Author(s): LEVAČIĆ, D., HREN, D., Institution: UNIVERSITY OF SPLIT, Country: CROATIA, Abstract-ID: 561

INTRODUCTION:
Participation in extreme open water swimming, including long-distance channel crossings, has increased markedly in recent decades. While a wide range of health risks have been described, existing research has focused predominantly on physiological measurement and incident reporting. Less is known about how experienced swimmers themselves perceive, interpret, and manage health across preparation, performance, and recovery. The objective of the study was to explore how experienced channel swimmers experience and understand health challenges, prevention strategies, and recovery processes throughout all phases of channel swimming.
METHODS:
A qualitative study was conducted using semi-structured interviews with 30 experienced channel swimmers (20 men, 10 women; median age 49 years, range 30 to 70) from 14 countries, each of whom had completed at least two Oceans Seven channel swims. Interviews were transcribed verbatim and analysed using thematic analysis with an inductive approach to identify physical, psychological, and management-related themes.
RESULTS:
Three interconnected themes were identified. (1) Physical and physiological lived experience: pain, overuse injury, and hypothermia were widely normalised as inherent to the sport, with chronic musculoskeletal problems commonly managed rather than avoided. Acute in-swim events such as nausea, vomiting, and jellyfish stings were expected, while delayed post-swim consequences including prolonged fatigue, respiratory illness, and cold-related symptoms were frequently under-anticipated. (2) Psychological and cognitive journey: swimmers described in-swim cognitive impairment related to fatigue and cold exposure, often recognised only retrospectively, alongside post-swim emotional lows characterised by loss of purpose despite successful outcomes. These psychological effects were common but rarely openly discussed. (3) Proactive and reactive management: health management relied heavily on experiential and embodied knowledge, with highly individualised strategies for preparation, real-time decision-making, and recovery. Recovery was viewed as an active, holistic process and a critical learning phase informing future swims.
CONCLUSION:
Health in channel swimming is understood by experienced athletes as a dynamic, non-linear process shaped by adaptation, lived experience, and community norms. These findings informed the development of the Marathon Swimmer's Integrated Model of Challenge and Adaptation, conceptualising channel swimming as a continuous feedback loop linking preparation, in-swim challenge, coping, and recovery. Clinicians, coaches, and event organisers should integrate experiential knowledge with evidence-based guidance, with greater attention to injury management, cold-related risks, and post-event psychological wellbeing to support safety and long-term athlete health as participation continues to grow.