Swimming with Parkinson’s or multiple sclerosis

30/08/2024

Created: July 2024

This fact sheet explains how you can take part in swimming and other aquatic activities if you have Parkinson’s or multiple sclerosis.

What is Parkinson’s

Parkinson’s is one of the most common degenerative neurological condition affecting 153,000 people in the UK, but particularly in the over 50 age group, although some are diagnosed at a younger age. It is known that a gradual degeneration of cells in an area of the brain that controls movement occurs with Parkinson’s, although in most cases the cause of this is unclear. This brings about a reduction in molecules called neurotransmitters which send signals from cell to cell. Over time, this process can lead to symptoms including slowness of movement, stiffness in certain joints and a tremor becoming noticeable leading to investigations and a diagnosis of the condition. It is worth noting that there are other symptoms, for example anxiety or bladder frequency, which can also affect everyday activities. As the condition progresses, some people with arkinson’s find it harder for medication to control their symptoms, so experience periods of unpredictability in their movements over the course of a day.

What is multiple sclerosis

Multiple sclerosis (MS) is also a common degenerative neurological condition affecting around 150,000 people in the UK with nearly 7,100 being diagnosed each year. The exact cause is unknown, but is thought to have genetic and environmental factors. MS affects the brain and spinal cord, where it damages the coating that protects nerves. This causes unpredictable symptoms like blurred vision and problems with how we move think and feel. Symptoms might come and go with ‘relapses’ and periods of ‘remission’, or they might get steadily worse.

People with Parkinson’s may experience:

Problems with balance.
Poor co-ordination and slowness of movement, especially more on one side of the body than the other.
Rigidity (stiffness) in the muscles and joints.
Muscular tremors.

People with MS may experience:

Visual problems.
Numbness and tingling.
Muscle spasms stiffness and weakness.
Poor co-ordination, especially if your symptoms affect one limb more than the other.

With both conditions people may also experience fatigue, mobility problems, pain, problems with thinking, learning and planning, depression and anxiety, sexual problems, bladder and bowel problems, speech and swallowing difficulties. All or any of these symptoms could affect someone’s capability or motivation to swim.

How can swimming help with Parkinson’s or MS

Being active can offer a range of benefits if you have Parkinson’s or MS. This could include muscle strengthening, improved heart and lung health, improvements in mood and quality of life, and your ability to perform every day activities with less fatigue. Exercising in water offers a range of unique benefits. Water stabilises and supports your body giving greater freedom and range of movement. This can help you to improve balance – decreasing the ongoing risk of falls and can also provide temporary relief of some aches and pains.

The resistance of water can help you to gradually build up your strength. The pressure of water around the body can help to reduce any swelling and increase the work of the heart, lungs and kidneys, improving the blood supply to the brain and other parts of your body. Some people may find the cooling effect of water beneficial, particularly in outdoors water spaces. Others may find warmer water can help some of their symptoms for a time afterwards.

Things to consider before, during and after swimming:

Before

See if you can have a tour the facilities to make sure you can access everywhere safely, for example, is there a ramp or lift available if steps might be harder for you. Some facilities may also have virtual tours that you can watch on their website.
It is worth planning to attend around the least busy times of the day, when there are less people around and therefore less turbulence in the water. This will help with your confidence and balance and also allow time and space to do warm up exercises in the pool before you swim.
It is worth asking what type of tiles line the bottom of the pool as non-slip, textured tiles may help if you have sensory problems and can’t feel the floor well, or if balance and the ability to grip with your feet is affected.
Ask about specific changing facilities if you might need help from a friend or family member to get changed and explain any space requirements, especially if you might need a wheelchair afterwards.
If you are nervous about getting back in the water, maybe ask a friend or family member to join you. Lots of pools also offer one-to-one swimming lessons, with swim teachers who have specific training that suits you. Some pools may have a disability swimming club with specialist coaches.
Swimwear with a separate top and shorts may be easier to change in and out of, particularly once wet, for example a t-shirt or rash vest, with shorts or thin leggings. Most pools let people wear full body coverings in most pools, so check this beforehand.
If you struggle to dress at home after a bath or shower, it is advisable to wear or bring loose clothing that is easier to put on after you have been in the water.
If your condition has affected your bladder and bowel control, ensure you go to the toilet before getting into the pool. Incontinence swimwear is widely available if you have concerns about this. You might find something online that suits you, or could ask your continence service for advice.
If you have problems with your speech or swallowing, a buoyant neck collar may help you feel more confident.
If you have particularly buoyant or ‘floaty’ legs, you could try light aqua ankle weights to anchor your feet to the floor for upright and walking activities. You may need to ask for assistance or supervision in the pool if this is the case.
Pool ‘noodles’ may be useful to help support you in forward or backward lying positions if you find it difficult to stay afloat. Pools may have equipment available and may provide some guidance around their use. Be considerate of other swimmers when using equipment.
If you take medication, plan what time you go to the pool, so it does not interrupt your normal routine.
You might find it better to warm up your muscles and stretch on poolside where it is warmer, before getting into the water, which may prevent your body from becoming tight, particularly if the water temperature is a little low. It is common for pool temperatures to be below 30 degrees Celsius.
If you have MS, very warm temperatures can add to fatigue. For example hydrotherapy pools can range from 32-35.5 degrees Celsius, so you may need to try different pools and work out what’s best for you.
Being active in water, particularly in a humid indoor pool area might mean you won’t notice feeling as warm or sweaty. But it’s still important to stay hydrated during a session. Take some water in an unbreakable bottle to keep near the pool side.

