hi, I searched for and read some earlier posts here about cold water swimming but have a slightly different question ... I hear of people going into shock in cold water, is that a situation where adrenal glands not being fully recovered could be dangerous? Theres winter outdoor swimming near me, I wondered about trying it .... I love swimming but usually in the warm. Sorry if silly question, I am realising that I dont know much physiology ....
çold water shock adrenal issues?: hi, I searched... - PMRGCAuk
çold water shock adrenal issues?
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Excelsior80
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Personally, although I love swimming, I would not go cold water swimming with PMR. Particularly as the weather gets colder. Even with a swimming pool I find some are now too cold as theyare trying to save on heating.
I do outdoor swimming in the Highlands and I love it. I always feel better after I’ve done it. Strangely my skin always feels really smooth afterwards too. Generally we go to local lochs but 10 days ago we went to the coast, swam in the sea and used the horsebox sauna there. It was fabulous! I’ve started layering up a bit in the lochs (swim leggings and thermal rash vest) and I wear gloves and booties year round (they make a big difference) but just wore a swimsuit in the sea. Is it sea swimming you’re considering or is it loch/lake swimming?There will likely be groups near you (Facebook actually have a lot of good ones) so maybe enquire with them first? Also it’s probably not a great time of year to start as the water is cooling down significantly now. Maybe wait until next year once it’s started warming up? Never go alone. Don’t stay in too long. Don’t jump in. Go in gradually. Know your own swimming abilities. Take a hot drink with you. Never go if you’re not feeling well. And if you do decide to do it, enjoy!
a lake and a local outdoor pool ... nothing as amazing as lochs and sea, but still nice . Thank you for advice 👍..... and the outdoor pool offers induction for beginners so might be best first attempt ... but i think next year good plan 🙂
I like it when the pool is slightly on the cool side. I feel normal then. The aches and pains and fatigue vanish ... until I get out again! Then I go and have a nice warming sauna. 
I don't think that outdoor cold water swimming is something that I am ever likely to try, so I can't tell you if it is OK. I'm not keen on swimming in open water or where I can't see below the surface. Though I seem to remember in the past that a couple of people on here have mentioned it, so maybe they will stop by if they see your post. I have an idea that people who do this seriously, gradually build up the amount of time that they can spend in the water.
For sure, suddenly jumping into deep cold water can be dangerous, especially if you have a heart issue, but also, unless you are used to it, I have read that the danger for some people, is that the gasp reflex is so strong that they have inhaled water and drowned. So my suggestion would be that if you want to try it, see if you can find a group that meet for cold water swimming so that you can do it safety.
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There are a few people with PMR who cold water swim - I struggled to do aquafit in a WARM pool, if the boiler was playing up, I would get straight out again or I seized up! So it is a personal thing I think.
The cold water shock thing you have read about is probably the phenomenon where someone enters water when the air temperature is far higher than the water temperature but it also happens in cold air to cold water situations as in large lakes or the sea as described here:
coldwatersafety.org/cold-shock
Cold water swimming is a rather different situation, you enter the water in a safe manner so your head isn't under water when that big intake of breath happens!
outdoorswimmingsociety.com/...
There are lots of groups - see if you have one locally. But I would say speak to your GP before trying it and it is probably better to start in the late summer so you get used to colder temperatures gradually.
thank you everyone so much and very helpful ....I think Im still struggling to realise that just because mostly feeling OK, just a bit tired, at the moment I can't do everything I planned before pmr ☹️ I will ask medical advice, and think about next year when its warmer .... I do realise things could change at any moment .... its only been 4 1/2 months since diagnosis .... some setbacks can be expected and I definitely dont want to cause them
You could start to prepare now - with cold water showers, You start with gradually cooling the end of your shower - much gentler!
healthline.com/health/cold-....
Wonderful programme with the late Dr Michael Mosely last night (BBC1) .about cold showering and swimming.....amazing results!.....
Maybe something for people to watch on catch-up!
Certainly is....very surprising......
I wouldn't find it so - it's been a "thing" over here for many years, long before Wim Hof or Gwyneth Paltrow! They do a thing called Kneipp therapy which is application of warmth and cold water
kneipp.com/us_en/hydrothera...
Of course you don't REALLY need all the products they are flogging!!
suedtirolerland.it/en/leisu...
and can be done in any suitable water and surfaces - we even have a path built in one of our villages for tourists and locals to use. This video is from another local village
pustertal.org/en/video/knei...
