Sailing: A Heart-Healthy Guide for People with Cardiac Conditions

Quick take

Sailing can be a safe, enjoyable way to build aerobic fitness, strength, and balance — with a focus on planning, teamwork, and calm, steady effort. Aim for light-to-moderate intensity (Borg RPE 9–13), longer warm-ups and cool-downs, and choose settled weather and stable boats to start.

“ We cannot direct the wind, but we can adjust the sails. ” — Dolly Parton

What counts as sailing?

Sailing includes dinghies on lakes, keelboats on coastal waters, and larger cruising yachts. Roles range from light crew duties (watchkeeping, trimming lightly) to more strenuous tasks (grinding winches, hoisting sails). For most cardiac patients, beginning as crew on a stable keelboat or yacht in sheltered water is ideal.

Health benefits

• Steady aerobic work that supports blood pressure, lipid profile, insulin sensitivity, and mood.

• Functional strength and balance from controlled movements on an unstable surface.

• Social connection and outdoor time — both linked to better adherence and wellbeing.

The aim is “little and often,” building weekly minutes of moderate activity per cardiovascular guidelines.

Is sailing right for me?

Generally yes if your condition is stable and you can manage light-to-moderate activity. If you’ve had recent surgery or a change in symptoms/medication, get clearance from your clinician first. Avoid sailing until medically reviewed if you have unstable angina, uncontrolled arrhythmia, decompensated heart failure, concerning syncope, or new/worsening chest pain.

Risk management on the water (the big rocks)

• Personal flotation device (PFD): Wear a properly fitted lifejacket or buoyancy aid whenever you’re on deck. Service it regularly and use crotch straps if available.

• Cold water & immersion: UK waters are often cold enough to trigger cold-water shock. If you fall in, “Float to Live” — lean back, keep your airway clear, control breathing, then signal for help.

• Weather & sea state: Choose light winds and sheltered waters when starting out; always check the official inshore waters forecast before you go.

• Qualified people & training: Sail with an experienced, RYA-qualified skipper or take beginner courses (e.g., Start Yachting/Competent Crew).

Before you go: medical & practical checklist

• Tell the skipper about your cardiac history, meds (e.g., nitrates, anticoagulants), and any limits.

• Pack and keep meds accessible (including GTN if prescribed). Bring a printed med list.

• Seasickness: try non-drowsy strategies first (fresh air, horizon fixation, wristbands, ginger). Some medicines can cause drowsiness or interact with cardiac meds — ask your pharmacist.

• Hydration, sun and warmth: layer clothing, waterproofs, hat, sunglasses, and sun protection.

• Insurance: if sailing abroad, ensure your travel policy covers boating activities and declare pre-existing conditions.

Effort & pacing (Borg 6–20)

• Target RPE 9–13 for most sessions; fitter individuals may touch 12–14 in brief spells.

• Use “talk test”: you should be able to speak in short sentences.

• Avoid breath-holding/straining (no “max-effort” grinding/hoists). Exhale on effort; take micro-breaks.

• Typical heart-rate goal (if you use HR): 40–70% of heart-rate reserve, adjusted to your plan and meds.

Warm-up (10–12 minutes) — on the pontoon or deck

• Easy marching and ankle rocks (2 minutes).

• Neck rolls, shoulder circles, thoracic rotations (2–3 minutes).

• Hip hinges, gentle squats to a rail/seat (2–3 minutes).

• Wrist/forearm prep and gentle band pulls if you’ll be trimming (2–3 minutes).

Finish with 3–4 deep breaths; start tasks gradually.

Cool-down (8–10 minutes)

• Slow walking on deck or quay (2–3 minutes).

• Stretch calves, hamstrings, hip flexors, chest, forearms (hold 20–30s each).

• 3–4 minutes of relaxed breathing (in through nose, long exhale).

“First sails” progression (6–8 weeks)

Week 1–2 — Sheltered taster as crew (60–90 minutes afloat)• Aim RPE 9–11. Focus on moving safely, balance, and simple tasks (e.g., tailing lightly, fenders).

