Blood Disorders Dangerous and Safe Sports Choices for Children With Hemophilia By Amber Yates, MD Amber Yates, MD LinkedIn Twitter Amber Yates, MD, is a board-certified pediatric hematologist and a practicing physician at Baylor College of Medicine. Learn about our editorial process Updated on December 24, 2021 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Douglas A. Nelson, MD Medically reviewed by Douglas A. Nelson, MD LinkedIn Douglas A. Nelson, MD, is a board-certified oncologist and hematologist who previously served for 13 years as a physician in the US Air Force. Learn about our Medical Review Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process Print Learning that your child has hemophilia (or another bleeding disorder) can be life-changing, particularly if there is no family history of this condition. Many questions may be swirling through your head. A common question heard in the pediatric hemophilia clinic is “can he still play sports?” The short answer is yes, but there are some things to consider. Nick David / Getty Images Although spontaneous bleeding is most common in severe hemophilia, bleeding with injury is increased in all forms of hemophilia. This is the biggest concern when children with hemophilia play sports, particularly in sports with contact (basketball) or collision (football) sports. Although there are concerns in certain sports, physical activity is recommended for all patients with hemophilia. This includes participating in physical education classes in school, with appropriate restrictions. Being in good physical condition can prevent injury and bleeding episodes. However, the risks and benefits of each type of physical activity must be carefully weighed. Factors for Your Child's Safety There are many factors that go into determining if your child can participate in sports or what sports are safe for your child to play. These include: The severity of your child's hemophilia: There are three levels of hemophilia: mild, moderate, and severe. More severely affected patients are more likely to have bleeding episodes secondary to a sports injury. Families of children with severe hemophilia are likely to recognize a bleed secondary to injury early and treat aggressively. It is important for families with more mildly affected children to be watchful and initiate treatment as soon as possible. Number of bleeding episodes/condition of joints: Joint bleeding causes damage to the joints themselves, increasing the risk of additional bleeds. It is important to consider what joints will be more likely to be injured during sports. So, if your child's target joint is his dominant elbow, maybe tennis isn't the best choice. Level of activity: As children age, the intensity of sports also increases. Basketball is considered a relatively safe sport for young children but might need re-evaluation if your child is participating on the high school varsity team as the likelihood of injury increases. Recent bleeding: It is important to discuss with your hemophilia treatment team when it is safe to resume sports after a bleeding episode. Increasing physical activity too soon after an event could lead to repeat bleeding and/or joint damage. Physical Activity and Sports Risk Ranking The National Hemophilia Foundation ranks sports/physical activities from 1 to 3 based on risk. These are often also used for other types of bleeding disorders like platelet function disorders. Examples are as follows: Category 3: Dangerous These activities are NOT recommended for anyone with hemophilia. These sports have a risk for significant, life-threatening bleeding. BMX bikingBoxingPowerliftingRodeoFootballHockey Category 2.5: Moderate to Dangerous BaseballBasketballCheerleadingSkateboardingSoftball Category 2: Moderate Risk AerobicDanceJumping ropeRowing/crewTennis Category 1.5: Safe to Moderate Risk Circuit trainingPilatesTreadmillWeight lifting (resistance training, not powerlifting) Category 1: Safe Elliptical machineGolfHikingSwimmingTai Chi If your child with hemophilia wants to play sports, it is important to include your hemophilia treatment team in the decision. For some sports, there are modifications that can be made to reduce the risk of bleeding. For example, when playing baseball/softball it is recommended to wear a helmet (all the time, not just with batting) and to avoid sliding into base. Similarly, a helmet should be worn while riding a bicycle/scooter or skating. A potential solution for higher risk sports (not category 3, which is never recommended) for patients with severe hemophilia is timing prophylactic factor treatment just prior to sports activity. Patients with mild to moderate hemophilia may need to start prophylactic factor infusions, particularly during their sporting season. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. The Centers for Disease Control and Prevention. What is Hemophilia? University of Michigan Health. Hemophilia: Preventing Bleeding Episodes. Hemophilia News Today. Severity Levels of Hemophilia. UpToDate. Hermarthrosis. Costa e Silva L, Fragoso MI, Teles J. Physical activity–related injury profile in children and adolescents according to their age, maturation, and level of sports participation. Sports Health. 2017;9(2):118-125. doi. 10.1177/1941738116686964. The Cleveland Clinic. Hemophila.