Raynaud’s Phenomena (white fingers or toes) and Sailing

Raynaud’s Phenomena (formally known as Raynaud’s syndrome) causes the extremities (fingers and toes, and less commonly, ears and nose) to temporarily turn white from loss of blood flow.  2.2% of women and 1.5% of men suffer from this condition and sailors who have it can lose their ability to handle their boat at their best level.

I have the condition and at regattas I hear sailors talking about their white fingers and not knowing what they have, or knowing what they have, but not having good strategies to manage it. I think it’s worth a brief review of what I experience and techniques and gear I use to deal with it.

The white or blue skin color you see in Raynaud’s is caused by spasms in tiny blood vessels or capillaries. It is brought on by cold, tension and in my case often by long periods of muscle tension. It lasts from a few minutes to a few hours. The skin is cool to the touch and without the warming effect of blood flow it puts the affected area at a greater risk for frostbite. I experience a loss of feeling in the affected area similar to what you’d expect from overly cold fingers during the winter.

If I break away from my activities and hold my fingers under warm water or in a flow of warm air (I can’t feel the temperature so I constantly check with an unaffected part of my skin.), I can literally see the skin jump back to a red color as sections of capillaries relax. I can warm up mild cases by holding my hand in my armpit or even against the warm skin of my face. Once the fingers turn white they don’t generate much warmth, so even putting them into a well insulated glove doesn’t help to bring back the circulation.

Cold water or cold air can be a major stimulus. If I allow my overall body to get cold it can trigger an attack even if my hands aren’t that cold. Any weather capable of bringing on hyperthermia can cause an incident. If you watch me at spring or fall regattas I often have a neck gaiter over the collar of my spray jacket. The gator keeps more of my neck warm and reduces any breeze down my neck; necks carry a large volume of blood.

I also switch to a cold weather hat before many of my competitors. At our club’s October regatta I was wearing three layers under my spray jacket and those in tee shirts, spray tops and shorts were looking at me like I was crazy. Even in the summer I usually wear a pair of fingered gloves to give myself a little insurance.

My toes can also “kick off” so I wear neoprene hiking boots and if the water is at all cold (Think Ocean) I wear polypropylene or Seal Skin socks in the boots. I use to try to keep my hands and feet dry, but the waterproof gloves and boots were too clumsy and it is impossible to keep the mainsheet dry on a Laser. So now I try other techniques.

One of the things that triggers my Raynaud’s is keeping constant muscle tension without frequent breaks. Tight muscles help to constrict the blood to major vessels and this can cool the skin just a bit and the next thing I know my fingers are numb and splotchy white. I have to remind myself to loosen my grip on the tiller extension whenever it’s possible and to wrap the mainsheet around the gunwale or over my leg to give my hand and arm a chance to get a good shot of rejuvenating warm blood. Between races I often dangle my arms to both relax the muscles and to encourage gravity to assist the blood flow to my hands.

But the key to keeping my hands less tight has been buying gloves with maximum palm-grip material. The difference has been less Raynaud’s Phenomena, or in other words – phenomenal!

My toes are affected in cool weather when I reduce the blood flow past my knees by crouching during light-air days, so I work to regularly straighten my knees or at least to stand up in the boat between races. Sometimes messaging the backs of my knees encourages some blood flow.

I’ve had occasional success with taking niacin (it causes a flush reaction in some of us) or rubbing a stimulating skin ointment (think Deep Heat) on my hands. When I can get them to work, I put a dry chemical heat pack in an inner shirt pocket. They need oxygen so it isn’t always successful even in a Gore-Tex garment, but the concentrated heat seems to help a bit to keep my whole body warmer.

Damp days are a particular challenge. I have a waterproof, kayaking beanie that I wear under my hat. And I take particular care to keep water off my neck. Except in the hottest weather my spray jacket is my insurance against a cold, wet torso.

Inactive periods during the day are both threats and opportunities. I take advantage of between race lulls to stand, dangle my arms, hold any cool feeling fingers in my armpits and make adjustments to my clothes. I also keep small high calorie snacks in my waterproof pocket to keep my energy level at its peak.

Raynaud’s isn’t particularly threatening, but it does threaten my concentration, my smooth boat handling and my stamina. The only situations where I have found it unmanageable is during frostbite sailing on a Laser. I now have to get my “off season” boat time in warm climes.