Hydrotherapy for Bodyworkers Improving Outcomes with

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 HANDSPRING PUBLISHING LIMITED
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Originally published in 2008 as Modern Hydrotherapy for the Massage Therapist by Lippincott Williams & Wilkins

First published 2020 in the United Kingdom by Handspring Publishing

Copyright © Handspring Publishing 2020

All rights reserved. No parts of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical,
including photocopying, recording, or any information storage and retrieval system, without either the prior written permission of the
publisher or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency Ltd, Saffron House,
6–10 Kirby Street, London EC1N 8TS.

The right of MaryBetts Sinclair to be identified as the Author of this text has been asserted in accordance with the Copyright,
Designs and Patents Acts 1988.

ISBN 978-1-912085-52-1
ISBN (Kindle eBook) 978-1-912085-53-8

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Library of Congress Cataloguing in Publication Data

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Notice
Neither the Publisher nor the Authors assume any responsibility for any loss or injury and/or damage to persons or property arising out
of or relating to any use of the material contained in this book. It is the responsibility of the treating practitioner, relying on independent
expertise and knowledge of the patient, to determine the best treatment and method of application for the patient.

All reasonable efforts have been made to obtain copyright clearance for illustrations in the book for which the authors or publishers do
not own the rights. If you believe that one of your illustrations has been used without such clearance please contact the publishers and
we will ensure that appropriate credit is given in the next reprint.

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Sinclair_Modern Hydrotherapy for Bodyworkers.indb 4 30/06/20 6:06 PM

 CONTENTS

Foreword vii
Preface ix
Acknowledgements xi
Permissions xiii
Glossary xv

1 Introduction to hydrotherapy 1

2 Effects of hydrotherapy 23

3 Preparing to give hydrotherapy treatments 53

4 Fomentations, hot packs, compresses, and other local heat treatments 87

5 Cold packs, compresses, and ice massage: local cold applications 119

6 Immersion baths 141

7 Hot air baths 179

8 Showers 195

9 Body wraps 217

10 Friction treatments 231

11 Hydrotherapy self-treatments for health and wellness 243

12 Hydrotherapy and massage for musculoskeletal injuries 267

13 Hydrotherapy and massage for non-injury conditions 311

Appendices
A Simple hydrotherapy record and self-treatment handouts 369
B Pool therapy 375
C Pyrotherapy (treatment of disease with artificial fever) 377
D Answers to review questions 381

Index 387

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Sinclair_Modern Hydrotherapy for Bodyworkers.indb 6 30/06/20 6:06 PM
 FOREWORD

Author MaryBetts Sinclair has poured her very exten- ing materials, tools, and methods. Different populations
sive research as well as her considerable professional ex- and their unique needs are considered alongside specific
perience into this comprehensive and remarkable work, health or pathology conditions, injuries, and many other
Hydrotherapy for Bodyworkers: documenting historical data important factors. Treatment background information,
and methods, presenting wellness traditions as well as purpose, logistics, practicalities, case histories, discus-
new treatment techniques from around the globe, and sion points, references, summaries, review quizzes, and
doing so with a fresh and practical approach offering resource information add to the thorough content and
pathways to easily integrate hydrotherapy with modern practical teaching of each hydrotherapy modality (in
bodywork practices. view of COVID-19), together with step-by-step instruc-
tions for preparation, application, and careful sanitary
I grew up in Europe, where water-based health treat-
clean-up.
ments were commonly employed as part of the medical
system. When opening Body Wisdom Massage Therapy Practitioners will find answers and assessment options
School in Iowa in the late 1990s, I was surprised how dif- to choose the best techniques for their unique practice
ficult it was to find a hydrotherapy instructor and suitable and specific clientele, how to effectively incorporate
textbooks and resources that focused on the science and hydrotherapy with other common and specific bodywork
medical benefits of hydrotherapy. Thankfully a search modalities, how to create a session menu, and how to
led me to Sinclair’s book. Hydrotherapy for Bodyworkers will combine multiple treatments to successfully market these
inspire anyone to explore hydrotherapy, whether as a skills. The author demonstrates how modern hydrother-
client, to enhance self-care and home use, or for profes- apy is possible within any professional setting: private
sional study; it will be a delight for each vocational in- practice, assisted living, nursing home, health spa, in-
structor and a great resource for any business or facility home care, and more.
where these techniques are offered.
Hydrotherapy for Bodyworkers is a wonderful and highly
Well written, structured and sequenced, and full of valuable teaching tool and resource especially for mas-
useful images, Hydrotherapy for Bodyworkers presents a vast sage and bodywork. I am grateful to MaryBetts Sinclair
store of information about hydrotherapy in relation- and everyone who has supported her studies, including
ship to the functions, needs, and wellness of the human Handspring Publishing, for recognizing the power and
body and its individual physiological systems. Medical significance of hydrotherapy in today’s wellness educa-
aspects, as they relate to any part of the body, are tak- tion and care.
en into consideration with indications and contraindica-
tions. Applications are clearly laid out and detailed, with Almut Hatfield
their benefits and effects, as well as up-to-date scientific Owner, Body Wisdom School
findings. Further detailed are basics and specifics on Davenport, Iowa, USA
water and temperature itself, and the array of conduct- June 2020

