Bleeding disorders, sports and exercise
Resistance training program
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- Bu səhifədəki naviqasiya:
- 2. The Borg Rating of Perceived Exertion Scale
- 3. Your Target Heart Rate
- Your Current Activity Level
- Bowling
- Cardiovascular Training Equipment
- Dance
- Diving, Recreational
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Resistance training program Begin resistance training only under the supervision of a therapist or trainer who can teach you the appropriate exercises and proper Play it Safe I 11
Stretching is one of the most important parts of your conditioning program, making your muscles more flexible and allowing your joints to move more freely. Here are some important guidelines you can follow: I Stretch slowly, holding each stretch for at least 30 seconds. I Stretch to the point where you feel a steady pulling sensation, but no pain. I Breathe regularly. I Don’t bounce; bouncing can damage your muscles. I Gradually increase the number of repetitions and the duration of each stretch. Your muscles may be sore after stretching, but soreness should subside within a day. If pain continues, decrease the intensity of your stretching. If a bleed occurs, stop exercising immediately and start appropriate treatment. In the first 24-48 hours following a joint or muscle bleed, factor replacement is the most important step to stop bleeding. Always remember R.I.C.E., a therapeutic method that can help you feel more comfortable and reduce swelling: R est
Rest the affected extremity, may use splints and crutches. I ce Apply ice packs or ice massage. C ompression Use an Ace wrap™ or compression bandage. E levation Elevate the arm or leg above the level of the heart as often as possible. Consult with your HTC team prior to resuming any stretching program. In Appendix 1, page 35, you’ll find a basic program of stretching which focuses on all of the major muscle groups. You can use these stretches to warm up or cool down. A physical therapist can also help you develop additional stretches for a particular activity. Strengthening A gradual, well-designed program of regular exercise to increase your muscle strength is another important part of any conditioning program. 10 I
1. The Talk Test I If you can sing during exercise, you are working at light intensity. I If you can talk but not sing during exercise, you are working at moderate intensity. I If you have difficulty talking during exercise, you are working at vigorous intensity. 2. The Borg Rating of Perceived Exertion Scale I Using the scale below, choose a number from 6 to 20 that best describes how hard you feel your body is working. To help you choose, think of slow walking as very light exercise (9). Exercise that is hard, but not so hard that you have to stop, would be rated 13. The most strenuous activity you’ve ever performed would be rated 19. technique. DO NOT apply resistance until you’ve seen the proper form demonstrated. DO NOT start with too much weight. A physical therapist or trainer can determine what amount of weight is right for you, based on the severity of your disorder and the condition of the muscles and joints you are training. If you have any joint degeneration, keep within a range of motion that is not painful for you. Begin with lighter weights and gradually increase the number of repetitions of each exercise. Prior instruction in weight training technique is necessary in order to reduce injuries. Warm-up, stretching, and cool-down should always be part of your weight-training program. In addition, spotting (having another person there to watch and help you) and good breathing technique are also essential. Weight training can help you maintain muscle strength and prevent joint or muscle bleeding. For more recommendations about strength training, see Appendix 2, page 40. Aerobic Training Aerobic training is exercise that boosts your cardiovascular fitness and increases your endurance. It usually involves low to moderate exertion over extended time periods. Generally, aerobic programs begin with continuous exercise for at least 15 to 20 minutes, three times a week. By increasing how long you exercise and how often you exercise, you will gradually become more fit. You can swim, ride a bike, or walk without high risk of injuring your joints, and these activities will also strengthen your muscles. In Appendix 3, page 42, you’ll find more recommendations about aerobic training. Measuring Your Effort How hard your body is working during exercise depends on how much effort you are putting out. For example, slow walking is light activity, brisk walking is moderate, and jogging or running is vigorous. The three methods below are commonly used to measure how intensely a person is exercising: 12 I National Hemophilia Foundation 6 No exertion at all 7 Extremely light 8 9
