Cold water puts real strain on the body: in the first minutes your heart rate and blood pressure rise sharply and your breathing speeds up. For a healthy adult who gets used to it gradually and in good company, it is a great experience, and many love it precisely for its refreshing, toughening effect. This page sums up when to talk to a doctor first, and which medical documents you need for competitions and ratified swims.
Important: this page is general information and does not replace a medical examination or advice. The international requirements are based on the IISA Medical and Safety Regulations (in force from 1 November 2024). The official, current IISA guidance and the event's own announcement always apply.
Before you start
Before you start, be sure to talk to your doctor if you have heart or circulatory disease, high blood pressure or an irregular heartbeat, if you live with epilepsy, asthma, Raynaud's syndrome or cold urticaria, if you are pregnant, or if you take medication regularly. In these cases cold water can be dangerous, so do not start without your doctor's approval.
When to stay out of the water on a given day (when ill, under the influence of alcohol, exhausted) is covered on the Safety page.
For competitions
You can only enter competitions, both Hungarian and international, with medical clearance:
- Hungarian competitions: currently, a clearance stating that you may swim in ice water, signed by a sports physician, a cardiologist or another doctor.
- International (IISA) competitions: the IISA medical assessment form, completed and signed by a doctor. Para athletes need an additional form, see below.
- In every case, an ECG taken within the past year is also required.
At the competition you show your documents at the medical check; if the doctor does not let you swim, their decision is final. The further steps of entering are on the competing guide.
Sports medical clearance
In Hungary, a sports physician examines whether competitive athletes are fit to compete and issues a sports medical clearance. The examination is available at the Budapest centre of the National Institute for Sports Medicine (OSEI) or at the clinics of the national sports medicine network; booking and the list of clinics are on the OSEI website (in Hungarian). Over 18 the clearance is valid for at most one year, over 65 for at most six months. For our Hungarian competitions, a sports medical clearance issued for swimming, long-distance swimming, open water swimming or triathlon is suitable and accepted.
Ice Mile and long-distance ice swims
The medical requirements of an Ice Mile are stricter than those of competitions:
- IISA medical form: have your own doctor complete and sign the IISA medical assessment form. Tell them you are preparing for an Ice Mile and share your medical history.
- ECG: a 12-lead ECG is required.
- Validity: the form and the ECG are valid for 12 months before the swim date. They lapse if you have since had COVID-19, pneumonia, a cardiac or pulmonary event or another major medical event.
- History: a cardiac history needs a cardiologist's report, epilepsy a neurologist's report.
- Long-distance ice swim: for a swim of at least 3 km, the IISA medical form and ECG must be within three months of the attempt.
What happens on the day at the venue is described on the Ice Mile page.
Para athletes
Ice swimming is open to para athletes too. At IISA competitions para athletes compete in their own categories; to enter, they need a separate evaluation form in addition to the general medical form.
- IISA para swimming categories: the category descriptions, to find out which one you belong to.
- Para athlete evaluation form: required to enter international competitions.
At competitions, as a para athlete you may have a second at every distance: Your second.
[HUNGARIAN COMPETITIONS: PARA CATEGORIES AND ENTRY REQUIREMENTS]
Official documents
- IISA medical assessment form
- IISA Medical and Safety Regulations – in force from 1 November 2024
If you have questions, get in touch.