It is said that rarely do health and pleasure come together like they do in a Spa! Though many may think of spas as a luxury item, reserved for those that have the means to enjoy the fine life, or others a spa is an indispensable part of making it through the day. The scientifically proven benefits associated with regular hydromassage use are beyond dispute and even useful for prevention and complementary therapies of many ailments.

 According to Margaret Reid Campion, the author of book Hydrotherapy, “To go into water is a unique experience affording everyone opportunities of widening their knowledge and skills physically, mentally and psychologically. The uniqueness of water lies mainly in its buoyancy, which relieves stress on weight bearing joints and permits movements to take place with reduced gravitational forces, thus non-weight bearing activities commenced before they are possible on land".

Water therapy, which may also be called "aquatic physiotherapy" or, “hydrotherapy”, is a supportive form of therapy that has been practiced since thousands of years. Through the course of history, it has evolved from primitive hot-spring baths, hot-cold showers and water stepping, to modern in-home spa and hydromassage therapies!

 Traditionally, hydrotherapy refers to the medicinal use of water, including hot tubs, cold water treatments, ice packs, vapors, saunas, mineral springs, hot springs, sitz baths, wet towel applications, water exercises, and water massage. Now most of these effects can be obtained by using portable, DIY, hydromassage machine, which generates ozone in beneficial concentrations, pumps it through a flexible tube to a mat placed in the bottom of water tub, oozing out millions of oxygen bubbles as ozone converts to oxygen coming in contact with water. Person in the bath tub experiences hydromssage effect as well as disinfectant effects of ozone and presence of negative ions!

The action of this kind of hydromassage may be compared to the delicate excitation of a micromassage which has a general relaxing effect the nervous system. Hydromassage bath is considered very good for many ailments, discussed in details later. It is helpful in states of nervous excitation, light organic and functional diseases of the heart and the circulatory system, minor arteriosclerosis of blood-vessels and insomnia. It is also considered ideal in the fight against obesity, cellulite and stretch marks, thanks to the bubble peeling - especially in conjunction with ozone.

 The enrichment of the bubble hydromassage with OZONE additionally helpful in improving the blood circulation, diminishing muscle stress, aerating and nourishing the skin, and has analgesic effects. The skin is immediately cleaned of keratinised epidermis and disinfected. 

 Ozone, which is 15-times more water-soluble and plasma-soluble, helps improving metabolism, removing toxins from the body, accelerating circulation of the lymph system, clearing the liver, helping in the effacement of 'bad' cholesterol, accelerating the processes of digestion, regulates the sense of hunger, increasing the elasticity of the skin and stimulating muscles.

Why massage is more effective in water, than on land?

 Here are some explanations

Buoyancy of water

The distinctiveness of the hydrotherapy and most of its physical benefits originate from therapy being done inside the water. Since the water has property of buoyancy, which reduces the weight-bearing strain and allows greater ease of movement with less tension on bones, joints, and muscles, the massage effect is more pronounced and effective.

Density of water

Higher density of water, as compared to the outer environment, creates an even fluid resistance in all directions. This helps the ozone/oxygen bubbles, being, literally, bombarded by the hydromassage machine in the bath tub, to help tone and strengthen the muscles.

The collective result of the mechanical effects due to the buoyancy of water, reduced weight and gravity, water resistance offered by density of water, hydrostatic pressure, bubbles produced by the ozone hydromassage machine, ultrasound produced by the collision of bubbles, release of ozone and high concentration oxygen in the bathing water, negative ions and thermal effects due to water temperature, heat conductivity and capacity of water, and ozonated or herbal bath oils and salts, makes ozonated hydrotherapeutic massage an effective modality of the complementary therapy. The exercise effects produced in this way are not possible outside water or without ozone hydromassage machine.

Hydromassage's supportive healing properties also exploits body's reaction to hot and cold stimuli, to the protracted application of heat, to hydrostatic pressure and to the sensation the collision of millions of oxygenated bubbles.

