The psoas muscle runs from the side of the backbone and sweeps forwards round the pelvis to emerge in the front of the thigh. If not stopped quickly bleeding into it compresses the major nerve to the quadriceps group of muscles leading to weakness, instability of the knee and a loss of sensation to touch which can extend from groin to foot. Recovery from a poorly treated psoas bleed can take many months. Physical activity promotes powerful muscles which protect the major joints. Flabby muscles cannot support joints properly and bleeding episodes are more frequent.
Obesity adds to the problem by putting more strain on the unstable joints.
Children of all ages should be encouraged to participate in sports By the time the boy with haemophilia has reached adolescence he should know which activities he enjoys. He should also be learning those activities which result in bleeds and, if these occur during a sport he has set his heart on, whether he can control them with prophylactic factor VIII or IX beforehand. Regular, enjoyable sport results in feelings of well-being and fulfillment, which help counterbalance the unease and loneliness that haemophilia can provoke. Team work is another powerful weapon in dispelling ideas of isolation or handicap. Recently, on behalf of the World Federation of Hemophilia, I asked colleagues for their views on sports most suited to people with severe haemophilia A or B. All were agreed that swimming, table tennis and walking were to be encouraged, and many more sports were recommended.