10 11 Light 12 13 Somewhat hard 14 15 Hard (heavy) 16 17 Very hard 18 19 Extremely hard 20 Maximal exertion © Gunnar Borg 1970, 1985, 1994, 1998 Play it Safe I 13
Sports Safety and Instruction Even if you’re physically ready and in condition to participate in a sport, there’s still one more thing you should think about: safety. You should have properly-fitted safety equipment specific to your sport. If you play on a field, it should be on an even surface, free of glass and other trash. Other possible causes of sports injuries: I Inadequate physical exams before participating I Grouping teams by age instead of size I Failure to warm up, stretch, and cool down I Playing while hurt or tired I Stress
I Playing on very hot or cold days I Not eating properly I Not drinking enough water When you begin a sport, instructors or coaches should explain the basic ability level you’ll need in order to play. They should suggest and explain conditioning exercises, including warm-up and cool-down periods, and tell you how to avoid injury. Ideally, coaches will be certified in CPR and first aid and understand how exercise affects the human body. Play it Safe I 15 3. Your Target Heart Rate I Your heart rate speeds up when you exercise and slows down when you stop. To measure your heart rate, find your pulse by placing your index and middle fingers on the side of your neck below your jaw or on the inside of either wrist. Using a clock, count your pulse for ten seconds and multiply by six. The resulting number is your heart rate in beats per minute. To condition your heart and lungs, you’ll want to get your resting heart rate to your target heart rate zone. Your target zone depends on your age and your maximum heart rate. You can figure out your maximum heart rate by subtracting your age from 220. Your target zone will be from 60% to 75% of your maximum heart rate, depending on how far you have gone in your conditioning program. Here are some examples: After six months or more of a regular program, exercises can be done at up to 85% of the maximum heart rate. However, you do not have to exercise that hard to stay in good condition. Set a comfortable workout pace and go slowly at first. If it takes longer than 15 minutes for your pulse to slow down after you stop exercising, or if you have trouble breathing or feel faint or weak, set a slower pace. These guidelines are a good starting point for an aerobic training program. As you become more fit, you can add skills that are specific to particular sports. And before you begin any aerobic program, talk to your doctor or physical therapist. 14 I
Your maximum Your target zone is 60% If your heart rate is 220 to 75% of your maximum age is
minus your age, or heart rate, or 15 205
123-154 35 185 111-138 50 170 102-127
Safe or Dangerous? No matter how well conditioned you are and no matter what level of instruction you’ve received, different activities carry different risks. Understanding these risks can help you make good choices about physical activity. In the table on the next two pages, you’ll find activities rated from 1 to 3: With the color coded table, you can easily see the level of risk involved in the particular activity you are considering. Levels one through two indicate that the benefits of these exercises or sports outweigh the associated risks. All sports that are rated 3 are not recommended for people with bleeding disorders. On the pages that follow, you’ll find information regarding each activity listed in the chart. Play it Safe I 17 Choosing a Sport: What to Think About Before you decide what sport or type of exercise is best for you, it’s important to think about how often you will participate, where you’ve had bleeds and whether you have any joint or muscle problems. Other considerations include: I
