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Water used in varying temperatures to
maintain health and prevent dis-ease.

What is Hydrotherapy?
Hydrotherapy is the use of heat and cold for therapeutic effects. Hydrotherapy has been used throughout history in the form of healing baths and hot springs, and is still commonly applied in the form of heat and ice packs. The effects of hydrotherapy vary depending on the
temperature, how it is applied, and length of

Your therapist may instruct you to apply hydrotherapy at home following your treatment, and will provide specific instructions to ensure the safety and effectiveness of hydrotherapy for you and your condition.

Here are some general guidelines, followed by answers to common questions about hydrotherapy:

Hot Hydrotherapy
Heat is used to make muscles and fascia softer and more flexible, increase circulation, reduce pain, and provide relaxation. It is often applied for relief of tight, achy muscles present in chronic conditions.

Hot hydrotherapy can be applied through a hot bath, an electric heating pad, a hot water bottle, or a grain or rice-filled microwaveable cloth bag.

Heat should be applied for up to 10-30 minutes at a time, and temperature should never be uncomfortably hot.

There are a number of precautions to observe when using hot hydrotherapy. You should not use heat when swelling or bleeding are present, as it will increase blood flow to the area. If you have an infection or a burn, do not use heat over the area. Those with circulatory conditions such as high blood pressure or conditions where sensations are altered such as diabetes and multiple sclerosis may be instructed to modify hydrotherapy applications. Always ask your therapist for specific instructions.

Cold Hydrotherapy
Cold hydrotherapy is used to reduce pain and decrease blood flow. It is commonly used in first aid to minimize pain and swelling after an injury. Ice is often used following a deep or specific massage treatment to ensure the greatest benefit from the treatment.

Cold can be applied using ice or gel-filled ice packs, ice baths, or cold, wet towels. To eliminate the risk of frostbite, ice and ice packs should be wrapped in a small towel, and should not be applied directly to the skin.

Cold can be applied for 10-15 minutes, depending on the body part being iced. Your therapist will advise you on the ideal duration for you. If you wish to reapply the ice, wait for twenty minutes between applications.

Precautions for the use of cold hydrotherapy include either increased or decreased sensitivity to temperature, as you may misjudge the temperature you are applying. Cold is also not advised if you have insufficient circulation (as with Raynaudís disease or diabetes, especially when applying ice to extremities). If you feel chilled, do not apply cold hydrotherapy until your temperature has returned to normal.

Contrast Hydrotherapy
Contrast hydrotherapy is an application of heat followed by an application of cold. This increases blood flow to and from the area, which speeds healing. It is always advisable to start contrasts with very minimal differences in temperature!

A guideline for the timing of heat and cold applications is 3 minutes of heat followed by 1 minute of cold. This can be repeated for up to 30 minutes, and should always end with an application of cold. A simple application is a rule of 3's : 3 minutes heat, 30 seconds cold, 3 times.

There are a number of ways to apply contrast hydrotherapy. You can alternate hot and cold packs or hot and cold towels, depending on the body part being treated. For hands and forearms, you can fill a two-sided kitchen sink with hot water on one side and cold on the other, and alternate between the two. For all applications, follow the 3:1 ratio of heat to cold, ending with cold. Be gentle with your skin following the application; pat dry, do not rub.

The precautions for both heat and cold applications also apply to contrast applications. Be particularly cautious regarding contrast hydrotherapy if you have high, low, or irregular blood pressure. The bigger the contrast in temperatures (ie. really hot and really cold), the bigger the response your body will have. Please take precautions when trying contrasts to see how your body responds to this technique (ie. warm and cool water).

Always check with your therapist to determine whether contrast hydrotherapy is appropriate for you.

Frequently Asked Questions about Hydrotherapy

•How do I know whether to use heat or ice?
Generally, ice is preferred for acutely painful, new injuries, which includes post-massage tenderness. If the area is swollen, hot to the touch, or red, try ice to reduce the inflammation.
Heat is usually a more effective treatment if tissues are tight and achy, or if an injury is older. Heat is also the preferred treatment prior to stretching exercises, as it warms the muscles and makes them more flexible.

•What if I find ice uncomfortable?
As the applications of cold and cooler temperatures help significantly to reduce pain and inflammation, it is advisable to attempt to use ice whenever applicable. Add an extra layer around the ice pack or increase the temperature of the water slightly to reduce the discomfort of cold.

•When is it okay/not okay to have pain with ice applications?
If ice is used for a friction-type massage, the process of cooling the skin and associated soft tissues will involve stages that can be painful (ie. numbness and tingling occurs). If you experience any numbness or tingling or pain while using ice, and it is not an expected outcome of the ice application, remove the ice IMMEDIATELY and allow the body to return to normal temperature on its own. DO NOT apply heat to the area as your sensation will be dimenished and you could damage the tissues in that area.

•I only feel ice works when I leave it on for a long time, isn't this okay?
Absolutely not okay. The application of ice to an injured area is only beneficial if it is taken on and off over a period of time, allowing the skin to return to its normal temperature, allowing the blood to return to the area between applications. The ice acts by flushing out the inflammation and bringing in new blood to the injury. If you do not allow for this natural process, ie. you leave the ice on longer than 20 minutes, you are actually doing harm to your tissues, giving yourself a bit of 'frostbite.' Keeping the area healthy (avoiding frostbite-type damage to the superficial tissues) will help heal the injury faster. The key is to keep repeating the ice applications, 10-15 minutes on, 10-15 minutes off.