Week 3–4 — Short coastal or lake sessions (2–3 hours)• RPE 10–12. Try light trimming/helming in calm conditions. Sit/stand with support points; take 5-minute breaks each 20–30 minutes.

Week 5–6+ — Half-day day-sail with more roles• RPE 11–13. Add helming on reaches, basic tacks/gybes with help. Avoid heavy winching/hauling until your clinician okays higher loads or you have more conditioning.

Always step back a level if symptoms increase or conditions are choppy/windy.

Technique & ergonomic tips

• Three points of contact on deck; move slowly and plan handholds.

• Keep loads close to your body; use legs not back when hauling.

• Winching: two hands, smooth turns, avoid breath-holding; use self-tailing/electric aids where available.

• Trim from a stable, braced stance; sit out only to comfort.

Boat & kit choices that help

• Boat: pick a stable keelboat or yacht over a tippy dinghy to start. Choose boats with easy re-boarding ladders and handrails.

• PFD: Auto-inflate 150N+ with crotch straps; check service dates. Carry a light and whistle.

• Deck gear: non-slip shoes, gloves, layers, waterproofs; sun protection.

• Safety: VHF radio, charged phone in waterproof pouch, first-aid kit, and a means of calling for help (VHF Ch16/“Mayday” with skipper). Consider tethers/jackstays if going forward. (Local rules and skipper’s SOPs apply.)

Environmental awareness

• Cold water: dress for water temperature not air temperature; know cold-water shock and Float to Live.

• Weather windows: check the Met Office inshore waters forecast; avoid strong winds or poor visibility when learning.

• Tides & traffic: choose quiet, familiar areas at first; listen to your skipper’s passage plan.

Stop/seek help now if you notice

• Chest pain/pressure, new unusual breathlessness, palpitations, dizziness, faintness, cold sweat, or symptoms that don’t settle with rest. Use your GTN as prescribed and alert the skipper immediately — call emergency services (999/112) or issue a VHF distress call as appropriate.

Accessibility & getting started

Sailing is highly adaptable. RYA-recognised centres and the RYA Sailability network offer accessible boats, hoists, and trained volunteers — a great entry point for cardiac patients and anyone with mobility or balance limitations.

“ A ship in harbour is safe, but that is not what ships are built for. ” — John A. Shedd

Sample “easy day-sail” plan (sheltered water)

1. Pre-sail: meds, layers, snacks, water, sunscreen; warm-up on the quay (10–12 minutes).

   
   

2. Afloat: 20–30 minutes gentle sailing (RPE 9–11); 5-minute breathe-and-check break; repeat 2–3 cycles. Light helming on easy points of sail if you feel steady.

   
   

3. Post-sail: cool-down and de-brief; note how you felt (RPE, symptoms, seasickness), then adjust next time.

   
   
   
   

Frequently asked Questions

• Do I need to be able to swim? A lifejacket is essential; basic water confidence helps, but you don’t need to be a strong swimmer to start (ask your centre about confidence sessions).

• I’m worried about seasickness. Try horizon-gazing on deck, fresh air, small sips of water, ginger; ask a pharmacist about suitable options with your cardiac meds.

• Where can I learn safely? Look for RYA-recognised training or sail with a qualified skipper; beginner courses like Competent Crew are ideal.

“ The cure for anything is salt water — sweat, tears, or the sea. ” — Isak Dinesen

References & further reading

• Royal Yachting Association (RYA): Lifejackets & buoyancy aids; training courses.

• RNLI: Cold-water shock and Float to Live; Respect the Water.

• Met Office: UK inshore waters forecast (check before every trip).

• NHS: Motion sickness self-care and treatment advice.

• ESC: Physical activity guidance for cardiovascular prevention and rehabilitation.

This blog post was written by Jamie Pickett, Clinical Exercise Physiologist, with AI assistance.