Contrast bath therapy

Last updated
Contrast bath therapy
Other namesHot/cold immersion therapy
Specialty physical therapy

Contrast bath therapy is a form of treatment where a limb or the entire body is immersed in hot (but not boiling) water followed by the immediate immersion of the limb or body in cold ice water. [1] This procedure is repeated several times, alternating hot and cold. The only evidence of benefit is anecdotal and no plausible mechanism has been confirmed. [2] [3]

Contents

Theory

The theory behind contrast bath therapy is that the hot water causes vasodilation of the blood flow in the limb or body followed by the cold water which causes vasoconstriction. [1] The lymph system, unlike the circulatory system, lacks a central pump. By alternating hot and cold, it is believed that lymph vessels dilate and contract to "pump" and move stagnant fluid out of the injured area and that this positively affects the inflammation process, which is the body's primary mechanism for healing damaged tissue.[ medical citation needed ]

Treatment

Contrast bathing can be used to reduce swelling around injuries or to aid recovery from exercise. It can also significantly improve muscle recovery following exercise by reducing the levels of blood lactate concentration. For any injury presenting with palpable swelling and heat, and visible redness - such as a strain/sprain - contrast baths are contraindicated during the acute inflammation stage. Acute inflammation begins at the time of injury and lasts for approximately 72 hours.

Effectiveness in athletic recovery

The current evidence [1] base suggests that contrast water therapy (CWT) is superior to using passive recovery or rest after exercise; the magnitudes of these effects may be most relevant to an elite sporting population. There seems to be little difference in recovery outcome between CWT and other popular recovery interventions such as cold water immersion and active recovery. [1]

In a review on immersion therapy in general, Ian Wilcock, John Cronin, and Wayne Hing suggest that most of the benefits of contrast therapy are from the hydrostatic pressure from the water, not the variations in temperature. [4]

See also

Related Research Articles

<span class="mw-page-title-main">Lymphedema</span> Medical condition

Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns interstitial fluid to the bloodstream.

<span class="mw-page-title-main">Edema</span> Accumulation of excess fluid in tissue

Edema, also spelled oedema, and also known as fluid retention, dropsy and hydropsy, is the build-up of fluid in the body's tissue, a type of swelling. Most commonly, the legs or arms are affected. Symptoms may include skin that feels tight, the area feeling heavy, and joint stiffness. Other symptoms depend on the underlying cause.

<span class="mw-page-title-main">Compartment syndrome</span> Condition in which increased pressure results in insufficient blood supply

Compartment syndrome is a condition in which increased pressure within one of the body's anatomical compartments results in insufficient blood supply to tissue within that space. There are two main types: acute and chronic. Compartments of the leg or arm are most commonly involved.

<span class="mw-page-title-main">Sprain</span> Damage to one or more ligaments in a joint

A sprain is a soft tissue injury of the ligaments within a joint, often caused by a sudden movement abruptly forcing the joint to exceed its functional range of motion. Ligaments are tough, inelastic fibers made of collagen that connect two or more bones to form a joint and are important for joint stability and proprioception, which is the body's sense of limb position and movement. Sprains may be mild, moderate, or severe, with the latter two classes involving some degree of tearing of the ligament. Sprains can occur at any joint but most commonly occur in the ankle, knee, or wrist. An equivalent injury to a muscle or tendon is known as a strain.

<span class="mw-page-title-main">Hydrotherapy</span> Alternative medicine using water for pain relief and treatment

Hydrotherapy, formerly called hydropathy and also called water cure, is a branch of alternative medicine, occupational therapy, and physiotherapy, that involves the use of water for pain relief and treatment. The term encompasses a broad range of approaches and therapeutic methods that take advantage of the physical properties of water, such as temperature and pressure, to stimulate blood circulation, and treat the symptoms of certain diseases.

Delayed onset muscle soreness (DOMS) is the pain and stiffness felt in muscles after unaccustomed or strenuous exercise. The soreness is felt most strongly 24 to 72 hours after the exercise. It is thought to be caused by eccentric (lengthening) exercise, which causes small-scale damage (microtrauma) to the muscle fibers. After such exercise, the muscle adapts rapidly to prevent muscle damage, and thereby soreness, if the exercise is repeated.

