Everything you wanted to know about hydrotherapy but were afraid to ask!

Hydrotherapy is defined as: Any method that uses water to treat a variety of symptoms throughout your body. This water can be in the form of steam, ice, and liquid. This water can do different things depending on whether it is hot or cold, whether it is a local application or an all over body/soak. This water can carry heat and energy, and can dissolve other substances such as salts and minerals. Hydrotherapy can take many forms. One of the most common is aquatic exercise. Water creates a gentle resistance and can decrease the effects of gravity on aging, injured, or stressed tissues and joints. This aquatic option can open movement doors for individuals who struggle with chronic pain, aging, injury and resulting inflammation, and for whatever reason are not able to use conventional gyms, or do these exercises in gravity.

Ice has also plays a big part of many hydrotherapy treatment plans. Every day I tell clients to go home and ice the areas we worked on the table that day. First, ice does something called vasoconstriction. It narrows blood vessels and when this happens, less blood reaches the affected area keeping swelling down. There have been discussion in bodywork circles for a few years, about whether or not ice is doing what we think it is. For a long time we were taught the RICE (rest, ice, compression, elevation) method to address acute injury. With the RICE protocol, the overall goal is to reduce pain, inflammation, and discomfort and promote healing. Recently there has been discussion about the fact that vasoconstriction does not allow for prostaglandins, bradykinins, macrophages, and all the cells of healing - which is what inflammation is - to reach the affected area. It is interesting then to discuss that, the secondary effect of vasoconstriction, is vasodilation. Those blood vessels that had previously been narrowed, now open wider, leaving more space for all chemistry to be metabolized and flushed through the system. Many doctors and healthcare practitioners still recommend the RICE method, and I ALWAYS err on the side of decreased pain. These health care practitioners are starting to focus on pain relief and rehabilitation as the 2 biggest priorities in injury recovery. That said, with acute injury, you are never going to go wrong using ice. If your injury is more than 6 weeks old heat can be beneficial injuries in increasing blood flow, relaxing tight muscles, and increasing range of motion.

What else can heat do? Heat is really good for spasming muscles. Cramps, rigid joints, and range of motion issues can all be addressed with the application of heat. This heat can be applied directly to the affected area via heating pad, warm towels or from a microwave, steam rooms, saunas, and my favorite, hot tubs. Muscle pain responds well to heat. Heat can increase circulation, decrease pain, and address multiple chronic pain symptoms. Heat will trigger some of the same mechanisms in the brain and body as if you were physically engaged in cardiovascular exercise. While in the sauna, heart rate and blood flow increase, and blood vessels will vasodilate (expand) as your body works to cool down in order to regulate body temperature. On a very systemic level, whether hot tub, sauna, steam room, local application, heating pads or Epsom salt soaks, heat is good for relaxing the nervous system.

There are many hydrotherapy applications in addition to just hot and cold applications. There are poultices, body wraps, sitz baths, aquatic physical therapy, watsu, saunas, and the list goes on. Most often I find that just letting clients know what options are out there, gives them a greater amount of agency and power in alleviating uncomfortable symptoms.

In addition to this external hydrotherapy, I would like to put a plug in here about internal hydrotherapy. What is that you ask? Drinking more water. We ALL need to drink more water. It sounds very simple, but if it was so easy, why is it so hard for people to do? Increasing the amount of water you drink has many benefits. First, it helps maximize your physical performance. Dehydration can lead to altered body temperature control, reduce motivation, and increase fatigue. Drinking more water may also help reduce oxidative stress to your tissues and system. Fluid loss, even mild dehydration, can affect many aspects of brain function. Dehydration is often a big factor in headaches, and increasing water intake can positively affect symptoms. Drinking more water can also aid constipation, decrease symptoms from kidney stones, and most definitely can assist in lessening the impact of hangovers (this I can personally attest to).

Finally, I would like to mention revulsive hydrotherapy. This is the practice of using hot and cold applications to the affected area or full body depending on the desired effect. The alternating vasoconstriction, and then vasodilation acts as a large pump. This movement of blood being shunted from muscles and tissues during vasoconstriction sends these chemicals, that have been being held in stasis, to the viscera to be processed, metabolized, and integrated into the system. The following vasodilation opens up these blood vessels that have been steeped in inflammatory chemistry and ushers in a huge rush of fresh and oxygenated blood with which to support these tissues. These hot and cold applications can be localized as in a heating pad and an ice pack, or it can involve full body immersion hot water, and then a cold plunge for example. A few rounds of going back and forth between cold and hot is an amazing way to assist the body in processing and metabolizing the chemistry and stress of daily living. That said, please consult with a healthcare practitioner to assess what types of hydrotherapy may be beneficial for you.

Now go drink some water. I look forward to seeing you on my table soon.