Injury and rehabilitation

Hot tub health benefits

Hydrotherapy benefits after an injury

In addition to mild aches and daily stress, hot tub hydrotherapy can aid recovery from a variety of painful injuries. It can make the healing process easier to endure, and may reduce the likelihood of “deconditioning,” a process of physical or mental decline due to inactivity.

Immediately after an injury, appropriate rest is vital. Respect your bodily instincts and avoid re-damaging the injured tissue. Remember that the healing process involves three phases:

Inflammatory phase (0-7 days):  During the first week, blood vessels dilate to allow the flow of essential cells, nutrients and healing factors into the wounded area.
Proliferation phase (7-21 days):  In weeks two and three, the initial structural framework of the wounded area is rebuilt to support blood vessels. Immobilization, or limited movement, allows for the tissue to heal without extensive scarring.
Maturation phase (21+ days):  After three weeks, cells in the wounded area begin remodeling themselves into a more organized structure. Depending on the injury, this phase may take up to a year or longer.

Once soft tissue begins to regenerate, conservative movement helps the tissue to adapt. Movement also helps to prevent the loss of muscle tone and strength in surrounding areas. Mobilization may come in the form of gentle massage, weight, pressure, or other forms of load. Referred to as “optimal loading,” this maximizes the tissue’s ability to adapt without making the injury worse.

It is always wise to consult with a healthcare provider for guidance. But generally, clinicians treat injuries with a combination of protection, rest, ice, compression, elevation and support. An easy way to remember this is to use the acronym PRICES. Another acronym, POLICE, uses a variation of this method: protection, optimal load, ice, compression and elevation. Sports therapists appreciate the benefits of optimal loading, and hydrotherapy helps to make it easier.

According to a paper published in the Indian Journal of Orthopaedics, “Since early mobilization and tissue loading has shown to have a positive effect… it is wise to initiate a loading program as soon as pain permits.” Alluding to the benefits of hydrotherapy, it continued: “Introductory loading should involve a return to full weight bearing, which can also be achieved through hydrotherapy.” Since hydrotherapy takes place in water, it benefits from two side-effects of water: buoyancy and hydrostatic pressure.

The human body is buoyant, meaning that it floats in water. As a result, the force of gravity feels lighter and less painful to weight-bearing injuries. Hydrotherapy helps you transition from partial weight bearing to full weight bearing, and supports your ability to engage in optimal loading. This maximizes the ability of injured tissue to adapt to movement.

What about hydrostatic pressure? When your body is submerged, the weight of the surrounding water presses against it. This pressure is called “hydrostatic,” because the water is static, or not in motion. According to a paper entitled: “Rehabilitation of Ankle and Foot Injuries in Athletes," published in the journal Clinical Sports Medicine, “Hydrotherapy is an excellent means to work on range of motion while also gaining the benefits of hydrostatic pressure.” What are these benefits? According to a 2012 article entitled “The Science Behind the Soak,” “Simple immersion produces hydrostatic pressure on the body, which is the driving force to decrease joint swelling… As a result, this can facilitate pain reduction and increase joint movement.”

To illustrate, consider an injury such as rolling your ankle. Also known as lateral ankle sprain, this involves overstretching the ligaments that hold your ankle bones together. Not only is it painful, it limits the stability of the entire joint. It’s vital to regain full range of motion, strength and coordination, unless you want to hobble around for longer than necessary. After ice and rest, it may be too painful to work on full range of motion with your all your weight. So the buoyancy of hot tub water takes some of the weight off, and the hydrostatic pressure helps to reduce pain and increase joint movement.

Additional health benefits

Sometimes the side effects of an injury are as bad as the injury itself. For example, a scholarly review entitled “The Benefits of Hydrotherapy to Patients with Spinal Cord Injuries” examined the complications that result from spinal cord injury. It stated: “The majority of patients with spinal cord injury lead sedentary lives, associated with [risk of cardiovascular plaque], diabetes mellitus, increased insulin resistance, decreased insulin sensitivity, increased… obesity and body mass index as well as poor cardiorespiratory function.” In contrast, “The benefits of hydrotherapy include enhanced aerobic capacity, improved muscle strength and endurance, increased joint range of motion… as well as decreased muscle fatigue and joint pain, enhanced cardiorespiratory functioning and a reduced [risk of cardiovascular plaque].” It cited buoyancy, hydrostatic pressure and the ability of water to conduct heat as characteristics that make hydrotherapy beneficial for people with spinal cord injuries.

The physical pain of injury is challenging. But so is the emotional pain when you lack mobility. It isn’t easy to be stuck on the couch or in the car when everyone else is having fun. Because it is a fun place to congregate, hot tub hydrotherapy provides opportunities for social, family and romantic connection. As you recover from your injury, no doubt you have sore muscles that need attention or mental stress from which you’d like to escape. By combining the benefits of hydrotherapy and spa therapy, you can make the most of your recovery and share some of the many benefits of hydrotherapy with your friends and loved ones.

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