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Sinclair_Modern Hydrotherapy for Bodyworkers.indb 8 30/06/20 6:06 PM
 PREFACE

Hydrotherapy for Bodyworkers has been written to fi ll a sig- great deal more potential than I had understood. I took
nificant gap in the education of the modern massage more hydrotherapy classes, visited clinics where hydro-
therapist, who has typically taken only one short course therapy was used in a medical context, spent time in pools
in hydrotherapy during school. There are almost no con- with aquatic therapists, and did extensive research. When
tinuing education classes in this subject area, and few I began teaching hydrotherapy for a massage school,
books which inspire therapists to go further. Without however, the available curriculum was just as outdated
more background in hydrotherapy, today’s new massage as the teaching I had encountered on my own. Students
therapists have only the most basic information, and are struggled with outdated terminology, and treatments that
thus in danger of losing this important adjunct to their had been given by hospital nurses a half-century ago
hands-on methods. The purpose of this book, then, is were mostly seen as irrelevant to today’s massage ther-
to excite students about hydrotherapy and give them the apist. Students needed a textbook that would help them
knowledge to use it with ease. This will enhance their learn not only about the fascinating past of hydrotherapy
practices, allow them to better meet their clients’ needs, but also its potential for massage practice today; I wrote
and create unique treatments that combine their mas- the first edition of Hydrotherapy for Bodyworkers to fi ll that
sage and hydrotherapy skills. need. It explained in today’s language how hydrotherapy
works, and gave the massage therapist the information he
or she needs to use it safely and appropriately.
APPROACH TO HYDROTHERAPY
In the 13 years since the first edition was published, I
When I was licensed as a massage therapist in 1975, my have taught hundreds of massage therapists in the USA
study of hydrotherapy had been confined to one short and abroad. At the same time my own massage prac-
class. The book that was used in the course was very tice has expanded to include patients at physical therapy
old and its language antiquated, making the topic seem clinics, hospice patients, homeless people, guests at up-
irrelevant and boring. Moreover, hydrotherapy, like mas- scale spas, and loyal clients I have treated for decades. All
sage, was little used in mainstream medicine at the time. were willing to try hydrotherapy treatments, and they
What convinced me of the effectiveness of hydrother- taught me much more about how to incorporate such
apy, therefore, was not what I learned in my formal treatments into a practice. This edition features much of
education but my own personal experience. When I was what I have learned in that time: it also benefits from up-
younger and had a serious injury from a fall, I visited an dated medical research on the anatomy and physiology
old-school physical therapist who would treat me with of hydrotherapy, which scientifically validates a great
a relaxing soak in a warm whirlpool bath followed by a many treatments. Cautions, contraindications, and notes
rest period, massage, and therapeutic exercises. I found on proper scope of practice are included throughout to
this treatment very healing, and later also witnessed the ensure the safety of both client and therapist.
effectiveness of hydrotherapy in my professional life.
ORGANIZATION AND FEATURES
My first job as a massage therapist was at a health club
with a sauna and a swimming pool: I learned that both The first three chapters of the book provide a theoreti-
helped extend the relaxing effects of my treatments, while cal foundation for the study of hydrotherapy: Chapter 1
the physical therapist who worked there used hot silica gel introduces the reader to the field of hydrotherapy and
packs extensively to help his patients with their aches and provides a brief history of the therapeutic use of water;
pains. It became obvious to me that hydrotherapy had a Chapter 2 explains its effects on the body; Chapter 3

