What is hydrotherapy?
Hydrotherapy is a complementary treatment that uses temperature and water to help manage a variety of conditions such as headaches, low back pain, muscle cramps, arthritis, repetitive strain injuries (RSI), sprains, insomnia, and general stress management among many others.
Have you ever used a hot water bottle or an ice pack? What about a sauna or hot tub? Those are all forms of hydrotherapy. From polar bear swims to curling up with a heating pad - hydrotherapy is a very accessible form of care that is flexible enough for everyone to use in some capacity.
All about temperature
Temperature is a very important aspect for controlling the effects of the treatment. Below is a table of temperatures that are generally safe, and how they might feel to a person. Some people will be more or less sensitive to temperature depending on their exposure, health conditions, and body composition. Hydrotherapy should never feel painful or cause significant discomfort.
If you are sensitive to temperature, the treatment can always be adjusted for comfort. For example, if you have an aversion to cold try a cool or tepid temperature first, or decrease the amount of exposure.
Why am I writing this post?
As a massage therapist, hydrotherapy is a very important aspect of my education and my own self-care because of it’s wide array of benefits. It can be useful in treatments to help aid in relaxation, assist with certain techniques, and to allow for deeper work. It is also a familar form of care most people have used at home to help with pain or injury management.
I will almost always provide some form in your home care within our treatment plan.
Contrast Hydrotherapy
All forms are useful, but one of the methods I find to be the most beneficial is contrast hydrotherapy. I use contrast therapy after a full day of massage to reduce the risk of injury to my hands and forearms. While it generally requires a bit more effort, there are more benefits and less risk associated with the use of hot and cold (or warm and cool) and you can choose the best application method for you.
Cautions and considerations
It is also going to be important to keep in mind that all treatments that effect your body should be approached with care and consideration. Hydrotherapy is overall a very safe form of treatment, but it is not without its considerations. Here are a few of those considerations:
Acute Inflammation
Heat is not appropriate in the acute stages of inflammation as it can exacerbate the amount of swelling in the area. Heat is already our body's natural reaction to inflammation, but using additional heat can be too much of a good thing right after an injury which is why ice tends to be the best option.
Cardiovascular and Circulatory Conditions
Depending on the condition, heat or cold can have negative effects on conditions affecting the cardiovascular system. High or low blood pressure, heart disease, and venous disorders such as Raynaud's or phlebitis should all approach hydrotherapy with caution and consult a doctor when adding new treatments.
Diabetes
Diabetes can result in damage to the small blood vessels of the legs, as well as lead to neuropathies that decrease the feeling in their extremities. This means that there may be issues with blood vessels behaving as expected, and they may not dilate normally. This also means that they may not be able to feel negative affects resulting in tissue damage.
Subcutateous Fat
Subcutaneous fat is the insolation helping to balance our body temperature. Someone with more subcutaneous fat it will take longer to effect the deeper tissues, but it also means it will take longer to reverse. Someone with less subcutaneous fat will have an increased sensitivity and may struggle to regulate their temperature.
Intense temperatures or sudden shifts may not be appropriate for everyone, and it’s important that if you have health concerns to speak with your physician before attempting new forms of treatment. It is a good approach to limit your first application of hydrotherapy to 15 minutes.
Okay, but how do I do it?
The basic principle of this treatment is alternating temperatures applied to a part of the body. This article is for local treatments to a specifc area rather than a large or full body application which may have different considerations. There will be multiple approaches that you can use as long as you apply the same principles, and ensure you are using methods that are safe for your needs. The method I am going to outline is for a contrast bath.
You will need:
Two basins (or a double sink)
Water
Towel (to dry off)
Fill one basin with warm water, and the other with cool water. The temperatures should be comfortable enough to submerge without discomfort. You can increase the effects of the temperature through movement of your body under the water without increasing or decreasing the actual water temperature.
Immerse the area of your body being treated into warm water for 1 to 3 minutes.
Move to the cold water for 30 seconds to 1 minute
Repeat this cycle 3-5 times ending with the cold water
Modify treatment as needed as the benefits can still be useful with shorter or milder treatments. How we experience temperature, and what we can tolerate can vary and you may also wish to build up to the desired levels of treatment over multiple sessions to help acclimate your body to the treatment.
Alternatives can include using compresses such as cloths, ice packs, heating pads, especially for areas that are not easily submerged. Moisture is beneficial for enhancing the effects of the treatment in less time that dry methods of application which is why I have highlighted the use of contrast baths over other methods.
Conclusion
Hydrotherapy is a versitile form of treatment whether you are icing to reduce the swelling of an acute injury, or taking a trip to the spa for a relaxing soak. Contrast hydrotherapy packages the benefit of two into one, and can be a useful strategy for mitigating or treating injury.
Massage therapy and hydrotherapy are a great match with many overlapping benefits for injury and pain management. Come visit me in Gastown for a massage treatment, and we can go over how to incorporate hydrotherapy to help you reach your goals.
References
Sinclair, M. (2007). Modern Hydrotherapy for the Massage Therapist. Lippincott Williams & Wilkins. Petrofsky, J., Berk, L., Bains, G., Khowailed, I. A., Hui, T., Granado, M., Laymon, M., & Lee, H. (2013). Moist heat or dry heat for delayed onset muscle soreness. Journal of clinical medicine research, 5(6), 416–425. https://doi.org/10.4021/jocmr1521w Sullivan, D., Ph.D., MSN, R.N., CNE, COI, & Stanborough, R. J., MFA (n.d.). What to Know About Contrast Bath Therapy. HealthLine. https://www.healthline.com/health/contrast-bath
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