Hot Tubs for Hydrotherapy
Discover the health benefits of hot tubs and learn how jets, pumps, and water temperature aid in hydrotherapy.
By Kimberlee Courtney
Soaking in a warm bath is known to ease stress and invoke relaxation—but the warm water and massaging features of a hot tub can do even more. Hot tubs are commonly used as a method of hydrotherapy to treat a range of illnesses and injuries including arthritis, fibromyalgia, and high blood pressure. The warm water stimulates blood circulation—particularly the immune system’s white blood cells—and increases the production of endorphins (those “feel good” hormones). The combination of improved circulation and increased endorphins helps strengthen the immune system, decrease inflammation, restore injured tissue, improve well-being, and rejuvenate the body.
Because sitting in a hot tub elevates body temperature and the temperature of internal organs, most doctors recommend only 20-minute sessions. Luckily, all it takes is a matter of minutes for you to start reaping the benefits of hydrotherapy. Here’s what happens to your body as you take a relaxing soak:
After 5 minutes. Your blood pressure and pulse rates begin to drop.
After 8 – 10 minutes. The warm water increases your blood flow and circulation improves in your hands and feet, making them feel warmer.
After 12 – 15 minutes. The buoyancy effect of the water allows your muscles to relax and become more reactive to passive exercise. Your tissues are more malleable and become receptive to stretching, which encourages the release of lactic acid and other toxins from your body.
After 15 – 20 minutes. By eliminating the effect of gravity, pressure is removed from the joints, and stress on the supporting muscles and ligaments is lessened. Your aches and pains begin to decrease in severity.
Now that you know a hot tub’s therapeutic benefits, here’s what to look for in a model in order to maximize those benefits.
Jet Options
When selecting a model, consider your hydrotherapy needs. Jets can be positioned in a variety of locations to focus on certain areas of the body including the back, shoulders, neck, arms, and legs. Most hot tub models come with a preconfigured number of jets, each in a specific arrangement; but manufacturers offer such a wide range of models that you’re sure to find one that has the jet configuration you’re looking for.
The jets in a hot tub create a hydrotherapeutic massage by releasing a combination of air and water. Many types of jets are available and each offers a different kind of massage. Some jets provide powerful, direct streams of water that focus on specific muscle groups, while others swirl or pulsate the water to provide a more gentle massage. Jets can also be designed to rotate back and forth for a soothing back rub.
Several manufacturers offer interchangeable jetted seat backs that can be moved to any seat in the hot tub. This allows you to choose jet configurations that target specific areas and switch to a different configuration whenever you want. Other manufacturers offer jets that can be turned on and off individually and adjusted by hand to control the pressure and angle of the massage.
You can get a good feel of the jets and jet power by doing a test soak. Many dealers offer test soaks (in private rooms or in their showroom after hours) so that you can get a better idea of the seating, jet placement, and overall feel of the hot tub you are considering. Most often, numerous accessories are added to the test models so you can try out as many as possible, and then choose the features you want. A wet test will also indicate whether you can easily move from one seat to another to relieve various muscles.
Pumps & Jet Power
In addition to the jets, the size and power of the pump(s) will affect the overall quality of your hydrotherapy massage. The pump generates the air that shoots the water through the jets, so it’s important to have a pump that is sized appropriately for your model. Essentially, the more jets on your hot tub, the bigger and more powerful the pump needs to be.
Hot tubs can have one or several pumps, and the main pump can be one-speed or two-speed. Models with a one-speed pump also require a small circulation pump. While the main pump supplies the water pressure for the jets, the circulation pump quietly circulates the water and generates heat that is distributed back into the spa. A two-speed pump, on the other hand, handles both the circulation and the water pressure for the jets. It circulates the water on low speed and enhances hydrotherapy on high speed.
If you have only one main pump, you will not be able to power all of the jets at the same time. If you expect to have all the seats occupied on a regular basis, it’s worth having a second pump so all jets can run simultaneously.