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 PREFACE continued

covers a variety of practical information that the reader • Treatment overviews and step-by-step instructions
needs to know, including guidelines for buying equipment, are highlighted in the text for easy referencing.
cautions and contraindications, and general instructions. • Points of interest deepen the student’s understanding
Chapters 4–10 each present an overview and step-by- of hydrotherapy by highlighting interesting aspects
step instructions for a variety of treatments; these in- and concepts.
clude local hot and cold applications, water baths, hot • Case histories put concepts presented in the text into
air baths, showers, body wraps, and friction treatments. action, with all examples drawn from actual mas-
The last three chapters demonstrate how hydrotherapy sage therapists and their clients.
treatments may be applied to many specific situations:
Chapter 11 covers how hydrotherapy may be used by • Chapter summaries give a concise overview of the
the client and the massage therapist as regular self-care content of each chapter.
treatments for detoxification, tonifying, and prevention • Review questions at the end of each chapter allow
of repetitive stress injuries; Chapters 12 and 13 describe students to review the information they have just read.
how and why massage and hydrotherapy may be com-
bined to address many new injuries and conditions, as
FINAL NOTE
well as those discussed in the previous edition. Final-
ly, the appendices provide hydrotherapy handouts that Because water has positive effects on human beings in
therapists can give to their clients, as well as information both Mind–body and mechanical ways, water treatments
on pool therapy and fever therapy, and answers to all the have been paired with massage since time out of mind.
review questions in the book. Without contact with the earth through creeks, rivers,
The following features are included in the book as oceans, and other natural bodies of water, our emotional
learning aids: and spiritual health is at risk. Let us all work toward the
health not only of our clients but of our natural environ-
• Quotations from experts in a variety of fields and ment, which nurtures and sustains us all.
time periods, at the start of each chapter, give addi-
tional perspectives. MaryBetts Sinclair, LMT

• Chapter objectives clarify the goals of the chapter. State Licensed Massage Therapist (OR);
• Key terms, bold-faced in the main text and explained Certified Vocational Instructor (OR); Certified
in the Glossary, help readers to understand impor- Natural Vision Instructor; Member, Massage
tant terminology. Therapy Hall of Fame (USA)
• Introductions to chapters usher in the ideas presented Oregon, USA, June 2020
in the chapter.

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 ACKNOWLEDGEMENTS

This book, labor of love as it has been, would have been The good people of Uchee Pines Institute continue to im-
impossible without the generosity and expertise of a press me with their outstanding faith, compassion, ded-
host of fellow massage therapists, health professionals in ication and smarts. A huge thank you goes to Fifi Lim,
many other fields, historians, researchers, librarians, and humanitarian and entrepreneur, for inviting me to teach
wordsmiths. her spa therapists in Indonesia multiple times.
I cannot adequately thank all those who took the time Many thanks to Handspring Publishing for everything!
out of their busy days to answer obscure and not-so- I especially wish to give a shout-out to Jane Dingwall,
obscure questions and strange requests for informa- whose super-sharp eyes and meticulous editing have
tion, and especially my clients, who cheerfully let me vastly improved the organization and focus of both new
experiment on them, and otherwise encouraged, aided material and old. Wonderful helpers at the second edi-
and abetted me. I deeply appreciate the work of Laurie tion photoshoot included the staff of the Epic Spa of Cor-
Garrett, whose prescient book The Coming Plague began vallis, Oregon, and models Jill Beuter, Mari Hernadez,
my interest in hydrotherapy as a healing modality. The Craig Hanson, Krisa Gigon and Oscar Gigon. Special
reference librarians at the Corvallis Public Library con- thanks to April Robinson for helping me organize all the
tinued, as they have for decades, to give consistently help- hydro equipment.
ful, insightful and friendly service. Helena Tolis, RN,
And finally, a last heartfelt thank you to my dear Cor-
Agatha Thrash, MD, and physical therapists Pam Da-
vallis community – you know who you are – your love
vidson, Jean Yzer and Frank Hahn all offered their years
and support has been my rock through good times and
of perspective. Author Ruth Werner’s book, A Massage
bad, and I couldn’t have done it without you all!
Therapist’s Guide to Patholog y, continues to support and in-
form my writing and I often read sections out loud to my Mil gracias / terima kasih / tusind tak / thanks ever so
clients – that’s how good it is! Over the years, a great much.
many of my students have asked excellent questions, MaryBetts Sinclair
which spurred further research and led to many insights.