Lord knows when they filmed this - haven't seen boots like that in decades!!!!! But that was "mindfulness" long before it became fashionable.
bbc.com/travel/article/2023...
Lovely video. Along with the cold water etc….nature, can’t beat it…. Getting away from all that’s going on.
Two old friends picked me up on Monday to go out for lunch, took extra pred, was lovely catch-up, today can hardly get out of the chair! Sunny here now so hopefully escape in the summerhouse., out of one chair into another. Thanks for that.
His book Just One Thing is also good
I watched that. He did say to start with a few seconds in the shower and more than 30 seconds doesn't make any difference which made me think one day I might try it.... might is the operative word... 😉
might! 🤣
A girl should always keep her options open. 
Was going to comment 'madness' until I read your reply! Don't want to think I have a closed mind......🥶
lol well, I won't be getting into a cold shower. But I don't mind a coldish swim. I'm going to Mexico next month, so hoping to do lots of swimming in warmish water.
I might try the shower ... but the joy of outdoor swimming outweighs a bit of cold and the shower isnt the same .... only swam outside in warm weather so far .... i could regard the shower as preparation for the real thing, that might work
It is used a lot here in Germanic Europe - people do take a lot of responsibility for their health here and generally do seem to be pretty healthy. It is used in mainstream medicine in their spas where they do rehab treatments. I could have a 3 week rehab in a German spa clinic if I wanted - I haven't been because a mix of back/hip problems and atrial fibrillation really made me feel I wouldn't get much out of it.
Exactly!!!
Personally, as an ex cold swimmer ( and coastal lifeguard in my very distant youth) prior to having GCA I would not touch cold water swimming with a barge pole.If you aren't used to it prior to having any health condition I wouldn't advise it either.
If you are going to try it you should test your pressor response to cold water beforehand by putting your hands in ice water for a minute, or try seeing your reactions after a minute in a cold shower.
You need to dress appropriately, with wet suit or long leg triathlon suit and rash vest , head gear , gloves and booties , if you are swimming in wild water ( not a pool) they usually recommend a foot float these days even if you swim in a group.
You also need to be well prepared with warming towels and a robe as you get out and a warm drink , then dress warmly as soon as possible, even if you've only swam for a few minutes .....which is usually the limit you can take as a beginner.
Wild swimming or cold water swimming isn't advised as a sport until you have improved your ability to swim, improved your breathing techniques and stroke pace and increased your muscle tone and strength in a normal pool.
Cold water swimming is like lifting a bar weight in comparison to leisure swimming which is like using hand weights at home. It's not really good for you to jump into the heavy stuff until you have built up from the light.
If your adrenal and autonomic responses are affected by your health issue or your medication swimming or bathing in water that is too cold or too hot will bring on an "overshoot" of your sympathetic/ cardiac reactions.
This can cause you to faint , be dizzy, or feel nauseous.
It can also produce a auto inflammatory reaction which can stiffen joints during the swim or dip and can produce a inflammatory flare or DOMS within the next 24-48 hours.
It's also important to take care with things like saunas, steam rooms and hot tubs, even very hot Hydrotherapy pools , especially if you also have cardiac or blood pressure conditions as well.
They can't be too hot, you need to warm up with a shower before them and not use the old process of a cold shower to hot space.
It's better to start with just a few minutes to ensure you are able to cope with it.
You need to drink plenty of water before and straight after.
You need to use them for a reduced time and when you leave have a warm shower before re-entering a pool , put on a robe or dressing gown for a while before getting dressed or swimming, make sure you are warm and properly dry before going outdoors.
You usually need a snack after using them like nuts or a small banana to help restore salts just as you would after a workout.
It's better to leave it 15-30 minutes after a heat therapy before driving.
Heat therapies can be useful for the stiff joint pain as long as you use care and prepare properly.
Any facility offering cold or cryotherapy should be requesting a full medical history and checking which medication you take before signing you up. This is true for heat therapies too. If they don't , and do not suggest you try a taster of a few minutes in a cold water tub I would not trust using it. If they don't follow the safety protocols before accepting you they are also unlikely to be well trained in helping you if something goes wrong.
Basically, when I did Coast Lifeguard duty and guard sessions at the outdoor swimming pool , I would have sent people with things like PMR back to the changing room.