Cryotherapy, sometimes known as cold therapy, is the local or general use of low temperatures in medical therapy. Cryotherapy may be used to treat a variety of tissue lesions. The most prominent use of the term refers to the surgical treatment, specifically known as cryosurgery or cryoablation. Cryosurgery is the application of extremely low temperatures to destroy abnormal or diseased tissue and is used most commonly to treat skin conditions.

A soft tissue injury is the damage of muscles, ligaments and tendons throughout the body. Common soft tissue injuries usually occur from a sprain, strain, a one-off blow resulting in a contusion or overuse of a particular part of the body. Soft tissue injuries can result in pain, swelling, bruising and loss of function.

<span class="mw-page-title-main">Strain (injury)</span> Injury due to slight tearing of a muscle or tendon

A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both. The equivalent injury to a ligament is a sprain. Generally, the muscle or tendon overstretches and partially tears, under more physical stress than it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity. Strains most commonly occur in the foot, leg, or back. Immediate treatment typically includes four steps abbreviated as R.I.C.E.: rest, ice, compression, elevation.

<span class="mw-page-title-main">Lymphangitis</span> Inflammation or infection of the lymphatic channels

Lymphangitis is an inflammation or an infection of the lymphatic channels that occurs as a result of infection at a site distal to the channel. It may present as long red streaks spreading away from the site of infection. It is a possible medical emergency as involvement of the lymphatic system allows for an infection to spread rapidly. The most common cause of lymphangitis in humans is bacteria, in which case sepsis and death could result within hours if left untreated. The most commonly involved bacteria include Streptococcus pyogenes and hemolytic streptococci. In some cases, it can be caused by viruses such as mononucleosis or cytomegalovirus, as well as specific conditions such as tuberculosis or syphilis, and the fungus Sporothrix schenckii. Lymphangitis is sometimes mistakenly called "blood poisoning". In reality, "blood poisoning" is synonymous with sepsis.

<span class="mw-page-title-main">Sitz bath</span> Bath in which a person sits in water up to the hips

A sitz bath or hip bath is a bathtub in which a person sits in water up to the hips. It is used to relieve discomfort and pain in the lower part of the body, for example, due to hemorrhoids (piles), anal fissures, perianal fistulas, rectal surgery, an episiotomy, uterine cramps, inflammatory bowel disease, pilonidal cysts and infections of the bladder, prostate or vagina. It works by keeping the affected area clean and increasing the flow of blood to it.

Heat therapy, also called thermotherapy, is the use of heat in therapy, such as for pain relief and health. It can take the form of a hot cloth, hot water bottle, ultrasound, heating pad, hydrocollator packs, whirlpool baths, cordless FIR heat therapy wraps, and others. It can be beneficial to those with arthritis and stiff muscles and injuries to the deep tissue of the skin. Heat may be an effective self-care treatment for conditions like rheumatoid arthritis.

Cold compression therapy, also known as hilotherapy, combines two of the principles of rest, ice, compression, elevation to reduce pain and swelling from a sports or activity injury to soft tissues and is recommended by orthopedic surgeons following surgery. The therapy is especially useful for sprains, strains, pulled muscles and pulled ligaments.

<span class="mw-page-title-main">RICE (medicine)</span> Medical acronym

RICE is a mnemonic acronym for the four elements of a treatment regimen that was once recommended for soft tissue injuries: rest, ice, compression, and elevation. It was considered a first-aid treatment rather than a cure and aimed to control inflammation. It was thought that the reduction in pain and swelling that occurred as a result of decreased inflammation helped with healing. The protocol was often used to treat sprains, strains, cuts, bruises, and other similar injuries. Ice has been used for injuries since at least the 1960s, in a case where a 12-year-old boy needed to have a limb reattached. The limb was preserved before surgery by using ice. As news of the successful operation spread, the use of ice to treat acute injuries became common.

