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Because Contrast Hydrotherapy stimulates tissue without stressing the tissue, it is a valuable tool in pain management and rehabilitation. Also known as therapeutic contrasting or vascular flushing, Contrast Hydrotherapy quickly alternates the temperature from hot to cold causing vasodilation immediately followed by vasoconstriction. The increased metabolic activity is stimulatory, forcing the tissue to adapt to the sudden changes; it constitutes a gentle tissue workout – stimulation without stress; strong sensation without movement and this can be particularly helpful for an area that needs rest while it heals (ie. Repetitive Strain Injuries).


Transition from comfortably hot and cool, to hot and cold and then to as hot and as cold as you can safely withstand.  Basically, increase the intensity of the contrast as you proceed.  Although there are many suggested times, a 2:1 ratio is recommended by the majority.  Two steadfast guidelines are:

Always end with cold

Cold is always a shorter length of time than hot

Transition as follows:

  • 2 Minutes of comfortably hot
  • 1 Minute of cool, not cold
  • 2 Minutes of hot (hotter than before)
  • 1 Minute of cold (colder than before)
  • 2 Minutes of hot (hotter than before and as hot as you can safely withstand)
  • 1 Minute of cold (colder than before and as cold as you can safely withstand)

Three to Six alterations between hot and cold are generally recommended.

The major delivery methods are:

  • Immersion (sinks, pails or tubs)
  • Wrapping (heating pads, thermophores, ice packs, hot and cold towels)
  • Spraying or pouring (shower, faucet or simply pouring from a pail)

Immersion is the preferred method as the body part is fully surrounded.

This document does not apply to Full Body Contrasting, which is a very different matter –

Please consult a trusted source for full guidelines, contraindications, etc.

This document applies to individual parts, limbs or segments.  Practicality dictates that limbs can be treated most effectively and because Repetitive Strain Injuries can benefit from Contrast Hydrotherapy, the following conditions are good candidates:

  • Carpal Tunnel Syndrome
  • Golfers Elbow
  • Tennis Elbow
  • Plantar Fasciitis
  • Achilles Tendonitis
  • Shin Splints

It should also be noted that it is contraindicated to apply Contrast Hydrotherapy to an Acute injury or an injury that is still swollen, red, hot and/or inflamed.