Have you tried swimming at the local pool or aquafit classes , they would be a better start.
Take care , Bee
brilliant advice, many thanks
kept getting logged out so made it short ..... i recently learned to sail, small dinghy local club and wondered whether capsizing into the lake might be extra problematic now .... stopped for winter anyway ..... and i do swim a lot normally but as you say leisure only
What dose of steroids are you on ? Do you have other health conditions and take other medications?
This all makes a difference to what are considered safe sport activities, especially water sports.
When you say a dinghy what type of dinghy do you use.
Personally I found sailing was too hard on the arms and hips and could bring on DOMS or a flare.
I was able to continue kayaking , canoeing and paddle boarding in summer or warm waters on good days or when my symptoms were under control, but that was something I worked back up to after having my symptoms under control for some time.
Sailing does put more strain on the muscles , shoulders , arms and hips than you might feel as you are enjoying it, much like golf or racquet sports.
If you do capsize you obviously don't have the same sympathetic reaction because your cortisol level is already being kept artificially high by the steroids.
This can be problematic if you put your body under rapid stress so although you may be fine when you capsize you are more likely to feel the effect of that stress in the days afterwards with more intense DOMS pain or a PMR flare.
I have Chronic Dysautonomia which causes similar reactions to activity as high dose steroids on my cardiac reactions and temperature regulation , it's not well controlled currently so I can't even manage a gentle swim.
Basically, you are early in your PMR journey, it's better to learn to pace your activity now and have a gentle balance of rest and activity to reduce stress because this reduces the risk of having increased inflammation and PMR flares which requires you to keep Yoyoing steroids doses up and down.
Very comprehensive info from bleary eyed. It prompted me to check the water temperature for Gulf of Mexico at this time of year and I found 24*C. Compared with what seems to be average for a UK indoor pool of around 28*C. I find the pool at the gym a bit warm some times, so I think that will be OK for me. I guess I will just have to take care not to stay in the water for too long. I'm really hoping to get some snorkelling in. I won't be swimming alone.
24C in the sea sounds blissful, I don't think it got beyond 20C on the Welsh Coast this year even in the middle of August. If you aren't alone and you pace yourself you should be fine.
You should do some gentle stretching or have a stroll to increase your heart rate and warm up before you get in.
When you get out , get dry , get dressed including a cap if your hair is wet and get warm even if the weather is hot and have a drink of water and a warm drink.
The point of this is to stop the big swing in temperatures from cold to hot ( which you feel even in the sun if you have wet hair and skin as air drying super cools).
You can always reduce your clothing when you have warmed up.
Have a snack after a swim because you do lose salts in the water , and do perspire when you swim even if you can't feel it.
Moisturise or put on new sun protection as soon as you have dried.
Steroids make your skin dry , more fragile and less elastic so swimming can make this worse.
The cream also prevents you losing more moisture and salts to the air from your skin.
The act of putting on the moisturiser warms you up quicky because the rubbing action encourages better circulation at the surface of your skin,
Listen to your body even if you are really enjoying yourself. It's often better to do a few ten minute swims or water walks over a day rather than one long one.
When you feel swimming is taking more exertion or muscles start to feel tighter as you use the same stroke , or you require more rapid breathing to keep going it's time to get out, even if you have booked a longer session or your mind wants to do just ten more minutes.
Try not to make the holiday mistake in general of trying to fit in too many activities or doing sports or exercising longer than you would at home. If you don't want DOMS or a flare of inflammation you need to continue at a well balanced pace as you hopefully do at home. Unlike before PMR you can't do lots on one day and hope you will just cope with the extra muscle pain it causes. If you do get DOMS from any activity you must have a slow day even if you'd planned another day of sight seeing. If you don't , you won't just work out the pain you will increase it and that is more likely to trigger a flare.
Use those tricks and you should be able to enjoy your lovely warm sea water. I'm very jealous sitting here already needing the heater on and a hot water bottle at night....Bonne Voyage, Bee
"I don't think it got beyond 20C on the Welsh Coast - actually the highest sea temps are often in early September. And that would be positively mediterranean compared to the North Sea. So I looked - Cardiff average temp is under 17C in August. and here is some interesting info on sea temps around Wales!!
seatemperature.org/europe/u...
The warmest beaches in the UK are around Kent and Essex.