During

A towel or swim poncho can help you stay dry from the changing room to the pool and back again, do ask for help on where items can be kept during your swim.
Multipoint walking aids are recommended on wet surfaces rather than single point walking aids.
Aqua shoes may also help on the pool side and even in the pool if you plan to do walking activities.
Most pools have pool side hoists or lift systems to help get in and out of the pool, particularly if you can’t use steps.
You might want to make the lifeguard, coach or teacher aware of your condition and any difficulties you might have floating or turning from face down to face up positions for example. Especially if it is your first time at the pool.
In the water you may find you can move in ways you can’t achieve on land. Gradually explore what you can and can’t do by the side of the pool at first. Hold onto a bar or trough if there is one.
If you find you are lacking buoyancy or coordination to kick effectively while swimming strokes like front crawl, consider using a ‘pull buoy’ to help keep a streamline position in the water.
Professionals can help you find specific activities that might suit you, including a neurologist or nurse specialist, aquatic physiotherapist, or an exercise professional with an Aquatic Activity for Health qualification.
It’s important to keep warm in the water in between bouts of activity, so keep moving when you can. Do what feels right for you, but for example that movement could be walking, forwards backwards and sideways in water that is just up to your chest. Other movements could be marching on the spot, swinging a leg forwards, backwards and sideways, or doing squats.
If you get fatigue, don’t try to do too much at once. Start with 10 to 15 minutes at first. See how you feel and gradually build up your time in the pool as you adjust to it.

After

When you get out of the water, you might really notice the difference as the buoyancy of the water is taken away. Being wet might add to feeling tired and heavy. So even if you don’t use one to get in, you might find using a hoist or lift valuable for getting out.
A towel or swim poncho can help you stay warm before you get to the changing room. Most pools will have somewhere near the poolside to hang a towel or keep a few items you might need.
Once you’re dressed, make sure you have a drink to replace water lost during exercise. You could also eat a banana or a salty snack to replace salts.
If you have MS muscle stiffness, you might find this stiffness eases from being in the water. If you usually walk with a level of stiffness, you might find that you will need some extra help moving around when you first get out. You may find sitting for 10-15 minutes helpful, until your body has adjusted to being back on land again.

Tips for swimming with Parkinson’s or MS

Do: consult with a healthcare professional beforehand who has knowledge of your condition. For example, your GP, physiotherapist, neurologist or nurse specialist. This is particularly useful if you’re newly diagnosed or you’re working out treatment plans. They may also be able to advise on issues such as muscle stiffness, or co-ordination and how that may affect you in the water.
Do: check how well you can get yourself standing upright or floating on your back if you feel you’re sinking. Do this before you start to swim, especially if you’ve not been in the water for a while.
Do: start slowly and build up gradually at your own pace. Take time after a swim or session to see how your body recovers and adjust things if you need to on your next visit.
Do: contact your local pool to find out what other activities they have available, such as:
Aqua Aerobics: group classes of exercise and movements in the pool, often to music, with an instructor leading the class – might be less suitable if your movement is very limited.
Aqua walking: walking around the pool with the water resistance requiring more effort to walk than on land.
Water Wellbeing: sessions provided by instructors who have achieved the ‘Aquatic Activity for Health’ qualification providing one to one or small group water-based activities tailored for people living with health conditions.
Good Boost: personalised aquatic rehabilitation programmes provided on waterproof tablet computers, with options for group sessions led by a facilitator or individual. Home exercise options are also available.
Aquatic Physiotherapy: supervised exercises, techniques and advice from a specialist physiotherapist in a warm hydrotherapy pool. Apart from the benefits mentioned above, the warmth of the water can be beneficial for some symptoms, including if you have painful joints or aching muscles
Do: aim for little and often, rather than too much all at once.
Do: allow yourself recovery time and keep track of any changes in levels of fatigue, spasms, increased tremor or weakness.
Do: let your healthcare team know about any changes or new symptoms.

Specific tips on outdoor swimming with Parkinson’s and MS

Swimming regularly in your local pool is a good way of building up your fitness and stamina. But if you’re thinking of trying open water swimming in a lido, the sea, lake or river, you may need to do some extra training or preparation first. It is best not to swim alone outdoors. It might be a good idea for you to join a club. Some clubs run introductory courses and training programmes, or can help you prepare for an event. You will also be able to get advice from other members.

Outdoor swimming could mean colder water temperatures and possibly greater risks if there’s a problem. Only try outdoor swimming if you are already a competent swimmer.
Do: discuss your condition with an instructor or coach beforehand so you both have a good idea of your abilities.
Do: choose appropriate swimwear for the environmental conditions. That could be a wetsuit in colder climates. Wetsuits may also provide extra buoyancy in the water, but do think about how difficult it might be for you to get a wetsuit on and off.
Do: consider in advance how easy it will be to get in and out of where you swim. Make sure help is on hand in case you need it.

If you are swimming abroad:

Do: ensure that you take a copy of your prescription and some extra medication in case any get lost or stolen.
Do: consider that local pool hygiene standards may be variable. Don’t simply assume that outdoor pools are clean. Check with the pool operator first and if in doubt avoid swimming rather than risk becoming ill.