30. Physiotherapy Evaluation and Intervention in the Acute Hemarthrosis: Challenging the Paradigm

  1. Emérito-Carlos Rodríguez-Merchán MD, PHD3,4 and
  2. Leonard A. Valentino MD5
  1. Nichan Zourikian BSc, PT1 and
  2. Angela L. Forsyth PT, DPT2

Published Online: 12 MAY 2011

DOI: 10.1002/9781119979401.ch30

Current and Future Issues in Hemophilia Care

Current and Future Issues in Hemophilia Care

How to Cite

Zourikian, N. and Forsyth, A. L. (2011) Physiotherapy Evaluation and Intervention in the Acute Hemarthrosis: Challenging the Paradigm, in Current and Future Issues in Hemophilia Care (eds E.-C. Rodríguez-Merchán and L. A. Valentino), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119979401.ch30

Editor Information

  1. 3

    Department of Orthopedic Surgery and Hemophilia Unit, La Paz University Hospital, Spain

  2. 4

    School of Medicine, Autonomous University, Madrid, Spain

  3. 5

    Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, USA

Author Information

  1. 1

    Hemostasis Center and Quebec Reference Center, for Coagulation Inhibitors, Sainte-Justine University Hospital Center, Montreal, QC, Canada

  2. 2

    Penn Hemophilia and Thrombosis Program, Hospital of the University of Pennsylvania, Philadelphia, PA, USA

Publication History

  1. Published Online: 12 MAY 2011
  2. Published Print: 13 MAY 2011

ISBN Information

Print ISBN: 9780470670576

Online ISBN: 9781119979401



  • musculoskeletal;
  • hemophilia;
  • synovitis;
  • arthropathy;
  • physiotherapy;
  • hemarthrosis;
  • ice;
  • swelling;
  • rest;
  • weight-bearing


Musculoskeletal involvement in hemophilia, primarily synovitis and early arthropathy, continues as a hallmark finding. As comprehensive hemophilia treatment team members, physiotherapists focus on promoting joint health and maximizing functional ability. In hemophilia care, it is necessary for physiotherapists to combine clinical expertise with research findings to question and improve upon current practice standards. The current trend in the health professions is to employ evidence-based practice, rather than continuing to rely solely on anecdotal evidence or merely following the same traditional methods. This chapter will explore two current practices and future trends in physiotherapy for the acute hemarthrosis, using an evidence-based approach. The use of ice and recommendations for rest, as part of the traditional RICE protocol, will be addressed within the framework of the risk versus benefit model.

The importance of the evaluation in identifying potential causative factors will also be highlighted, as will proactive physiotherapy intervention, focusing on prevention of musculoskeletal complications.