We used to be quite lucky on Anglesey until the weather in Summer has become so awful , the sea temperature would reach 20/21C during late summer early autumn, sometimes in sunny years it was that warm in July. The irony of Global Warming isn't lost on swimmers whom like to swim in the sea in the Northern Hemisphere.
I have that nasty pale freckly skin that goes with red hair, so I doubt that there will be much exposed flesh about, except for when I am in the water. lol
I've been watching the weather out there and next 2 weeks at least is 29/30 *C, so I don't expect to be cold when I get out of the water. However, the hotel is right on the beach and I don't sit on beaches, so I am expecting to don my Toncho and waddle back to my room for a shower and whatever ablutions are needed.
I swim fairly regularly, so I am used to the pool temperatures, at least, and I will have a bit more stamina by the time that I go away. Anyway, with regard to getting over tired, I am just sorting out a hire car for the week that I am there on my own.
It's quite an interesting trip, really. it is a 10 day birdwatching trip with some time to visit Chichen Itza and also the opportunity to swim with turtles. I like to go out the day before a birding trip starts to get over my jet lag, but this time I am heading out the week before the rest of my group, as the hotel is in a really beautiful place. The car means that I can visit another of the archaeological sites not too far away and the archaeological parks are usually good safe birding spots. Plus, I can then also visit the cenotes, which are natural limestone sink holes, where you can go to swim for a small fee and are also good birding spots. There is also a possibility of catching the foot ferry out to the offshore island Cozumel and I am checking out whether there is a park that I can go to site and bird there. Anyway, the whole point of the car is that I can get back to the hotel to take a nap in the heat of the day, and if necessary, I can take a rest in the car if I am out for the day. The idea of the week before is to relax in the warmth and build up my strength for the birding tour.
Sounds amazing, as a photographer and ornithologist it's just my kind of trip.I've read what you are planning and I might add the suggestion that you remember you have gone over early to recover and rest from the travel as well as to build up your strength.
You've got a lot of potentially physical trips listed with very few quiet ones. I know you won't want to miss anything but keep in mind that you don't want to do so much before the others arrive that you are having a flare when the birdwatching part of the trip begins. With PMR you do suffer DOMS much earlier than you would have before when you use muscle differently. If you do get DOMS with PMR you need to rest the following day , not just carry on and expect it to work itself out as you did before.
If you don't pace yourself , especially with DOMS , you will trigger a flare.
Resting in the car is a good idea but it will need to be longer than you would hope, as the driving itself will also be activity that will cause stress in a less known area.
Your body temperature drops quite quickly when you leave the water even in hot weather because of the movement of air over the skin, so it's still worth wrapping up straight after getting out of the water even if your plan is to head up to the hotel or beach shower.
Wrapping up and getting dry will be particularly important to plan for if you plan to go in a natural hot spring or go snorkeling.
As I say , it's sounds like my dream holiday so I'm just giving you the reminders I would have to give myself to pace myself and take the extra precautions to enjoy it without the rebound of pain.
Have a great time , Bee
Thank you, I'm sure I will have a lovely time. I've got pretty good at pacing myself now. I think the heat will be enough on its own to make sure that I take it easy.
Funny how much we learn about other people in the group and how much we have in common.
that sounds amazing! I swam in the sea last week on walking holiday in Spain, after strong warnings here about not overdoing it I did rest a bit every day and was alert not to get too tired or push myself but I was fine walking every day ... and felt so much better after a week mostly in the open air. Then felt very tired after coming back but I think that might have been the drop from 9mg to 8mg pred the day after I got back, and feeling back to normal a week later.
I find that being out in the fresh air does me a lot of good too. I always feel a lot better when I have been away and spent most time out of doors.
The cenotes are fabulous. I spent two weeks scuba diving in them a few years ago and I loved every minute. I also went to Cozumel to snorkel with the whale sharks which was good fun too. I didn’t go to Chichen Itza but went to Tulum which was amazing. Enjoy your holiday.
Thank you. I think that our trip does visit Tulum. I love the idea of diving in the cenotes, but alas, I think that would be well outside my capabilities. Lots to see and do over there. I have an idea that I might end up going back to the Yucatan as an independent traveller, if I like it there. This trip will just scratch the surface, I think, and I met some people recently who have visited several times.
Personally I can't think of many things that would be worse. Love swimming although it doesn't like my OA, but I hope to have three of the GC's swimming in the next few months. One just about there, one nearly and not started the third one yet, he will be "interesting".
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