Cold water immersion offers multiple health benefits, which work together to bolster a person’s immunity. Through better heat generation and improved circulation of blood, the body is getting well-insulated by stimulating the metabolism for enhanced protection. While this is an amazing way to boost your health, appreciating the potential risks of cold water immersion is essential for understanding how to safely interact with it. This appreciation can then lead one down a path toward developing an eventual love for engaging in these practices.
What to be cautious about while practising cold water immersion?

1Possible heart issues during cold shock
This is probably the biggest risk of cold water exposure – no matter the kind: ice plunging, winter swimming, or cold showers. People with pre-existing heart problems are often warned about the possibility of heart attack or other dangerous issues while getting affected by the cold shock.
Cold shock is the immediate reaction of the body to low temperatures exposure which turns on our ‘fight-or-flight’ mode. This process happens due to the activation of the sympathetic nervous system and the release of noradrenaline. During cold shock, the skin’s blood vessels constrict and the heart rate accelerates. This puts extra strain on the cardiovascular system which can result in a heart attack; with age having no bearing when it comes to this risk factor.
How to manage
It’s important not to rush if you are just starting to practice cold water immersion. You should get adjusted to the lower temperatures gradually and not ‘jump’ into it if you are not sure about your body’s possible response. Start with slightly uncomfortable temperatures and short sessions. Then, time after time, lower the temperature and increase the length of your cold showers or the frequency of ice plunging. After a while, it’s going to become easier to go through your body’s shock reaction.
If you are experiencing cold shock in the water, you should try to calm down and get your breathing under control. Avoid doing lots of energetic movements, instead, get your body relaxed. In about 60-90 seconds the effects of cold shock will disappear and you will regain control over your system.
It’s important to note that people with cardiovascular problems and heart conditions should consult doctors before practicing any kind of cold exposure.

2Problems with breathing and asthma attack
Another disadvantage of a cold shock reaction is losing control of breathing, and the possibility of triggering an asthma attack. When you are getting into cold water, involuntary gasps of breath cause breathing rates that may climb up tenfold – resulting in an overwhelming feeling of panic coupled with a heightened chance for inhalation directly into the lungs. This can lead to awful consequences, such as drowning.
How to manage
Even for those with healthy lungs, it’s very important to breathe in a proper way while practising deliberate cold exposure.
Before entering the water, expel all air from your lungs by exhaling through your mouth. Then slowly emerge yourself into the body of water and begin taking long breaths in through your nose while deep exhalations occur out of your mouth. Focus on calming breathing and visualize a sense of relaxation with each count: ‘1, 2…3’.
After around 20 seconds have passed, breathe at an even pace that will allow for easier maintenance of composure – even if internal panicking occurs momentarily. Further attempts are likely to restore regulation over one’s breathing patterns.
Please note that if you suffer from asthma or other lung issues, consult your doctor before practising cold water immersion.
3Risk of hypothermia
Did you know that cold water can cause your body to cool down 25 times faster than air, which is why it’s essential for people immersed in chilly waters to be aware of hypothermia.

Hypothermia is caused by an abnormal, life-threatening drop in core body temperature that may occur when it falls below 35°C (95°F). It’s important to know that hypothermia does not only occur in extremely cold water. It can occur even in the warmer waters of Bahamas – depending on how much time a person has spent in the water.
How to manage
The key is to spend a short amount of time exposing your body to cold water. You don’t need to stay in the cold shower for ten minutes a day if you want to increase your healthspan. According to neuroscientist Dr. Andrew Huberman, 11 minutes a week in total is enough for getting proper health benefits from deliberate cold exposure.
4Clouding of consciousness
Cold shock leads to a decrease in blood flow in the brain by about 30%. That is why while practising cold water immersion you are going to feel a temporary decline of cognitive functions which results in an almost-meditative state. Although the long-term effect of deliberate cold exposure on cognitive and mental health is actually very positive and impressive, it’s important to stay in tune with your consciousness while you’re swimming in the reservoirs with the possibility of drowning.

