Any type of temperature or water based therapy is called 'hydrotherapy’ - ‘hydro’ from the Greek word ‘hudōr’ meaning water.

A common question here at the clinic is ‘should I use ice or hot at home to help heal my injury?’. First, let’s break this down into the list of benefits each type of hydrotherapy can provide:

HOT

• increases circulation

• soothing physically

• soothing emotionally

• relaxes muscles

• pain relief

COLD

• decreases circulation

• invigorating

• decreases inflammation

• reduces pain

• reduces swelling

As listed, we can see parallel benefits between the two forms of hydrotherapy. So now we factor in the nature of the injury or pain you are trying to soothe. Let’s take shoulder pain as an example. Here are two types of shoulder pain we see commonly at the clinic:

• You have an achy, throbbing shoulder that hurts with certain movements and has just started up over the course of the last week. You feel it almost all the time, wonder if it’s affecting your sleep and feel a low level of annoyance related to the persistent level of pain as well as some heat on the top part of the shoulder.

  • We are most likely going to recommend ICE for this situation. With joint restrictions + temperature or any type of swelling there is often some type of inflammation and in order to restore some function we need to first treat your inflammatory response.

• You have an achy upper back with some shoulder tension and referral down the arm. You can sleep well enough but do notice this discomfort throughout the day. and your ability to focus on certain tasks is at times distracted by the sensations related to your shoulder and back.

  • We are most likely going to recommend HOT for this situation.. It sounds like a hot pack to the back and shoulder area might help relax the muscles and nerves that supply your shoulder and arm. Soothing heat for 20 minutes might help save the day.

Important Stuff! When NOT to use ice or cold?

When absolutely NOT to use cold? If you have Raynaud’s disease or are simply unable to physically relax into the cold sensation of ice. If the latter is true for you, than you might benefit from contrast hydrotherapy ~ more on that later.

When absolutely NOT to use hot? If you have a lot of swelling or heat in the area already - ice is best. Also, watch out if you have an ear infection as heat around the neck and upper back is not recommended.

Can I use both hot and cold to help my pain?

Most often, my answer is - yes! This is called “Contrast Hydrotherapy” and it’s a beautiful thing. Basically, your alternating hot & cold (always finish with cold if you can) and the ratio we recommend here is 3:1 or 3 minutes hot to 1 minute cold. However, your cold experience can be as little as 30 seconds to produce benefit for your body.

Why should I try contrast therapy?

OMG…as massage therapists it’s our favorite thing ever! In theory, basically with heat you are encouraging new blood flow, energy and circulation into an area and this helps bring nutritious healing movement to the injured site. With ice, you are shunting all that beautiful flow away from the area helping to clear away inflammation and metabolite clutter. When you repeat this cycle of hot and cold a few times, it really helps with systemic, internal healing of your muscle tissue.

Types of hydrotherapy to try - here’s a quick list for ideas:

• ice / hot foot baths

• ice / hot packs

• moist ice / hot compress

• hot bath with Epsom salts

• ice baths - especially helpful for runners

• wax baths for arms / feet

• steam inhalations / saunas

You will often hear us say ‘when in doubt, use ice’. Your body will always benefit from the ‘spot’ specific reduction of inflammation. Another commonly used rule is RICE as a form of acute injury management:

R - rest

I - ice

C - compress

E - elevate

With the application of cold, we have another helpful acronym to help you get the most of your cold hydrotherapy self-care - CBAN. With the use of cold you want to allow for these stages of sensation - especially with an acute injury:

C - cold, just a general sensation of coldness to the area your self treating

B - burny, tingly or even itchy

A - achy, potentially throbbing

N - numb - so important for you to keep your ice on until it feels numb as this is where we can assume your body will experience the greatest analgesic benefit. Once it starts to feel numb, please do remove your ice application.

Finally, if your using a bath or steam inhalation remember that Epsom salts &/or the addition of one or two drops of essential oil can be added. Essential oils engage with your olfactory system which is directly related to your brains’ limbic system and can help to reduce your overall stress response. Love essential oils, but don’t know where to start? We really like Sofia Ferrari’s free on-line learning events - click here. So whether your goals are related to injury recovery or general healing essential oils can be helpful with a systemic reset.

Stay warm, open & refreshed.

We hope this helps.