Saturday, April 8, 2017

Swim Failure/Cold Incapacitation - No matter who you are as a swimmer-The cold will take you at some point.

If a swimmer swims past their limits in cold water - The risks are very serious. 
The impact of the cold water will stop us as swimmers from rotating our arms or the swimmer will fail - Every swimmer has a limit in Cold Water-the cold will eventually incapacitate us all that is a certainty. Allowing a swimmer to get this point can be very dangerous so knowing the limits of each swimmer is vital for safety. 

One of the scariest moments I have ever experienced was when crewing for a cold water swim I realised that my swimmer was still moving their arms but was not actually lucid-they were swimming in 'automatic', when their eyes looked at me they were not focused and their ability to communicate was nil.  We were terrified. All I could think about was 'how am I going to get this swimmer back?' How are we going to get this swimmer out of the water? and mostly how did that happen? No one trained us for this moment-Understanding the challenge of each swim is vital -more to prevent a swimmer getting to this point-we were shocked as to how a swimmer could have over ran their own check system and how they continued to swim past their own signs of failure. How did the swimmer continue to swim when there was no cognitive responses?  

Swimming long distance in cold water (Distance is relative to temperature for this article) is a very challenging task both from a physical but also more importantly a cognitive level.
It is very possible for the swimmer to swim beyond their limits. 

How a swimmer responds depends on how cold the swimmer has become on the inside and how cold the environment is on the outside.  For a certain period of time the swimmer can produce adequate heat to stay warm -at very low temperatures the body will begin to cool down.
 The temperature of the muscles in the arms and legs starts to cool down first - That is our priority area for swim failure. In Ice and cold water this can occur rapidly -muscles can lose up to 3% of it's maximum power per 1 deg loss of muscle temperature according to Golden and Tipton (2006).  We see this loss of power so clearly defined and visible with swimmer's arms moving badly, and not able to maintain the full push or pull of the stroke.

As the swimmers become colder and colder -many will lose adequate power even to maintain the body position either to stay going and or in some cases to stay above the water.
It is at this point that the risk increases exponentially.
There will also come a point in some distance swims where the swimmer's ability to make safety decisions will be impacted. What I want you to think about is-because the body is functioning does it mean that it is in control?

 The question that I put is -
Should Ice and Cold Water Swimmers determine their own personal limits or their own ability to continue in the water-can they act in their own best interest or should the outcome of the swim depend more on the work of qualified teams? Sometimes do we need to intervene earlier?

Many wonder how a swimmer can swim a long distance at extremely low temperatures-With training and individual's ability, the human body without question has supreme survival capacity in extreme conditions. If we need it to push into 'negative' the body will keep functioning. Without question-we are born to survive. 
The survival mechanism exists in all of us and our responses to extreme are without doubt 'superhuman' at that moment for a specific length of time when required. 

It is also important to
understand the responses of the human body/mind to stress and mostly our capacity to continue through and past-or to override or ignore the signs and symptoms of failure. The body can keep moving. 
Teams and crews should understand that the swimmer or the athlete is not the person to decide how they feel-they are vested in the outcome-being a team member is a huge responsibility in Ice and Cold water swimming and it is the emerging of so many swims which once would have been 'expedition team rescue cover' to now a minimal rescue cover if any and sometimes little experience in the monitoring of the unit. For me we have to always manage the swim based on the risks to life.  

So How did we get to this accepted practice? 
Not so many years ago our perception of life and performance was different. Some people would leave a pub after drinking 10 pints of beer and get in the car and drive home-we believed them to be great drivers, amazing that they could control a car under the influence. 
Some people can drink a bottle of vodka and continue to function as 'perceived' normal, it takes a trained to eye to know the person is drunk when they are a 'functional' drunk. The fact that we have a term 'functional' alcoholic is testament. 
There are an amount of people who will try and convince you that they are perfect fit to function despite being exhausted. We schedule a person to work a 24 hr shift and make life and death decisions without sleep in the health service-  Adventure racers race for days without rest and solo expeditionaries function beyond all limits with a mere 10mins sleep an hour. But how?   Are we performing or are we surviving? I don't know I just know that the body works-but challenged the failure will be immediate. 