Benefits of using ozone hydromassage system in complementary therapies

Muscles - How can it help in prevention of muscle weakness and wasting?It can help prevent wasting of muscles in case of long immobilization, for instance, in post-stroke paralysis or after surgery (in case of use after surgery, close under medical supervision is required). It can be helpful in muscle cramps as well. Within 10 minutes, a warm bath starts dilating blood vessels, increasing the blood circulation, advancing the capacity of muscles, thus removing fatigue; within 15 minutes, a warm bath reduces muscle tension, removes lactic acid, and eases pain and spasm.

Adjuvant to physiotherapyA physiotherapist can employ hydromassage system for muscle training or in rehabilitation after traumatic accidents, muscle trauma, bone and connective tissue injuries, post-stroke recovery, muscle wasting, motor neuron lesions, cerebral palsy, muscle stiffness, and other kinds of neurological rehabilitations. Where impaired, improves the quality, range and balance of motion. The physiotherapeutic and exercise effects are pronounced in the water due to its properties of buoyancy, hydrostatic pressure, density, and body’s weightlessness, etc.

The objectives of prime importance for a physiotherapist in neurological rehabilitation are to enable patient to regain independence or minimize dependence by regaining skills of daily living - standing, sitting, walking and self-care, etc. These objectives can be achieved by improving joint mobility and muscle strength. Beside convenience of hydromassage in a bath tub, it may be noted, it does not involve pool phobia, which most patient experience when they undergo hydrotherapy in pool environment. Adaptive motor behaviors, like muscle stiffness can also be minimized in comfortable environment of a bath tub.

Total body massage effect

“Millions of strong bubbles produced per minute can stimulate, oscillate and massage 320 points over the body with rhythms, and also can help to dilate the vessels and promote blood circulation and the movement of lymph. Besides, these bubbles can massage the muscles, produce warming and relaxing effect, promote circulation and ease fatigue rapidly. When ultrasonic goes into liquids, there will be numerous tiny bubbles; with water pressure, they will burst and regenerate, and then produce strong power. These invisible millions of bubbles will transmit in liquids by a high speed of vibration and produce numerous tiny negative-pressure vacuum bubbles among molecules of liquids and thus cavitation is caused.” 

Aches and Pains

It can be very helpful in back pains, which mostly occur due to localized muscle strain. Orthopedicians can make a good use of this machine in low back pain therapy due to muscle strains, osteoarthritis, rheumatoid arthritis, etc.

Joint painsHydrotherapy is considered very good therapy in cases of tendinitis, bursitis, joint pains and inflammation resulting from sports injuries and overexertion. Shoulder joint pain, knee joint pain and ankle rehabilitation may well get good support from hydromassage. When joints swell and become painful and sometimes hard to move as adjacent muscle become stiff, especially after heavy or moderate exertion, hydromassage can help alleviate pain and restore mobility. Skeletal problems and inflammatory conditions of spine may also possibly respond well with this kind of water massage. Thermal effects of warm water coupled with the massage effect by the millions of ozonated bubbles are far more effective than dry heat pads. In nutshell, warm bubble bath with hydromassage system my result in increased joint mobility, flexibility and range of motion. It may be helpful in reduction in joint stiffness and swelling.

Exercise effect - a gym in a bath tub

Hydromassage system is really like a gym in a bath tub. One can use hydromassage system 10 – 15 minutes every day, once or twice. This can burn 200 – 300 kcal each time and hence help reduce blood sugar levels. This can be good support in management of diabetes. 

It is especially helpful in cases where a land-based exercise programme is not possible due to pain, decreased bone density, disability or other factors. Hydromassage is also effective approach for patients with rehabilitation needs. One can also make use of changing positions during hydromassage or employ various Tai Chi and yogic (yoga) breathing techniques as well.

Antenatal exercise and infertility

It helps by virtue of pelvic massage effects while body is inside water, to improve fertility in women and prepare her better for having baby and conception.

Balance Disorders

A vestibular rehabilitation therapist may make a good use of this machine and devise hydro-exercise programs, which may help overcome balance disorders. Effects of hydrotherapy in balance was studied by Resende SM, Rassi CM, Viana FP. They evaluated the effect of a hydrotherapy program for balance, in relation to the risk of falls in elderly women. They concluded that their hydrotherapy program for balance "gave rise to an increase in balance and a possible reduction in the risk of falls among these aged women". 

