Hand and Forearm Contrast Hydrotherapy
This week we are sharing a massage therapy trade secret! Well, not really a secret, but I do consider this a career extender for RMTs like myself. I have been using this technique on myself for over a decade now - since 2012! I frequently teach clients how to do contrast forearm baths, as recommended home care for a variety of forearm, wrist, and hand conditions.
If you’re in a rush, scroll down to the photograph to learn how to use this popular massage therapy and acupuncture home care technique!
In the context of a blog post, I cannot say if this will be a right fit for you, as it depends on your particular condition, health history, and goals. Ask us at your next massage or acupuncture appointment, or check in with another health care provider before proceeding to see if this technique would be helpful for you.
However, since I recommend this so frequently, I wanted to take the time to write out the instructions, so our clients can use this as a reference. I won’t make any health claims, but it is quite safe and anecdotally, the feedback is quite positive. The idea is that you are alternating between hot and ice cold immersion baths for the hands and forearms. Hot water immersion is dilating blood vessels, increasing blood circulation. Ice water immersion is constricting blood vessels, reducing bloodflow to the skin, reducing inflammation and distracting from pain. Alternating between the two, dialating - constricting, dialating - constricting, dialating-constricting, in theory creates a pumping or plunger effect with the blood vessels, with the intended result of increasing circulation, decreasing inflammation, and confusing the nervous system input to decrease pain sensations. That is the theory at least! In the massage therapy world, the actual reasons certain techniques work may not always match the theory we learned in school - but that is a topic for another time. What I can say is that many registered massage therapists have done contrast hydrotherapy on our hard working hands and forearms at one point or another, many of us make time to do this on a regular basis over the span of our careers. Our hands are our tools and we need to keep them in good working order! And your hands are your tools too! Conditions of the forearms, wrists and hands are common and can really impact quality of life. Again, it depends on the person and the condition, it can be complex, and it is always very important to seek proper medical care. This is a homecare technique, to assist healing but absolutely not a stand alone treatment.
I am so glad that I learned about contrast hydrotherapy baths while in massage therapy college. I went to school at the West Coast College of Massage Therapy in Victoria BC, entering the program in 2012. At that time, the program consisted of 7 full-time 4-month semesters (3000 hours of schooling), with only short breaks between the semesters. I was definitely concerned about the stress and strain on my body, especially my hands and wrists. We learned about contrast baths in the first semester and I still remember doing it in school, among rows of massage tables with my classmates, then purchasing two plastic kitty litter bins and diligently using them as hydrotherapy tubs at home, filling one with hot water, one with cold water and big blocks of ice. Looking back, I would say it took me a good four years to gain the strength I needed in my hands and forearms for working as an RMT. I have worked a lot over the last decade, like a lot, I mean a lot a lot! Early in my career, I would book my clients back to back, no lunch break, 5 days a week, very little time off. Then I would go home and my hands would cramp up as I cut vegetables for dinner. So contrast baths became my good friend, an almost daily routine, that I would never skip. I considered it as important as a woodworker maintaining their tools. As they say, you need the right tools to get the job done! Now my hands are much stronger and finely tuned after years of work, and I take more breaks. Thankfully that means my hands no longer cramp when cutting a tomato. But still I do contrast baths as needed and I think I always will.
This is a common and popular technique, but I couldn’t find where exactly it originated from. All I can say is that is was taught at WCCMT Victoria BC back in 2012, and it seemed like all RMTs at the time knew this rite of passage.
Contrast Hydro How-To:
* A clean double sink is ideal! Or set up two plastic bins next to each other with a towel under to catch drips. Bins need to be large enough to fit both of your forearms up to your elbow. New kitty litter bins work well for this.
* Fill one sink/bin with hot water as tolerated.
* Fill the other sink/bin with cold water. Add ice as tolerated.
* Alternate immersing your forearms/hands in the hot water and then the cold water for three cycles, starting with hot and ending on cold.
* Ratio of time should be 2:1 hot:cold or 3:1 hot:cold
Example: 2 min hot, 1 min cold x 3 cycles
Or 5 min hot, 2.5 min cold x 3 cycles
The skin will probably go bright red. Be mindful of the temperatures and length of immersion and make sure not to burn yourself or freeze your fingers. If it feels too intense, lessen the temperature extremes. This should be gentle! Never add salt to the cold water.
Tip: ice cubes tend to melt quite fast. Freeze a larger chunk of ice in a yogurt container/Tupperware and add that into the cold water. Don’t forget to freeze more for next time!
Optional: gently flex and extend you fingers in the hot water, for a general range of motion.
The biggest barrier to success is the rigmarole of set up/clean up. As well as the monotony of the process. Believe me I know! Keep in mind consistency and repeating the process over time increases chance of success.
Though not as intense, you can take this concept and modify in a number of ways.
1) After washing you hands in very hot water, blast a cold water rinse.
2) If you are soaking in a hot bath or hot tub, have a large ice cube in reach. Soak your arms in the warm water, then lightly run the ice over your forearms and hands for about 30 seconds, repeat 3 times.
3) Use a heating pad and ice pack wrapped in a towel and use the same timing described above.
4) If you are doing the dishes by hand, with hot soapy water, keep a bucket of ice water nearby to soak your hand in for a few cycles. (My mom’s idea - thanks mom!)
5) Cold water rinse to forearms and hands after a shower or sauna.
Using ice cube to massage forearms
So there you have it! Give it a go and let us know what you think. I know there are a lot people suffering with carpal tunnel syndrome, tennis elbow, and golfers elbow that would find this very helpful, just to name a few.
And if you find yourself needing a bit of extra care, please do not hesitate to get in touch with us to schedule a massage therapy or acupuncture appointment.
Looking forward to hearing from you soon!
- Oceanside Acupuncture & Massage Therapy
Proudly serving residents of all corners of Greater Saint John NB, including Rothesay, Quispamsis, and Westfield-Grand Bay.
Sources (click on the links to view web pages and articles):
NCBI article https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049052/
Semantics Scholar https://pdfs.semanticscholar.org/5b0d/e7b4fefda002c1b775a348a285682cc62be9.pdf
Journal article https://journals.lww.com/nsca-jscr/fulltext/2017/05000/effects_of_cold_water_immersion_and_contrast_water.32.aspx