Hydrotherapy: Water, Water, Everywhere

By Judith DeLany , LMT

Hydrotherapy: Water, Water, Everywhere

By Judith DeLany , LMT

Water is indisputably the most essential nutrient for the human body. Adults are composed of approximately 60 to 65 percent water, with somewhat less in elderly and much more in infants. In Job's Body, Deane Juhan jokingly quotes, "A human being is a container invented by water so that it can walk around."2 It is not surprising that the therapeutic application of water - in any of its many forms - is enjoyed throughout the world.

Hydrotherapy is almost as old as the hills from which the water runs. In fact, it has been historically accounted in a number of ancient civilizations, including Russian, Turkish, Chinese, Greek and Native American. Although it serves as a safe, effective and inexpensive treatment, hydrotherapy in modern times is often overlooked as a powerful healing tool.

Massage therapists classically use water therapies in their practices. Hot or cold packs, ice massage, steam (cabinets and rooms), and the massaging jets of a hot tub are just a few common hydrotherapies. Sheet wraps, cold and warming compresses, neutral baths, local immersions and soaks that contain minerals, such as magnesium found in Epsom salts also offer significant benefits.

Heat-based applications engorge the tissues with blood, while cold treatments reduce local swelling and congestion. In Water Therapy, Chaitow notes that while short applications of cold increase circulation, longer applications of cold (more than a minute) reduce the flow of blood to the area by contracting the local blood vessels, and depress circulation and metabolism.1 A short duration of heat increases blood flow with vessel dilation while a longer duration depresses circulation and metabolism drastically. Alternating hot and cold for short durations produces a circulatory interchange, improves drainage and increases oxygen supply to muscles, skin and organs. Chaitow suggests that the final application be cold so as to avoid leaving the tissues in a state of engorgement (potentially leading to congestion).

Practitioners can benefit from self-application, whether this is cold to calm inflammation, heat to increase blood flow to ischemic muscles or contrast hydrotherapy. Plunging the hands and forearms into bins of tolerably hot and then very cold water eight to 10 times, can have extraordinary benefit for these overused (and usually under-treated) muscles. After contrast hydrotherapy, the muscles can be more easily massaged and stretched. This technique requires only a little preparation and very little expense. You will need:

  • Two bins (dishpans) to hold water - These must to be large enough (length and depth) to completely submerge one or both hands and forearms (to just above the bend of the elbows).
  • Hot water (98-104 F°) - Bearable, but as hot as can be tolerated without scalding or burning the skin. Hotter than 104 F° may damage the tissues.
  • Cold water (55-65 F°) - Water so cold that ice will float (rather than rapidly melting) is usually very effective.

Common sense contraindications include avoiding heat applications on swollen or inflamed tissues, recent wounds and acute injuries. Cold should be avoided on those who are cold-intolerant (as in Raynaud's disease) or who have moderately poor circulation.

One extremity at a time can be treated or, if the pans are large enough, both can be done simultaneously. It is also possible to put one arm in the cold bin while the other is in the hot, then switch them to contrast the temperature. However, be prepared for unusual sensations, as the body is not accustomed to receiving mixed signals from thermal receptors.

Fully submerge the arm in the hot water for two to three minutes. Switch to the cold water and hold there for a similar time. Continue alternating between hot and cold for two to three minutes each. If massage therapy is to be used, the session may end with hot water. The massage strokes will provide a final drain of the tissues. If no massage is to be performed, it is best to end with cold to avoid producing congestion.

Contrast hydrotherapy can be a significant treatment all by itself or it can be a precursor to superficial and deep tissue treatment of the muscles. The muscles can also be stretched much more easily and with less discomfort after contrasting the temperature.


  1. Chaitow L. Water Therapy. Boston: Elements, 1999.
  2. Juhan D. Job's Body: A Handbook for Bodywork. Barrytown, NY: Station Hill, 1998.