Diabetes Type II

Diabetes mellitus (DM) is a set of related diseases in which the body cannot regulate the amount of sugar (glucose) in the blood. In a healthy person, the blood glucose level is regulated by several hormones, including insulin, produced by the pancreas. Insulin allows glucose to move from the blood into liver, muscle, and fat cells, where it is used for fuel. People with diabetes either do not produce enough insulin (type 1 diabetes) or cannot use insulin properly (type 2 diabetes), or both (which occurs with several forms of diabetes). 90% of patients with diabetes have type 2 diabetes. Resultantly, uncontrolled high sugar levels in diabetics can lead to serious complications such as high blood pressure, heart disease, kidney disorders, blindness, etc. The emotional factor and stress can affect the people with diabetes as well. When glucose derived from food is absorbed blood, blood sugar levels to rise. Automatically the hormone insulin helps glucose move into the cells thus decreasing the blood sugar content.

 The most accepted method for control diabetes type 2, beside medicines, is regular exercise and a good diet, which helps maintain the blood sugar levels. Unfortunately, many diabetics are physically unable to endure rigorous activity or unwilling for it and its often difficult for them to maintain optimum weight. These facts aggravate the problem more. According to the study by a Colorado researcher published in the New England Journal of Medicine, the hot tub therapy may be beneficial for diabetics. This research sheds new light on the advantages of spa therapy. According to the study, even merely soaking in a hot tub can be beneficial for people who are affected with Type 2 Diabetes Mellitus. Hydromassage system does even more. Beside warm water soaking, it provides exercise effects which help expend 200 – 300 kilocalories in 15 minutes. It thus can be very helpful in the management of diabetes type 2. Fifteen minutes of hydromassage is equal to about three kilometres of jogging, in terms of energy utilized. It thus may help lowering the blood sugar level due to exercise effects of the ozonized bubble massage in aquatic environment.

 One of the complications of diabetes is the numbness of feet. This may eventually lead to foot gangrene. It often caused by poor blood circulation. Due effect of diabetes on nerves resulting in numbness of feet (peripheral neuropathy), affected peoples’ sensations decrease and hence they tend to ignore minor physical trauma which may occur during walking. These factors may lead to occurrence of wounds and foot ulcers which may not heal due to, both, poor blood circulation and higher blood sugar levels and lead to gangrene of foot.

 Diabetes affects the autonomic nervous system too and can lead to paralysis of the stomach (gastroparesis), chronic diarrhoea, and an inability to control heart rate and blood pressure during postural changes, like standing up from sitting position, leading to fainting and falling down.

 Formation of fatty plaques inside the arteries (atherosclerosis) is accelerated and this can lead to blockages or a clot (thrombus). These complications can then lead to heart attack, stroke, and decreased circulation in the arms and legs (peripheral vascular disease).

 Diabetes raises the tendency of people to high blood pressure and high cholesterol and triglyceride levels. These conditions independently and together with high blood sugar levels increase the risk of heart disease, kidney disease, and other blood vessel complications.

 Diabetics are also prone to many infections, which could be dangerous. To compound the problem, infections may worsen glucose control, which further delays recovery from infection.

 It is important to start preventive measures, like balanced diet, exercise and ozonized hydromassage, well before diabetes starts causing such complications to avoid foot or limb amputations, blindness, kidney failure, etc. later. Once the complications have ensued, the benefit of complementary therapies may not be as it would be if the therapies are started before occurrence of such problems. The blood circulation also my not improve by hydromassage in the affected areas prone to gangrene, to the extent it improves in the normal or near normal tissue before the onset of complications. In some advanced complications of diabetes, it may not be advisable to undergo any exercise, exertion or hydrotherapy. The hydrotherapy is thus, best used before occurrence of the complications and in controlled diabetes, as complementary and supportive measure towards the management of the problem. 

 As complementary therapy, supporting mainstream treatment, it may help reduce the dose of insulin or other hypoglycaemic agents, thereby decreasing the chances of possible side-effects of medicines as well as decreasing the expenses incurred on the treatment. At the same time, it may improve the general health and sense of wellbeing, and thus contributes towards better quality of life. Beside these health benefits to your body and soul, the warm, twirling water in your spa tub relaxes your body and soul together. 