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Sinclair_Modern Hydrotherapy for Bodyworkers.indb 12 30/06/20 6:07 PM
 PERMISSIONS

Figure 1.1 (A) – Photo by Trinette Reed, courtesy of Stocksy Box 6.1, Figure 1 – Porcelain sitz bath, manufactured in 1905
images by Standard Sanitary Manufacturing Company of
Pittsburg, Pennsylvania
Figure 1.1 (B) – Courtesy of Alamy Limited
Figure 7.3 (B) – Courtesy of Natural Health Technologies,
Figure 1.2 (A) – Permission: Bath in Time Fairfield, Iowa
Figure 1.2 (B) – Permission: British Museum Figure 7.4 – Photo courtesy of Promolife, Fayetteville, AZ
Figure 1.2 (C) – Photograph courtesy of Thermae Bath Spa Figure 7.5 – Photo: Peter Rubens, courtesy of Breitenbush
Figure 1.5 – Painting by William Hoare, courtesy of Bath in Hot Springs, Breitenbush, Oregon
Time Box 7.1, Figure A – Photo courtesy of SaunaRay
Figures 1.6, 1.8 – Photos with kind permission of National Box 8.2, Figures B, C, D – Photos courtesy of HEAT Spa Kur
College of Naturopathic Medicine, Portland, Oregon Therapy Development, Inc., Bonita, California
Figures 1.9, 1.10, 1.12 (B) – Photos from Rational Figure 11.1 – Photo courtesy Mark Wexler
Hydrotherapy, by John Harvey Kellogg, 1923
Figures 11.2, 11.3 – Photos courtesy of New York City Rescue
Figure 1.11 – Reprinted with permission from Willard Library, Workers Detoxification Project
Battle Creek, Michigan
Box 11.1, Figure 1 – Photograph courtesy of Bob Madden
Figure 1.12 (A) – Illustration courtesy of Kunsstmuseum, Basel
Box 11.1, Figure 2 – Photo: Rodney Palmer, courtesy of
Figure 1.13 – Reprinted with permission from Franklin Delano SaunaRay
Roosevelt National Library, Hyde Park, New York
Figure 12.1 – Reprinted with permission from Bucholz RW,
Figure 1.14 – Photo courtesy of SaunaRay Sauna Company Heckman JD. Rockwood and Green’s Fractures in
Box 1.4, Figure 4 – Reprinted with permission from Joey Adults, 5th ed. Baltimore, MD: Lippincott, Williams and
Banegas and Walter Reed Army Medical Center, Wilkins; 2001
Washington DC Figure 12.2 – Reprinted with permission from Archer M.
Figure 2.1 – Photo courtesy of Rich Roberts Therapeutic Massage in Athletics, page 104. Baltimore,
MD: Lippincott, Williams and Wilkins; 2004, Figure 6.4
Figure 2.13 – Photo by Heidi Bradner, reprinted with
Figure 12.5 – Courtesy MaryBetts Sinclair
permission from Panos Pictures, London, England
Figure 12.6 – Reprinted with permission from Yochum TR,
Box 3.5, Figure 1 – Photo courtesy of Earl Qualls, PT, and
Rowe LJ. Essentials of Skeletal Radiology, 2nd ed.
Wildwood Hospital, Wildwood, Georgia
Baltimore, MD: Lippincott, Williams and Wilkins; 1996,
Figures 4.10, 13.2, 13.6 – With permission from Fomentek 1:398, Figure 6.38
company, Fayetteville, AR
Figure 13.1 – Reprinted with permission from Strickland JW,
Box 4.2 – Photos courtesy of The Dermatologist, East Graham TJ. Master Techniques in Orthopedic
Windsor, New Jersey Surgery: The Hand, 2nd edn. Philadelphia: Lippincott,
Williams and Wilkins; 2005, Figure 5.5
Box 4.3, Figure 1 – Photograph courtesy of March of Dimes
Birth Defects Foundation Images from History of Medicine, National Library of
Medicine, Bethesda, Maryland. Sourced from ihm.nlm.
Figure 5.2 – Photo courtesy of Whitehall Mfg Company nih.gov/images
Figure 6.3 – Courtesy of Charcoal House, Crawford, Nebraska Figure 1.3: A030070; Figure 1.4: A029447; Figure 1.7:
Figure 6.6 – Photo courtesy of HEAT Spa Kur Therapy 101393239; Box 1.4, Figure 1: A011823; Box 1.4,
Development, Inc., Bonita, California Figure 2: 101396512; Box 1.4, Figure 3: A09297;
Figure 4.11: 101449253; Figure 6.17: 101395644;
Figure 6.19 – Photo courtesy of Jeff Bisbee Box 8.2, Figure 1 (A): 101447290
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Sinclair_Modern Hydrotherapy for Bodyworkers.indb 14 30/06/20 6:07 PM
 GLOSSARY

