November 17, 2016


by: backFoCuSadMin


Categories: Physiotherapy, Rehabilitation Programs

Helping physical rehabilitation with heat

The cat you walk past on those balmy spring days, lazing in the afternoon sun, could in fact be self administering some much needed heat therapy. Humans on the other hand need to be a bit more wary of such practices, and the next best thing is perhaps one of the oldest forms of physical therapy, a nice hot bath.

From the natural thermal pools in Japan, to the ‘vapour baths’ of Ancient Greece, this affinity with heat and relaxation has been common across the globe. Today little has changed other than that heat therapy now comes in a variety of forms, sought for exactly the same reasons.

Heat itself in the right amount gives us pleasure by offering both physical and mental relaxation. Yet when we are injured there are many other benefits that heat can offer.

What happens to the body when we apply heat

Knowing the underlying physiological effect of heat, may provide some grounds for which to justify its use in rehabilitation and further its practical application.

Simply, when we administer heat there is an increase in the temperature of the skin and soft tissue, and this facilitates blood flow through the dilatation of blood vessels. This then increases the body’s metabolism providing ability for tissue to extend, and the greater blood flow brings with it proteins, nutrients, and an increased oxygen uptake to accelerate the healing of tissue.

When should heat be used

In general terms heat can be used after 48 to 72 hours of an injury occurring. It is helpful in the management of chronic injuries, that being conditions that are greater than six weeks old. It is also good for other long term conditions such as arthritis.

This is in contrast to when ice should be applied, which are injuries involving trauma, bruising or swelling and that are acute, meaning that the injury has occurred in the last six weeks. Heat generally does not apply to these injuries and may make matters worse. Cooling the injured area with ice will stem the flow of any bleeding within the tissue, and is best within the aforementioned 48 to 72 hour period, as part of the RICE principle. However, if the injured site still feels warm to touch after the initial 48-72 hour period has passed, it is best to continue with ice. This icing method also apply when a chronic injury has an acute flareup. As the area is best immobilised until being assessed by a doctor or physiotherapist, the limiting effects the cold has on mobility will not be of any concern.

In some cases these hot and cold methods may be combined, such as a cold press on the forehead for a headache, which later being determined as the result of muscle strain, can be treated by a heat wrap applied directly around the back of the neck.

For the most part though it will be either the administering of heat or cold. If in doubt, seek advice from your physiotherapist or doctor, as they may also offer guidance based on your medical or physiological history. They can take into account conditions such as diabetes, and with it the need to take caution in body areas of decreased sensation to avoid burns.

Other conditions such as heart disease and hypertension, or the recovery from surgery, may exclude heat as a form of pain relief or injury treatment.

How can heat be applied to healing

Heat therapy, otherwise known as thermotherapy, is an inexpensive, non evasive and non addictive way of providing some relief and assistance to a wide array of conditions and their treatment. It is particularly beneficial to those with arthritis, stiff muscles and deep tissue injuries.

Moist and dry heat

Moist heat has direct contact with the body as opposed to dry heat such as electric heating pads or saunas that draw moisture out of the body. Moist heat can be in the form of a bath for immersing the body or isolated as a hot towel or wrap. An extension of this would be heat pads that stick to the skin or heat creams that are more practical for when you are out and about.


For pain relief and injury treatment, hydrotherapy is essentially physiotherapy conducted in a very warm pool. As you are up to the chest in water, the effects of reduced weight bearing through buoyancy makes movement comparable to being on crutches. Hence it particularly benefits those who have chronic pain, or are undergoing the initial stages of rehabilitation. In addition to this the pressure of the warm water can be therapeutic, as can the stimulation of blood circulation.

Physiotherapy can be conducted safely in a hydrotherapy pool, especially for those whose balance is an issue. The water can be either used to assist or resist. Exercises can begin at a very easy level, where the water is assisting the direction of the movement. As the person’s ability increases, the water can be used to resist movements and build up muscle strength.

The warmth makes exercise more comfortable so that someone with a difficult condition can slowly build up the length, intensity and complexity with which they exercise. This progression makes hydrotherapy an ideal bridging program to work towards gym sessions. After an initial assessment, your physiotherapist can design an individual program or you can be part of a group session, and more importantly they can determine the suitability of this therapy to your particular circumstances.


Ultrasound as a form of therapy, to treat injuries like muscle strains or runner’s knee, is used by some physiotherapists. There are many varieties of ultrasound but the basic principle remains the same of stimulating connective tissue such as ligaments and tendons with sound waves.

When looking at osteoarthritis the results of its affect on injury recovery are more favourable in contrast to other conditions such as carpal tunnel syndrome. Your physiotherapist will determine whether this treatment is applicable to your condition.

Heat can provide comfort and some relief but will require other techniques such as manual therapy and exercise to aid the process of recovery. It may also be combined with other techniques such as dry needling to target specific areas of muscular tension. Consulting a physiotherapist or myotherapist will offer the opportunity for vital feedback relating to your condition and the formulation of a plan to tackle the underling cause of your condition.

Regardless of the physical benefits of heat, at the end of a busy working week, the thought of taking a bath or curling up on the couch with a hot water bottle and your favourite book, is always appealing.

So please indulge yourself, we’re sure you earned it.