Temperature & Controls
The ability to control and vary the pressure of the jets is an important component to maximize your hydrotherapy experience. By adjusting the water flow of the jets, you can choose between a vigorous or gentle massage, depending on your needs and personal preference.
A hot tub control panel can have settings that are pre-programmed by the manufacturer for ease of use, or self-programmable for a custom massage. Hot tubs with multiple pumps typically have independent seating controls, which allow each user to control the intensity of his or her massage.
The control panel also allows you to manage the temperature of the water. Heat is one of the main elements of hydrotherapy, and different levels of heat are recommended for different treatments. A water temperature between 102 and 104 degrees F loosens tight, tense muscles and relieves pain from arthritis, muscle spasms, and backaches. A neutral temperature of 92 – 94 degrees F calms the nervous system and is effective in treating insomnia and reducing anxiety, exhaustion, and chronic pain.
When choosing a hot tub, make sure the control panel displays the set temperature as well as the actual temperature to ensure safety. Doctors recommend that users spend no more than 15 minutes in water temperatures of 104 degrees F; the water temperature for young children and the elderly should not exceed 95 degrees F.
Ease of operation is another factor to consider. Many hot tub models have auxiliary control panels that let you adjust the pumps and water flow from multiple locations within the spa, so you won’t have to get out of your seat; some also have floating remote controls. For extra convenience, some models have a control you can keep inside your home so you can have a warm hot tub ready before you even step outside. There are also memory features that save your favorite settings, as well as energy-saving components that automatically lower the water temperature or shut off the jets at a specific time.
Healing Waters
Bruce E. Becker, M.D., clinical professor of the Department of Rehabilitation Medicine at Washington State University, has been conducting water immersion studies for more than 30 years. In his recent studies at Washington State University’s National Aquatics & Sports Medicine Institute, Dr. Becker found that within 25 minutes of soaking in a hot tub with a temperature of 102 degrees F, the autonomic nervous system produced changes similar to those that occur during relaxation. He says that along with relaxation, immersion in warm water may have a positive effect on cognitive performance.
The results of his study have also led Dr. Becker to believe that the use of warm water therapy may be beneficial in the management of post-traumatic stress disorder in soldiers. He recently assisted in the design of an aquatic rehabilitation component for the U.S. Army’s Wounded Warriors program that will help speed the recovery of injured soldiers. According to Dr. Becker, the program will have two phases: the first will help soldiers recover from the acute stage of their injuries, and the second will prepare them to return to active duty or civilian life. “Immersion in warm water can lead to a faster and longer-lasting recovery,” says Dr. Becker.
Photo courtesy of Hot Spring Spas
Warm Water Therapy for Arthritis
Exercise has always been an important component in the long-term management of arthritis—it helps keep joints moving, increases strength and flexibility, reduces pain, and protects joints against further damage. According to a case study by the Mayo Clinic, exercising in warm water can alleviate pain and improve joint function for people with arthritis. The Mayo Clinic study found that after participating in the National Arthritis Foundation’s Aquatic Exercise Program, participants suffering from arthritis reduced their perception of pain by 12.8 percent and difficulty by 18.2 percent.
The warm water in pools and spas provides an ideal setting for relieving arthritis pain because the heat helps relieve pain and stiffness, while the buoyancy lessens the strain on joints and the gentle resistance helps build muscle strength. For those who do not own a pool or spa, The Arthritis Foundation offers aquatic exercise classes at public pools nationwide. The Arthritis Foundation Aquatic Program (AFAP) is conducted two to three times per week at local indoor pools for 45 to 60 minutes. The classes involve 72 range-of-motion, strengthening, endurance, and mobility exercises performed in water with a temperature range of 83 – 89 degrees F. The program also provides an educational component, which teaches participants about arthritis and how to manage it.
Be sure to consult your doctor to determine the appropriate exercise program for you. Visit www.arthritis.org to contact your local Arthritis Foundation office and find programs in your area.