Registered Massage Therapist
Member of the Massage Therapists' Association of Nova Scotia
Since 2000

2369 Agricola Street • Suite 202
Halifax, Nova Scotia • B3K 4B7
jessica.marsh.hfx@gmail.com
902 • 580 • 2708

Hydrotherapy: Heat, Contrast and Cold, Contrast Foot Bathing, Therapeutic Sauna

What is Hydrotherapy?

Hydrotherapy is traditionally defined as the use of water to revitalize, maintain, and restore health. Hydrotherapy treatments include saunas, steam baths, foot baths, sitz baths, and the application of cold and hot water compresses.

Father Sebastian Kneipp, a 19th century Bavarian monk, is said to be the father of hydrotherapy. Kneipp believed that disease could be cured by using water to eliminate waste from the body. Hydrotherapy is popular in Europe and Asia, where people "take the waters" at hot springs and mineral springs.

There is a physiological basis to hydrotherapy. Cold is stimulating, and it causes superficial blood vessels to constrict, shunting the blood to internal organs. Hot water is relaxing, causes blood vessels to dilate, and removes wastes from body tissues. Alternating hot and cold water also improves elimination, decreases inflammation, and stimulates circulation.

More recently, "hyrdotherapy" has come to include thermal applications that are not water, like wax baths, freezable gel packs, thermaphores (moist electric heating pads), hyrdocollators (gel filled heat packs).

It's important to know when to use either heat or cold for an injury.

Too often when someone has back pain, they will automatically apply a heat pack to the area, only to find themselves hours later in a great deal more pain. Do NOT put a heat pack on an acute injury (See "Acute / Subacute / Chronic" for a definition of "acute".)

It bears repeating that an "acute" injury includes pain and immobility due to sudden movement. For example: you are raking leaves and you turn suddenly and now you can't straighten up all the way and you feel pain in your back. This is an ACUTE injury and you should apply a COLD hydrotherapy.

Here is the basic outline of what type of hydrotherapy you should use during each stage of healing for an injury:

ACUTE (the first 3 days after an injury) : use COLD

SUBACUTE (3 days to 3 weeks after an injury) : use CONTRAST

CHRONIC (any time after 3 weeks) : use HEAT


It is important to recognize that you can have an acute flare up of a chronic injury. For example: Say you had a car accident five years ago and had whiplash and pain down the left side of your neck. Five years later, the pain is minimal, but yesterday you turned quickly to back your car up and now you have that familiar pain in the left side of your neck. This is an acute flare up of an old injury and you should apply cold hydrotherapy.

It is more accurate to define the stage of healing by the symptoms you see and feel, rather than a textbook definition of when a specific stage begins and ends. For help determining stage of healing, read "Acute/Subacute/Chronic"

Contraindications
People who have sensory changes, poor circulation or any sort or cardiovascular (heart or blood circulation) condition should check with their doctor before using hydrotherapy. If you have any questions regarding the above information, feel free to email me, and/or consult with your physician or other health care provider.

HYDROTHERAPY AT HOME

Cold 
A cold gel pack, cold compress (wrap each of these in a cold, wet towel - do NOT apply directly on the skin.) or a cold towel compress (towel or cloth soaked in cold water, wrung out and applied, covered with an insulating towel.) Apply any of these modalities for 25-30 minutes.

Contrast 
Alternating heat and cold hydrotherapy. The ratio used is 3:1 ( 3 minutes of heat : 1 minute of cold (or 30 seconds, depending on your tolerance level.)). Always end with the cold application.

Heat
A thermaphore (moist electric heating pad), hyrdocollator (gel filled heat pack), hot water bottle (wrap in a towel), hot compress (towel or cloth soaked in hot water, wrung out and applied. Cover with an insulating towel.) Apply any one of these modalities for up to 10 minutes. NOTE: Never lie on top of any of these heat sources.

Do NOT use heat if you have an infection - do not place it directly on an acute injury or muscle spasm - but also do not use it if you have a systemic infection - for example; sinus, ear, or lung infections.