<span class="mw-page-title-main">Hydro massage</span> Use of water pressure for massage techniques

Hydromassage is a massage technique which uses water pressure and temperature to reduce muscle tension, improve blood flow, and reduce stress.

Cold shock response is a series of neurogenic cardio-respiratory responses caused by sudden immersion in cold water.

<span class="mw-page-title-main">Musculoskeletal injury</span> Damage of muscular or skeletal systems

Musculoskeletal injury refers to damage of muscular or skeletal systems, which is usually due to a strenuous activity and includes damage to skeletal muscles, bones, tendons, joints, ligaments, and other affected soft tissues. In one study, roughly 25% of approximately 6300 adults received a musculoskeletal injury of some sort within 12 months—of which 83% were activity-related. Musculoskeletal injury spans into a large variety of medical specialties including orthopedic surgery, sports medicine, emergency medicine and rheumatology.

<span class="mw-page-title-main">Cold injury</span> Medical condition

Cold injury is damage to the body from cold exposure, including hypothermia and several skin injuries. Cold-related skin injuries are categorized into freezing and nonfreezing cold injuries. Freezing cold injuries involve tissue damage when exposed to temperatures below freezing. Nonfreezing cold injuries involve tissue damage when exposed to temperatures often between 0-15 degrees Celsius for extended periods of time. While these injuries have disproportionally affected military members, recreational winter activities have also increased the risk and incidence within civilian populations. Additional risk factors include homelessness, inadequate or wet clothing, alcohol abuse or tobacco abuse, and pre-existing medical conditions that impair blood flow.

<span class="mw-page-title-main">Ice bath</span> Therapeutic body immersion in iced water

In sports therapy, an ice bath, or sometimes cold-water immersion, Cold plunge or cold therapy, is a training regimen usually following a period of intense exercise in which a substantial part of a human body is immersed in a bath of ice or ice-water for a limited duration.

Ischemia-reperfusion (IR) tissue injury is the resultant pathology from a combination of factors, including tissue hypoxia, followed by tissue damage associated with re-oxygenation. IR injury contributes to disease and mortality in a variety of pathologies, including myocardial infarction, ischemic stroke, acute kidney injury, trauma, circulatory arrest, sickle cell disease and sleep apnea. Whether resulting from traumatic vessel disruption, tourniquet application, or shock, the extremity is exposed to an enormous flux in vascular perfusion during a critical period of tissue repair and regeneration. The contribution of this ischemia and subsequent reperfusion on post-traumatic musculoskeletal tissues is unknown; however, it is likely that similar to cardiac and kidney tissue, IR significantly contributes to tissue fibrosis.

References

  1. 1 2 3 4 Bieuzen, François; Bleakley, Chris M.; Costello, Joseph Thomas (2013-01-01). "Contrast water therapy and exercise induced muscle damage: a systematic review and meta-analysis". PLOS ONE. 8 (4): e62356. Bibcode:2013PLoSO...862356B. doi: 10.1371/journal.pone.0062356 . ISSN   1932-6203. PMC   3633882 . PMID   23626806.
  2. Petrofsky J, Lohman E, Lee S, de la Cuesta Z, Labial L, Iouciulescu R, Moseley B, Korson R, Al Malty A (2007). "Effects of contrast baths on skin blood flow on the dorsal and plantar foot in people with type 2 diabetes and age-matched controls". Physiother Theory Pract. 23 (4): 189–97. doi:10.1080/09593980701209295. PMID   17687732. S2CID   7515998.
  3. David J. Magee; James E. Zachazewski; William S. Quillen (14 February 2007). Scientific Foundations and Principles of Practice in Musculoskeletal Rehabilitation - E-Book. Elsevier Health Sciences. p. 251. ISBN   978-1-4160-6854-9.
  4. Wilcock, Ian M.; Cronin, John B.; Hing, Wayne A. (2006). "Water Immersion: Does It Enhance Recovery from Exercise?". International Journal of Sports Physiology and Performance. 1 (3): 195–206. doi:10.1123/ijspp.1.3.195. ISSN   1555-0265. PMID   19116434.