For many young children, the risks of playing soccer, baseball, or basketball are greatly outweighed by the social pressures to participate in these activities. As children get older, they are more likely to want to participate in organized sports. While different activities tend to be popular for different age groups, some sports, like swimming, tennis, golf, and bike riding, are good choices for everyone. They also strengthen muscles and increase flexibility, which can help prevent future bleeding episodes. I
Where you live affects the types of activities you are likely to consider. In some parts of the country, skiing is an everyday part of life. Riding a horse may be important if you live in the country, but less so in cities. You’ll also want to think about the overall expense. Are the fees, costs of the equipment and instruction within your budget? I
If you have not been active in a sport or exercise routine for a certain period of time, consult with your HTC team on the best way to start. 16 I National Hemophilia Foundation 1 1.5 2 2.5
3 Safe
Safe to Moderate risk Moderate risk Moderate to dangerous risk Dangerous
18 I National Hemophilia Foundation Play it Safe I 19 Activity Category Aerobics
2 Archery
1 Aquatics
1 Baseball
2.5 Basketball 2.5 Bicycling 1.5 BMX Racing 3 Bowling
2 Boxing
3 Canoeing
2.5 Cardiovascular Training Equipment Elliptical Machine 1 Rowing Machine 1.5 Ski machine 1.5 Stationary Bike 1 Stepper
2 Treadmill 1.5 Cheerleading 2.5 Circuit Training 1.5 Dance
2 Diving/Competitive 3 Diving/Recreational 2 Exercise Classes Body Sculpting 1.5
Cardio Kick-Boxing 2 Physioball 1.5 Spinning
1.5 Fishing
1 Football
3 Frisbee
1 Frisbee Golf 1.5 Ultimate Frisbee 2 Golf
1 Gymnastics 2.5 Hiking
1 Hockey (Field, Ice, Street) 3 Horseback Riding 2.5 Ice-Skating 2.5 Inline Skating 2.5 Jet Skiing 2.5 Jumping Rope 2 Kayaking
2.5 Lacrosse
3 Martial Arts – Karate/ Kung Fu/Tae Kwon Do 2.5
Martial Arts/Tai Chi 1 Motorcycling/ Motor Cross Racing 3 Mountain Biking 2.5 Pilates
1.5 Power Lifting 3 Racquetball 2.5 River Rafting 2.5 Rock Climbing (Indoor/Challenge Course) 2 Rock Climbing (Natural Setting) 3 Rodeo
3 Roller-skating 2 Rowing/Crew 2 Rugby
3 Running and Jogging 2 Scooter (motorized) 3 Scooter (non-motorized) 2.5 Scuba Diving 2.5 Skateboarding 2.5 Skiing/Cross Country 2 Skiing/Downhill 2.5 Skiing/Telemark 2.5 Snorkeling 1 Snowboarding 2.5 Snowmobiling 3 Soccer
2.5 Softball
2.5 Surfing
2.5 Swimming
1 T-Ball
2 Tennis
2 Track and Field 2.5 Trampoline 3 Volleyball 2.5 Walking
1 Water-skiing 2.5 Weight Lifting/Resistance Training 1.5 Weight Lifting/Power Lifting 3 Wrestling 3 Yoga
2 Table 5. Sports Ratings by Activity Activities have been divided into five ratings: Safe
Safe to Moderate risk Moderate to Dangerous Moderate risk dangerous risk Activity Category 1 1.5 2 2.5
3
Bicycling Riders of all ages should use American National Standards Institute (ANSI) or Snell Memorial Foundation approved bicycle helmets. From tricycles to multispeed bicycles, riding is a good non-impact sport. BMX Racing This is a high-collision, competitive sport with potential for serious injury. It is not recommended for people with bleeding disorders. Bowling This sport may cause excessive strain to elbows and wrists. Boxing Boxing is a high-contact, high-collision sport with high risk for head and brain injury and death. It is not recommended for people with bleeding disorders. Canoeing The risk of canoeing varies widely depending on the classification of the water current. While canoeing in relatively calm water can be relaxing and enjoyable, it can also provide a strenuous aerobic workout. Fast white water increases the risk for capsizing, with potential for head trauma and drowning. A U.S. Coast Guard-approved life vest/personal flotation device and ANSI-certified helmet should be used.
The equipment available will vary in different settings, but exercise can generally be self-paced.
This machine can be described as a cross between an exercise bike and a ski machine, with some treadmill and stepper attributes as well. Some have poles that provide an upper-body workout. Elliptical trainers provide a low-impact workout, lessening strain on the joints. They can provide a challenging cardiovascular workout. 1 2.5
3 2 3 1.5 Play it Safe I 21
This form of exercise varies widely and may involve participation in a structured class or use of a home video or DVD. Equipment such as steps, springboards, light weights or elastic bands may be used.