Contrast Foot Bathing 


Winter is upon us and our immune systems could use a boost before cold & flu season arrives. In addition to all the garlic, oil of oregano, vitamin C and echinacea you're consuming, an excellent way to strengthen your immune system (and improve your circulation) is to treat your feet to a contrast foot bath.

Instructions:
1. Fill two containers with water, mid-shin deep. One should be hot bath temperature (36-38 degrees C), and the other, cold (4-21 degrees C. You can build up your tolerance to include some ice in the water.)
2. Place both feet into the hot bath for 3 minutes.
3. Place both feet into the cold bath until 'aching' is felt, from ten seconds to one minute maximum.
4. Alternate this cycle three times, always end with the cold.
5. Pat legs & feet dry & put some warm socks on.
6. Rest for 20 minutes.

Contrast foot bathing is useful for:

Chronic sinusitis, head conjestion, pulmonary, pelvic and menstrual conjestion, weak immune system, poor overall circulation, chronic cold feet, 'tired legs', sluggish metabolism, low blood pressure, sub-acute or chronic sprains or strains of the ankle or foot, conjestive headaches (apply in conjunction with cold compresses at the back of the neck).

CONTRAINDICATIONS
Do NOT use contrast foot bathing if you have:

deep vein thrombosis or phlebitis
any inflammation of the legs or feet
heavy menstrual flow
insomnia - treatment may be too stimulating
varicose veins - treatment is possible but keep water below affected area
frostbite

Sauna
Modern day sauna therapy stems from healing techniques that have been practiced throughout history. From the Mayan sweat houses, the Mexican temescal, the Islamic hammam, the Russian bania, the Japanese mushi-buro, the Native American sweat lodge to the Finnish sauna, people throughout the ages have sought heat therapy to relax, relieve stress, heal and maintain health, develop spiritually and interact socially.


Sauna therapy involves sitting inside an enclosure with a heating element that raises your body's temperature to promote sweating and increase blood circulation. The therapy involves repeated sessions of heating and cooling the body to promote detoxification and healing.

Saunas have either a wood, gas or electric heater that warms the air and then your body. For therapeutic saunas, it is recommended that the temperature inside the sauna reach 80 to 90 degrees Celsius. Traditional saunas feature rocks on top of the heater on which you can throw water to temporarily increase the humidity and temperature of the sauna room - however most saunas in health clubs have electric saunas which you may not pour water on.

Sauna therapy has numerous detoxing and cleansing benefits. While you sit inside the hot room, your body attempts to reduce its temperature by driving blood to the surface of the skin and by perspiring. This therapeutic sweating releases toxins through the skin. The heat kills bacteria and viruses and relieves internal congestion. Sauna enthusiasts say that the warmth and the increased blood circulation relaxes muscles, relieves tension and pain in joints and calms the nervous system.

Health experts and physicians caution people with heart disease and pregnant women from indulging in sauna therapy. The Finnish Sauna Society recommends that people with fever or inflammatory disorders as well as people with communicable diseases avoid the sauna. They also say that saunas and alcohol don't mix. People should not drink alcoholic beverages inside the sauna and people under the influence of alcohol should not go to the sauna.

Here are some suggestions on how to take a therapeutic sauna, based on information published by The Finnish Sauna Society.


HOW TO TAKE A THERAPEUTIC SAUNA:
  • Begin by taking a shower.
  • Enter the sauna room wrapped in a towel. Some people choose to remain wrapped in a towel or wear a bathing suit and some people choose to be naked. 
  • The sauna temperature should be 80 to 90 degrees Celsius (100 at the most).
  • Remain in the sauna for a 20-minute session.
  • You may choose to scrub your body while inside the sauna with a loofah brush or washcloth to stimulate the skin and increase perspiration.
  • Follow by an equal amount of time outside the sauna cooling down. This may involve just sitting and letting your body return to your normal temperature, or it may involve taking a cool or cold shower. Sometimes sauna bathers like to jump in a cold lake or a snowbank!
  • Warming and cooling sessions can be repeated several times. 
  • Drink water during your sauna session to remain hydrated.
  • Finish by rinsing yourself off. 
  • Rest a while and drink more water. 
  • After the sweating has stopped, get dressed.