Weight management

 Since 15 minutes of hydromassage helps burn 200 to 300 kilocalories and is equivalent to about 3 km of jogging; it helps reduce weight, provided caloric intake is also managed properly. As hydromassage system has exercise effects while body is submerged inside water (buoyancy, less gravity, hydrostatic pressure, density and ozonated bubbles), it acts to tone up body, slimming and shaping it towards natural body contours.

Asthma and respiratory infections

 People suffering from respiratory issues, for example the common cold, allergic antipathy, laryngitis, sensitivity or sinus disorders, may benefit from warm or hot water ozone bubble spa with the hydromassage system. A regular bath with this system can be quite restorative. Nasal passages get cleared by the steam, extra oxygen and negative ions. This lowers the inflammation and makes it simpler for you to breathe. It may be beneficial to colds, influenza, bronchitis, and pneumonia. Water vapours and herbal oils may help to open airways, relaxing bronchial tree muscles and help white blood cells circulate and reach to the affected areas promptly, promoting healing and improving respiration.

Mental fatigue and stress relief

 Mental fatigue and stress related disorders are very common these days due to hectic lifestyle and environmental onslaughts. Such conditions may benefit well from the hydromassage. Due to physiological as well as psychological reasons, aquatic therapy successfully relieves stress and helps one unwind during tense times. Hydrotherapy with warm water and the buoyancy of being submerged in water, work together to release body tensions, loosen stiff muscles, and to make the blood flow more freely. Additions of aromatherapy herbal oils add more to this and help one relax, rejuvenate, revive and reflect. 

Elderly people

 Hydromassage is fast becoming a popular and beneficial home health management modality, especially among seniors. However, all safety precautions should taken to ensure adequate help and support is available to them when they use hydromassage system.

A natural remedy for insomnia

 With lavender essential oil, the mild hydromassage in the evening appears to promote sleep well and help overcome insomnia.

Detoxification

 Oxygen starvation at the cellular level leads to internal toxicity. 

Flooding the body with oxygen enhances health in so many ways, reducing its habitability to viruses and bacteria, aiding greatly in the elimination of waste and toxicity and providing enhanced alertness and vigour. As the skin is an excretory organ of the body and large numbers of metabolic end products are expected to be excreted from the body through the skin. However, due to modern lifestyle, environmental conditions, and closure of most of large number of skin pores results accumulation of metabolic end products in body, thus burdening kidneys in intestine to remove such metabolic wastes. Thermal effects of water, oxygen-ozone bubbles, and water, with all its properties mentioned elsewhere in this article, combine to cleanse skin and open the skin pores. Person getting hydromassage sweat in the bath tub, and thus excretes lots of such metabolic end products and toxins, hence helping body detoxify. It is said that marathon athletes either don’t get cancer (except malignant melanoma due to skin’s exposure to sun) or have very low chance of getting cancer. This is because they sweat a lot and excrete heavy metals such as cadmium, lead, copper and nickel. As they perspire, heavy metals, which may be a cause of cancer, in their bodies get excreted, and therefore they do not get cancer. This shows that: (1) Removing accumulated toxin via perspiration may prevent cancer. (2) To stay healthy, one must perspire much every day. When one undergoes warm hydromassage, one perspires profusely inside the water and thereby detoxify.

 SlimingAs for every 15 minutes of hydromassage, our body burns off 200 to 300 kilocalories, it can be a useful tool for overcoming obesity or sliming, toning and body contouring. By focusing the bubbles on areas that one wants to work on, the target slimming may be also be possible along with body firming and contouring.

Skin care and skin cleansing

 

The ultrasonic bubbles creates micro-vibrations that can effectively shake out all dirt from 150,000 pores of the skin, so one can literally feel clean and light as skin can breathe better then. This effect is very useful for ladies. Ozone, coming in contact with water results in formation of oxygen. This ozone and extra oxygen coupled with presence of oxygenated bubbles colliding with skin, provides skin whitening effect. The bubbles also strengthen and improve the structure of the skin, and at the same time are sources of great relaxation for the skin. Hydrosonic “Bubble bath can soften cuticle and remove wasted cuticles.” Beside this, “using essential oils can make achieve the best results of absorption.” The benefits of hydromassage bath include protection of skin from damage as well as ability to clean pores and skin folds such as place under breast and around the anus that other bathing methods cannot reach.