Activated charcoal Buerger’s disease (thromboangitis obliterans)

A substance made from heating or burning wood or other Inflammation of the entire wall and connective tissue
organic matter in the absence of air. Charcoal is used for surrounding medium-sized arteries and veins, especially of
its absorbent ability: it can absorb many times its weight in the legs of young and middle-aged men: associated with
liquids or gases. thrombotic occlusion and commonly resulting in gangrene.
Acute Buoyancy
Sudden onset and not prolonged. The upthrust which is equal to the weight of the fluid
displaced when a body is partially or wholly immersed in
Adhesive capsulitis
water.
Extreme stiffness caused by adhesions between a bone
and its joint capsule, often painful. Bursa
Closed sac filled with synovial fluid, found over exposed or
Adrenalin
prominent body parts or where a tendon passes over a bone.
A hormone produced by the adrenal glands that increases
the heart rate and has many other effects as well. Carpal tunnel syndrome
Chronic entrapment of the median nerve at the wrist,
Arthritis
accompanied by tingling, pain and numbness in the
Inflammation of joints, usually accompanied by joint pain.
distribution of the nerve in the hand.
The two most common types are rheumatoid arthritis, an
immune system disorder, and osteoarthritis, which is more Cholesterol
directly related to overuse of joints. A fat-like substance made by the body, with many
important functions.
Ascites
An abnormal accumulation of fluid in the abdomen, caused Chronic
when scarring of the liver damages its blood vessels and Lasting longer than three months, and showing virtually no
fluid is forced into the abdominal cavity. change.
Banya Cirrhosis
Russian sauna, similar to a Scandinavian sauna: a heated Scarring of the liver, most often caused by alcohol
room with water poured on the stove to make steam. consumption or viral hepatitis.
Baroreceptors Claudication
Sensory nerve endings, found in the walls of the heart, From the Latin word claudicare, to limp. An ischemia of the
vena cava, aortic arch, and carotid sinuses. These nerve calf muscles, causing lameness and pain when the patient
endings are very sensitive to stretching of the wall from tries to walk, because the blood supply to the calf muscles
increased pressure from inside the walls, so they can is insufficient to meet the increased blood demand during
monitor blood pressure. They report this information back exercise. The pain caused by this ischemia stops as soon as
to the central nervous system the person rests, but then returns when he or she starts
walking again, leading to the term to the term Intermittent
Bladder stones
claudication.
Stones in the bladder made of crystallized uric acid, caused
by problems such as urinary tract infections or prostatic Cold mitten friction
hypertrophy or chronic dehydration. A whole-body friction performed with a terrycloth mitt or
washcloth which has been dipped in cold water.
Bronchospasm
The muscles that line the airways of the lungs constrict Cold wet sheet wrap
or tighten, reducing airflow. Bronchospasms may be A body wrap in which the client is wrapped in a cold wet
caused by respiratory conditions such as asthma or sheet and two blankets: initially cold, the client gradually
bronchitis. becomes warm and then hot.

