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Hot/Cold "Contrast" Therapy

11/17/2015

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Contrast therapy (aka: hot/cold therapy) has been around for centuries.  Like ice therapy (cryo-therapy) and heat therapy (thermo-therapy), contrast therapy has varied and specific applications as well as some general contraindications.  Also like ice or heat therapy, contrast therapy is most effective when using moist heat/cold (view our last blog post for more on this) versus dry. Valued because of its calming and balancing effect on the body, contrast therapy can be an ideal treatment for conditions where rest is essential to healing, as with stress, repetitive use injuries, as well as cold and flu.  Read on and we'll delve a little deeper into the benefits of contrast therapy, as well as some of the contraindications that apply when utilizing this age-old natural remedy.  Trust us, it'll be worth it in the end! 

Contrast therapy takes advantage of the effects of both heat and cold when applied to the body.  As heat brings blood and nutrients into an area, cold constricts the vessels effectively flushing blood and wastes out.  This "pump-pull" type action is what makes contrast therapy so valuable to healing and restoration (as well as prevention!). 

With conditions such as localized ischemia (areas of reduced blood flow), repetitive use injury, or trauma, contrast therapy can be especially effective.  Nearly any time there is an area in the body that is in need of speedy healing, gentle contrast therapy can be applied without great risk to the body or person.  One should never apply contrast therapy to acute injuries that are still in need of RICE therapy to combat the inflammatory process (see "Icing for -itis" article), nor should it be applied to areas of open wounds or recent surgery.  There are also considerations when utilizing whole-body contrast therapy techniques, for example, one should avoid or significantly modify application if the recipient suffers from:
  • high or low blood pressure (hyper- or hypo-tension)
  • dizziness or fainting
  • dehydration 
  • diabetes 
  • neuropathy
  • nausea or vomiting
  • severe illness (NEVER complete full-body contrast sessions alone if you are severely ill!)
That being said, in general, contrast therapy is a lovely addition to any home-remedy arsenal and one that has little cost and can have profound overall effects.

So how does one go about applying contrast therapy?  Dr. John Harvey Kellogg did numerous studies on the application and efficacy of hydrotherapy in general, and if you're looking for in-depth reads on the subject, we highly recommend his books as reference material.  He, along with his predecessors, used time-tested methods that involved strict adherence to timed application, as well as thermal regulation.  A rotation of 6 repetitions of heat for 3 minutes and cold for 30 seconds should be applied to affect the most potent healing possible.  There are many who claim that specific timing doesn't matter, however, Kellogg thoroughly studied out the matter and discovered that in fact, as with a great many things in nature, timing is everything.  What was also discovered is that if an outcome is desired locally, the application must also be local to obtain the greatest affect.  

An important note as well is that temperature does matter, and one should generally utilize the greatest extremes that one can possibly use without burning or freezing the skin, roughly from 42F (yes! that's REALLY cold!) to 115F (however, this temperature range is reduced significantly for those suffering from diabetes, neuropathy, or extreme illness, or for those who are very young or very old; generally ranging from 70-80F to no greater than 90-104F).  Temperature tolerance will vary between individuals and this is essential in determining the correct therapy range for yourself or your loved ones (this can also change based on the season or the overall health of the individual being treated).  As the body or area being treated becomes acclimated to the temperature being used, the heat should generally be raised to a new tolerable level, and the cold temperature lowered to a new tolerable level.  If you have never done contrast therapy before, it is a good idea to begin with more neutral temperatures, and experiment to figure out what temperatures work best for you, and which extremes you can safely tolerate; again let me note here that this will typically be a bit different for everyone, so testing the area to be treated first can be especially helpful in preventing temperatures that are too extreme and thus preventing possible injuries.  Usually whole-body applications will range more towards the median of the given temperature range, whereas local application will be able to push the outer limits of the given range (yet, this doesn't seem to apply to the Russians or Canadians who regularly practice whole-body contrast therapy as a welcome health regimen, as well as a winter past-time). 

For a whole-body approach, such as with a contrast shower, the goal is to reach the most extreme temperature at each end of the hold-cold spectrum while ensuring that the temperatures used are still within the tolerable range (which tends to be a bit colder than most people actually care for!). 

As noted before, conditions such as repetitive use injury actually respond quite well to contrast therapy, particularly if applied after RICE therapy has been utilized for a period of several days to bring down the general inflammatory response.  The following is a brief list of some of the conditions that may be relieved with the application of contrast therapy:
  • carpal tunnel syndrome
  • tennis elbow
  • Achilles tendinitis
  • shin splints
  • plantar fasciitis
  • IT band syndrome

A couple other benefits worth mentioning, especially this time of year when cold and flu are in the air, is that contrast therapy has been shown to help boost white blood cell count in the body particularly if followed by a period of 30 minutes of rest which is an excellent perk if you are attempting to fight of the latest bug.  So, it might be worth it to adopt a contrast-shower regimen this winter if you'd like to improve your odds of warding off illness from those around you.  It takes a bit of getting used to, I won't lie, but when it becomes habit you actually begin to miss it when you don't have the time to indulge!  (Honest!)  Another quick note in favor of contrast showers is that they have been shown to assist in the fight against depression; which incidentally includes seasonal affective disorder (SAD) which is prevalent in this part of the country during the winter months.   

We know that the concepts of ice-therapy, heat-therapy, and contrast therapy can sometimes leave your brain in a fog. But we promise to leave these last three articles here for you to peruse for a while, just in case you need to refer back.  Now, why not go give that contrast shower a try? 

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    Jerri W., LMT, CWC

    Licensed Massage Therapist and Certified Wellness Coach with over 25+ years of experience in pain management, relaxation techniques and lifestyle education.

    Heather R., LMT, CWC

    Certified Wellness Coach and Licensed Massage Therapist with a passion for helping others achieve optimal wellness through healthier living.

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