What I have seen during my life as an swimmer, as a crew member/team member and in other working areas is that the body and the mind can override the natural level of capability, 
it does not mean what we are doing is safe-it does not mean that the person is in control of their actions and it certainly does not mean that that swimmer can in any way be responsible for their recovery or outcome, and the moment they finish their swim they may not have enough reserves to recover. 

Information and experience now shows us that the swimmer can continue past the cognitive control.
Decision making processes at this point by us swimmers and these individuals is not only flawed and dangerous but in many cases it's justified and defended. 
“I was fine” is the often response and they were at that moment-but it doesn’t mean that it should be best practice, especially in events and sport. 
 So what does this have to do with swimming-open water or Ice swimming?  

When Cold water or Hypothermia becomes a leading influence on our body temperature -our teams need to train for the expected outcome-They have to know when to stop a swimmer or what to do when a swimmer stops or is stopped. If a swimmer collapses after a distance swim -there is a huge difference between normal fatigue at higher temperatures and fatigue influenced with hypothermia. 
It is the role of teams and swimmers to understand the risk, recovery, recognition and safety planning of the entire individual event-your job as a crew is to plan for the ‘unlikely event’ and all outcomes, not just to 'be there'. 
Being able to risk assess as the swim progresses is vital.  

If you never use your safety plan-that is not a problem.  

The cold/thermal impact on the body and the brain, of swimming distance in cold water shows us repeatedly that the cold water will eventually incapacitate all swimmers -
The amount of time before that ‘failure’ will take to impact the individual performance of the swimmer depends on so many variables. 

Ice Swimming and Cold water swimming has exploded in it’s popularity and so many swims have pushed boundaries both of physical and human endurance at temperatures lower than previously thought possible. Very few of these swims were 'random' they were managed and they had dedicated teams. My mind has been blown at what I have witnessed and experienced in the last 10 years -amazing swims but the positive outcomes of many of these 'Extreme' distance swims were only possible in my opinion, because of the support and recovery teams at that moment and more importantly the absolute focus on the swimmer.
I was present at the 2,400m@0 deg, 2,150m @ 0 deg 2km plus @ 0 deg and multiples 1,650m @ 0 deg all at up to - 30 deg air temperatures. I was also present for some very scary recoveries both in channel and Ice swimming.
I can say confidently that very few swimmers would have been able to manage their own recovery at the end of the swim - so many outcomes without doubt may not have been successful with a lesser qualified team.

On a few occasions the swimmer post swim had no memory of being taken from the water-or leaving the water.  So again why do we need to know this?
Would I want swimmers to go to these limits again with the information I now have ? 

 How is it that the swimmer can then function albeit as ‘perceived normal’ to continue the swim?
I have no idea how the body can continue to function-I just know that it does.

How far do we allow that swimmer to swim so as to ensure they are strong enough to make that recovery with the location you are in?
Let’s look at the ‘new’ norm in life-the new athlete. Extreme swims which were once remote locations and expedition in planning can now be experienced- the same distance and temperature in a 'perceived' mainstream environment like a pool. Swimmers can be naive to believe that there is safety in a confined space.

People are under more and more stress to succeed and there are greater ramification to the fear of failure, in many areas of our lives, not just sport-we have moved beyond the ability to stop maybe driven by the perception of opinion and external pressure.

The athlete is now taking on distance open water swims 'unsupported' in difficult conditions which previously would have been swims considered with the assistance of an expedition team/or a qualified boat crew.
Full teams are vital for safety-our first Ice Mile
attempt in 2011 

Why is passing that point in cold water swimming more dangerous than other mainstream sports like running?

The athlete’s response in cold water is measured by how cold the athlete is on the inside and the outside, a runner, cyclist can despite the cool temperatures can increase clothing and increase heat in a way that a swimmer cannot. -The runner can collapse over the finish line but the body is rarely in an acute hypothermic state. 
The runner who wants to stop/needs to stop and collapse at the side of the road they have an opportunity to get their breathing under control -they have a chance at survival but the swimmer who slows or continues to swim while being semi conscious can do untold damage to a heart-up to and including death.  As the runner is slowing down their slow up to the jog, to the walk, or stumble or even fall down.
When the swimmer slows down over a period of time and loses power to the cold muscles and the inability to use their arms and legs at the same function-the body position drops lower, the drag increases with legs falling, the swimmer can start to swallow water maybe even sink. The risks are much greater.  
A solid team is vital

Being able to recognise the signs of Swim Failure and Swim Incapacitation as it approaches are the basic tools to create the limits for our sport. So how do we do that?