Cellulite and stretch marks

Ozone effectively whitens skin and removes dead skin cells. Presence of ozone has body firming effect as well as skin thickening effect. It thus helps improve the cellulite, stretch marks and wrinkles of neck as well.

Cautions and warning notes

 Musculo-skeletal System: The use of hot water, hydromassage system and bubble bath may be good for many people with arthritis and other health conditions but not all. Consult with your physician first.

 

Dizziness: With water temperature greater than 40°C, the one may feel too hot and may become dizzy on exiting the tub, especially when hurried to stand. Therefore, one must exercise caution and elderly or those with low blood pressure should be routinely helped to exit from the tub. They should remain seated until they could safely walk. 

 

Epilepsy: People with epilepsy must not use hydrotherapy or hydromassage system, unless someone is supervising over them (fear of drowning or precipitation of fits).

 

Diabetics: In cases of diabetes with complications, the blood circulation to the feet may be impaired; thus the impact of hydromassage may not be as great as in people without complications of diabetes. Prolonged soaking in water may cause maceration of skin, which may become susceptible to injury. Therefore water temperature in such cases should be kept at comfortable levels / nearer to the normal body temperature and prolonged soaking avoided.

 

Skin infection (Pseudomonas folliculitis): Since the use of public spas and whirlpools may result in development of skin infection, Pseudomonas folliculitis, it is advisable for all to use their personal ozonated hydromassage system at home, instead of using non-ozonated whirlpools or public baths and spas. Though Pseudomonas folliculitis is a self-limiting skin infection, it does cause skin irritation for 2-10 days. People with contagious rash, scabies or lice may also avoid hydrotherapy.

 

People with heart problems: At water depth 60cm, human body bears pressure of 0.06 atm (60cm/1,000cm). Diving into water 12 cm (5 inches) under surface, the pressure equal as in the central veins. Diving deeper has a compressive effect particularly on the venous vessels increase in the cardiac preload which can be dangerous for patients with an advanced cardiac problem. Signs of stress caused by hydrostatic pressure include: feelings of tension, constriction and possibly tachycardia, being short of breath and agitated, cyanosis of the lips and tips of the nose, and bulging jugular vein. Hence, such person should exercise caution and preferably only be given half or ¾ baths to avoid accidents. Also, for good effects of hydromassage bath, the water depth is crucial; therefore, one needs to choose a standard-size bathtub. In such a bath tub, bubbles will be bigger and better after they go through a cycle of expansion and compress. In such a bath tub, bubbles, after going through several times of cycle, will expand to the extreme, break at the instant and produce extreme heat, high pressure and ultrasonic energy.

 

Some other conditions in which hydrotherapy should not be carried out include, Infections or fever, vomiting, catheters (esp suprapubic), open wounds, membrane rupture with pregnancy, menstruation without internal protection, severe burns with altered or impaired thermal sensation, Nontunnel IV catheters, severe peripheral vascular disease, bleeding disorders, impaired/decreased thermal sensation (diabetic foot, numbness), atopic eczema, ichthyosis, acute rheumatoid arthritis, and urinary or fecal incontinence.

 

Respiratory dysfunction of moderate or sever nature also needs special attention or avoidance. 

 

References

 

Hot-Tub Therapy for Type 2 Diabetes Mellitus; Philip L. Hooper, M.D. McKee Medical Center, Loveland, CO 80537; N Engl J Med 1999; 341:924-92

Benefits of Home Ultrasonic Spa to Human Body; by Dr Chen Sing-Han 

RESENDE, SM and RASSI, CM. Effects of hydrotherapy in balance and prevention of falls among elderly women. Rev. bras. fisioter. [online]. 2008, vol.12, n.1, pp. 57-63. ISSN 1413-3555. doi: 10.1590/S1413-35552008000100011.