Archery, or shooting with a bow and arrow, can be done individually or as part of a team, and recreationally or in competition. Properly fitted and maintained equipment is required, and safety precautions should be followed to reduce risk of injury. Beginning archers should wear long armguards to protect from string rebound. Aquatics Aquatics, or water exercises, provides ideal conditions for people of all ages and levels of fitness. Water allows people with weak arms or legs and damaged joints to move less painfully. Chest-high water provides support, allowing people to complete exercises more easily than on land. Water resistance can also be used to strengthen muscles, and there are devices available that increase water resistance for a more challenging workout.
In this popular American sport, recreational and competitive teams are usually well organized and supervised. Risks include injury to the head, eye area, and chest as a result of being hit by the ball and joint trauma caused by sliding into base or colliding with other players. Players should use certified helmets with ear flaps on both sides, a chin strap, and eye protection. Padded chest protection and the use of softer baseballs may reduce the severity of injuries. Sliding and joint overuse due to pitching should be minimized or avoided. Playing the position of catcher presents additional risks of joint injury or trauma. Basketball Because of its popularity, most people who want to play basketball will do so despite the risk of significant joint and muscle trauma. The intensity of play varies from a casual game in the driveway to a highly competitive, organized game where heavy physical contact is the standard — a level not recommended for people with bleeding disorders. Protective equipment can be worn to protect eyes and joints, including high-top shoes or ankle supports. 2.5
2.5 1 1 2 20 I National Hemophilia Foundation
Cheerleading Basic cheers and jumps present minimal risk. The risk for injury increases with pyramids, lifts and throws, especially in competitive squads. Proper spotting is essential to minimize risk, and aerial moves are not recommended. Circuit Training This form of strength training uses machines or other resistance, such as free weights or exercise bands. Exercises performed in a sequence with little rest between sets can qualify as cardiovascular as well as strength training. There is little risk when using proper technique. Please see Appendix 2, page 40 for age-appropriate guidelines. Dance Dance may involve participation in a structured class with an instructor. It can be done both for recreation and performance.
A high-collision sport with potential for serious head and neck injury, competitive diving is not recommended .
Supervised recreational diving off a low board is acceptable. Exercise Classes Body Sculpting Classes generally combine cardiovascular and strength-training exercises to shape and tone the entire body. Equipment such as small handheld weights or resistance bands may be used. There are usually beginner to advanced level classes and participants can work out at their own pace. Cardio Kickboxing A popular trend in fitness programs, classes combine cardiovascular exercise with the agility, strength, balance, and coordination that can be achieved through martial arts training. Techniques range from easy to hard, with low impact to high impact movements and no contact to full contact. Full contact, high impact is not recommended. 2 1.5
2 3 2 1.5 2.5
Play it Safe I 23 Rowing Machine Rowing machines offer the benefit of an all over workout with little impact on the joints. Proper use requires some degree of coordination and practice. In addition to the aerobic benefits, rowing machines can strengthen arm, back, shoulder, and abdominal muscles. Users should be aware of possible strain to the knees and lower back. Ski Machine Ski machines mimic the movement of traditional ski poles in cross- country skiing. Instead of skis, they have long, narrow boards or foot pads that glide on rollers. Without impact on the joints, they provide a total workout to the arms, legs, back, and abdomen.
Stationary bikes provide a good aerobic workout and don’t require a lot of balance or coordination. Upright bikes position the legs below the body, while semi-recumbent or recumbent bikes place the legs slightly below heart level or directly in front of the hips, which allows for a reclined position. Some stationary bikes have dual-action levers for handlebars, which can be pulled back and forth to provide an upper body workout while pedaling. Stepper Steppers are excellent for exercising the major muscle groups of the lower body. The best steppers keep your feet on an even plane with the floor at all times, allowing natural foot movement. Accessories for the upper body can be added to provide a total body workout. Using proper form lessens strain on the knees. Yüklə 423,23 Kb. Dostları ilə paylaş:
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