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Hot and Cold: A Beginner's Guide to Hydrotherapy

Posted by Douglas W. Stoddard MD, M Sp Med, Dip Sport Med, ES on 2 May 2017
Hot and Cold: A Beginner's Guide to Hydrotherapy

Heat (thermotherapy) and Cold (cryotherapy) have stood the test of time and continue to have an important place in the wonderful world of healthcare, and what better time than spring to discuss its benefits and uses!

Together with manual therapies such as corrective exercise and deep-tissue massage, temperature therapy can play a key role in not only injury recovery (rehab), but injury prevention (prehab) as well. These can be used as local treatments which target a specific part of the body, or systemic treatments which are applied wholesale.

Heat collar on the neck? Local, and lovely. Dumping a bucket of ice on an unsuspecting friend? Systemic cryotherapy at it's finest.

Today we'll look at a few instances where heat or cold could be applied. As always, make sure to follow the guidelines of your healthcare provider (we have a bunch of those at SEMI, by the way) before diving into a pool of lava or sunbathing on a glacier.


Warm and cuddly, heat utilizes the bodies' natural response of vasodilation to cause an influx of blood to the target area. While cold is appropriate for the acute stage of an injury, heat is mainly used for chronic conditions over longer periods of time, and is a cornerstone when dealing with the following:

  • Non-inflammatory muscle pain and trigger points - When "ache," "stiffness", and "knots" are your first words when asked how you feel, this one's for you. This would also include DOMS (delayed-onset muscle soreness), which your average 'do-you-even-lift bro' can gladly inform you about.
  • Limited range of motion (ROM) of joints - Used in tandem with stretching and mobility drills, heat can be used to help increase tissue length and pliability in the ongoing battle against poor posture.
  • Anxiety/Stress - Often overlooked, anxiety and stress can actually act as a catalyst to musculoskeletal pain. While not directly causing the pain itself, the altered breathing mechanics, tense posture, and clenching most certainly can. Systemic heat is wonderful here.


Ok guys, time to get serious. Cold is, cold.

When used to heal injuries, it's very cold. Some enjoy it, most don't. But after it helps you through your first injury, you'll be thanking your ice-cube tray every time you open the freezer. Cold utilizes the bodies' natural response of vasoconstriction to reduce inflammation and swelling of the target area.

When dealing with acute injuries, cold is often the first into the fray, used in shorter intervals than heat. Here's just a few of the many, many instances in which cold could be implemented:

  • Soft tissue trauma - Bruises, sprains, edema, fractures, the whole nine yards. This is where cold really goes to work. Using cold and compression in intervals helps decrease swelling and refresh local blood supply, effectively shoving blood to and from the injury site.
  • Acute muscle spasm - Helps supress the neurological firing that is causing the muscle to contract, which is pretty much constant when a muscle is in full spasm. The sharper the pain feels, the colder the therapy should be.

If you're suffering from one of the aforementioned ailments, SEMI clinics offer a wide range of sport physiotherapy, active release techniques, prolotherapy, PRP injections, shockwave therapy you get the idea.

To find a treatment that's right for you to get back to the summertime sports or activities you love, book an appointment at SEMI today!

Author: Douglas W. Stoddard MD, M Sp Med, Dip Sport Med, ES
About: Dr. Douglas Stoddard is a sports medicine physician and is the Medical Director of the Sports & Exercise Medicine Institute (SEMI). After receiving his medical degree from the University of Toronto, he trained in Australia at the Australian Institute of Sport in Canberra, obtaining his Master Degree in Sports Medicine. He is also a diplomat of the Canadian Academy of Sport and Exercise Medicine and has his focussed practice designation in Sport Medicine from the Ontario Medical Association. Dr. Stoddard is a consultant to the Canadian Military and has consulted with well over 30,000 unique patients in his career. Dr. Stoddard is constantly searching for new and promising therapies to help SEMI patients, and is responsible for developing the RegenerVate Medical Injection Therapy Program. He is married and the proud father of two boys, is an avid triathlete and occasional guitar player.
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Did you know that The American College of Sports Medicine (ACSM) and American Heart Association (AHA) recommends that adults between the age of 18-65 should accumulate at least 30 minutes of moderate-intensity aerobic activity 5 days a week or 20 minutes of vigorous-intensity aerobic exercise 3-days a week. In addition, strength training should be included twice a week with a minimum of 8-10 exercises at 8-12 repetitions.

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