How to manage
Avoid submerging your head in cold water if you are not planning on going out immediately after that. It can be extremely dangerous due to the amount of heat lost through the head. When compared to other parts of the body, a large surface area and limited capacity for contractions make it difficult for veins located in this region – meaning up to 80% of the total bodily heat is transferred away quickly when exposed to chilling temperatures. This drastic decrease leads to not only dizziness but also an increased risk potential for hypothermia or even drowning if one passes out from sudden shock exposure.
Therefore, swimming alone should always be avoided as a precautionary measure against such risks. Cold water swimmers also keep their brains sharp by wearing hats! This clever tactic works to slow the transfer of heat from their heads, helping them remain in frigid waters far longer.
5Possible incapacitation
If we are talking about such ways of cold water immersion as swimming in cold water pools or natural reservoirs, it can quickly rob health enthusiasts of their strength, leaving them unable to control the movement of their arms and legs, which is also known as incapacitation. The symptoms of it include exhaustion, weakness, and numbness that render self-rescue impossible.
Without floatation devices or assistance from others, this progressive muscular deficit will soon become life-threatening as it prevents individuals from keeping their heads above the surface long enough to avoid drowning.
How to manage
If you are not experienced in cold water exposure, start doing it in safer ways such as taking cold showers and plunging in ice baths. Don’t rush jumping into cold water pools or reservoirs. You can also take care of possible incapacitation by limiting your time in water and getting someone with first-aid knowledge to monitor you during the session.
6Risk of circum-rescue collapse
Circum-rescue collapse, a surprisingly little-known yet critical phenomenon, occurs when a person experiencing extreme physical or psychological stress suddenly collapses, either during or immediately following a rescue from cold water.
It is now understood that the phenomenon can be triggered by a dramatic drop in stress hormones once the imminent danger is gone, resulting in reduced blood circulation and, subsequently, the loss of consciousness. Loss of hydrostatic pressure from the water can also contribute to a sudden drop in blood pressure. This condition is very dangerous as it can cause heart or brain failure and lead to fatal results. According to a recent study, the occurrence of rescue collapse is linked to a doubling of the risk of death in severely hypothermic patients.

How to manage
Circum-rescue collapse is often a result of hypothermia and severe stress, so it’s important to avoid these conditions. Don’t stay in or under cold water for too long and start practising cold exposure gradually, with a slow temperature decline. Once again, you won’t get healthier by mindlessly jumping into a cold lake without any safety precautions. To minimize the potential for afterdrop and circumvent rescue collapse, a person being rescued from the cold water should be handled with care by using minimal arm and leg movement. It is also beneficial to swiftly remove wet clothing as it can restrict further maneuvers.
7Increased risk of cramps
Even staying in normal-temperature water can trigger muscle cramps, but cold water can seriously increase the risks of that unpleasant and dangerous condition. We know that cold causes muscles to contract, and stiffen which greatly contributes to cramping.
How to manage
To stay safe, keep aware of this increased risk and take the necessary precautions – such as swimming and plunging with friends. If you are taking a cold shower, try to think through the ways of getting out of the shower safely in case you get cramps. If you are already prone to muscle cramps you can also pay attention to your hydration and electrolyte balance.
Safety tips for cold water immersion

There are many rules for different kinds of practices but we are going to list the most common ones:
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Do not practice cold exposure if you have taken alcohol or are unwell.
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Never plunge or swim alone in natural reservoirs.
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Start the practice slowly with a gradual temperature decline.
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Breathe deeply and calmly as you emerge into the water. This helps reduce hyperventilation.
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Do not dive headlong: this increases the likelihood of vegetative conflict and accelerates heat loss.
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Limit your first plunge or swim to 1-10 seconds. Increase the time when you get used to it and learn to better control your breathing.
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Never plunge or swim under the layer of ice. You risk panicking and drowning.
What to be cautious about during cold water immersion?

The main risks that occur during cold water immersion are: possible heart problems as a result of cold shock, losing control over breathing, possible asthma attack, muscular cramps, and clouded consciousness. Other major risks are hypothermia, incapacitation, and the possibility of circum-rescue collapse. To avoid these you should start practicing cold exposure by gradually decreasing the temperature and seriously limiting your time in the water, by using a special breathing technique. Never swim or do ice plunging by yourself, and consult your doctor before the practice.
Hungry for knowledge? Here is more
Watch this short but very informative video with tips from cold water survival expert – professor Mike Tipton – on what do to if you find yourself affected by cold shock in the water.
If you want to learn more about the world of cold water immersion, we recommend you read the book ‘Winter Swimming: The Nordic Way Towards a Healthier and Happier Life’. Dr. Susanna Søberg, the author of the book, practices cold water immersion herself.
