrast, hemophilia severity was not significantly associated with the rate of bleeding episodes in this group.
“The findings showed that how often the boys played sports — particularly more than three times per week — was a stronger predictor of bleeding than how severe [hemophilia] was,” the researchers concluded. They suggested that young adolescents, especially those in junior high school, should regularly consult their doctors and adjust prophylaxis based on their level of physical activity.