The Marathon Swimming/Channel swimming has been responding to management of Swim Failure over the years mainly in the form of observers, their reports and teams, pilots and experienced crews.  
Management of the stroke rate is the most obvious tool we use and after that an experienced crew who can watch for signs and symptoms of failure. 

In the distance swims and marathons- cold incapacitation is a slow development-in low temperatures in the ice- this is a fast process and the margin for error is tiny-mistakes can be huge. 

When we see a swimmer's stroke count drop along with a body position change-when the legs collapse, when the angle of the body changes and the head is unable to turn adequate so as to not get enough oxygen - these issues can be life threatening. 

One of the biggest risks in cold water swims is the reduction in power of the swimmer. Cold slows us all down, the drop in stroke rate is not a problem-the reduction in power is the problem in the Ice. 
Cold water Incapacitation is real and under a certain temperature in the cold water it is a matter of time. 
There are some amazing exceptions to the rules, but one of the certainties of Ice water <5 deg is that there is a end ‘time in the water’ to the body. 

How is the swimmer physical output impacted by cold? 

Most of the research is done on muscles cooling and exercising in cold environments-and stationary research has shown that the temperature of the arms can drop below 27 deg in 20 mins in 12 deg water. 
The double side of the equation-if the arms are rotating and creating heat-and also if the Ice water then strips the heat away from the muscles 20 times faster than air-we have a really complex but inevitable conclusion. 

So what about 10-15 mins at 0 deg? 

There is no reason swimmers competing over 10-15 mins with adequate training would have any loss of power which would lead to swim failure but the experiences we have seen show us that past 20 mins @ 0 deg there begins a power drop for some swimmer and past 30 mins sub 5 deg shows some power reduction to potential risk to some swimmers. 

It does takes some time for the arms and legs to cool. The faster the swimmer the more heat generated, the slower the heat loss. The body type,the training, the individual etc all impact. 

The Major Risks are: 

When the swim is remote and off the side of a boat into very cold water -the risks are greater. 
Having the information and the ability to confidently to step in -knowing that once the cold water has reduced the power- swim failure cannot be reversed-your information can save lives and mostly avert a difficult experience for teams and maybe a life threatening experience for the swimmer. 

Now with the volume of swimmers entering events-many without the back up in training and experience it is so important that we push forward the ethos and culture of knowing your safety plan in advance of your swim. When you exist the water is no time to start organising your recovery.    

Recognising your limit will save lives. That's the Gold Standard-knowing when to pull and when to allow the swimmer to continue.

The survival instinct and the ability of the body to survive is not a mechanism that a swimmer should be using. It is not healthy to push continually beyond the controlled -the risks of systems failure are greater by the personal confidence "I am ok" until some day a 'curve ball' a 'variable' is thrown into the mix and the skill set cannot or is not able to process the change. 
Expedition swims cannot be confused to controlled swims- extreme cannot be confused with mainstream and reality will always be reality. 
If you have decided to take on a swim at a temperature that you have not prepared for, take on a distance that you have not trained for -preparing for the failure is responsible-not a negative. 

The main problem is when the swimmer exists the water-the team have to work hard to recover the swimmer-act responsibly.  
Take on swim distances and temperatures that you have trained for. 
If you have not trained for the distance or the temperature make sure you have your exit plan and your team know your limits. 

Know who and how you are going to be recovered-manage your exit from the water -you are not someone else's problem.
Don't arrive at an event and believe that it is ok to take on a distance without a full personal dedicated team. 

Always check out your own requirements and make sure you have your tools to recover. 

At some point when you are swimming distance at temperatures below a certain temperature.. the cold will stop you or you will stop or be stopped... 
Just because you can does not mean you are in control or you should. .. 

I have written a manual on the technical side of Ice swimming, swimming in cold water and mostly the impact of cold water immersion on the physiology on the body. 
for €11.00 post included anywhere in the world . for more details

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