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 GLOSSARY continued

Complex regional pain syndrome stress the ribcage, such as plunging a toilet, performing
A chronic pain disorder which can develop after a traumatic planks in Pilates, or lifting heavy loads.
injury or a period of immobilization. Patients often have
edema, skin sensitivity, limited range of motion, and
Counter-irritant
A substance that stimulates nerve endings on the skin and
difficulty bearing weight on the injured limb.
distracts the central nervous system from deeper-seated
Compress pain.
A folded cloth dipped in water, with or without additives
such as essential oils or mineral salts, which is applied to Cryokinetics
the body. Combining cold applications with light therapeutic exercise.
The idea behind cryokinetics is that muscles can atrophy
Concussion after injuries such as joint sprains, because pain prevents
An injury to a soft structure caused by a blow or violent the client from using the injured part. A typical method is
shaking. to apply ice or immerse the part in very cold water – 34˚F
(1˚C) – in order to numb it. Then the client performs light
Conduction
exercises–such as range of motion which would otherwise
The transfer of heat by direct contact between one heated
be too painful – for 2–3 minutes or until the part becomes
or cooled substance and another.
painful again. The cold–exercise combination is repeated a
Constipation few times.
Reduced or difficult bowel movements.
Depletion
Continuous bath Decrease in blood flow to one area, caused by a reduction
A bath in which the patient is placed on a hammock which in the size of local blood vessels.
is suspended in a bathtub. The tub with the patient in
it is then covered with a canvas sheet which has a hole Derivation
From the Latin words derivo (to draw off) and rivus
for his or her head; then warm or neutral water is run
(stream), derivation is the decreased flow of blood and
continuously, often for extended periods of time.
lymph to one particular part of the body created by
Contracture increasing the flow of blood and lymph to another part.
Myofascial shortening due to tonic spasm or paralysis of When less blood is flowing into an area, local blood
antagonist muscles, leading to fibrosis and loss of motion pressure is lowered and then fluid (congestion) can be
in related joints. Contractures in early stages may be drawn into the blood vessels again, thus pulling it out of the
reversed with bodywork and stretching. congested area.
Contralateral reflex effect Detoxification
Heat applied to one limb causes vasodilation in the other Removal of toxic materials from the body.
limb as well.
Diabetes
Contrast treatment A disease characterized by glucose intolerance, excess
Alternating hot and cold, using either hot and cold baths, discharge of urine containing glucose, and disturbances in
or hot and cold applications to the skin, such as hot packs the metabolism of fat, protein, and carbohydrates.
followed by ice packs.
Dialysis
Convection An artificial method of purifying the blood, which is used to
The giving off of heat by moving currents of liquid or gas. substitute for normal kidney function.
Costochondritis Douche
Inflammation of cartilage, usually at ribs 4–6, with A spray of water directed against some portion of the
tenderness and swelling. It can be caused by activities that body. Douches may be of different temperatures, different

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 GLOSSARY continued

directions (horizontal or vertical), and applied locally or to Fomentation

the whole body. Any warm moist application which delivers heat
to the body for healing. In this book, we refer to
Dry brushing fomentations as the large pads, made for moist heat
A friction technique using a dry brush applied to the skin applications, which comprise many layers of thick
surface. laundry flannel or toweling.
Dry sheet wrap Fracture
A body wrap consisting of two blankets and one sheet, A break in a bone.
with external warming devices placed on top of the client’s
wrapped body. Frostbite
A cold injury caused by the freezing of body tissues, and
Embolism occurs most often in the hands and feet. When a person’s
The plugging of a blood vessel by an embolus that has body temperature is decreasing due to cold exposure,
broken loose and traveled through the bloodstream. The constriction of the blood vessels of the arms and legs
embolus then cuts off the flow of blood to the part of the keeps warm blood in the body core, and if necessary
body supplied by the blood vessel. sacrifices the extremities to maintain the internal organs
Embolus and brain.
A blood clot formed inside a vein. Glabral tear
Emetic The glabrum is a cup-shaped rim of cartilage that lines
An agent that causes vomiting. and reinforces the socket (glenoid fossa) of the ball and
socket shoulder joint. A tear in this firm white structure
Encephalitis can be caused by direct injury to the shoulder, or from
Inflammation of the brain. overuse. Eventually the soft glabral tissue gets caught
Endorphin between the glenoid and the humerus, the shoulder
A brain chemical which interacts with the opiate receptors tissue cannot hold the joint together as well, and the joint
in the brain to reduce our perception of pain and which can becomes less stable.
act similarly to drugs such as morphine – that is, it relieves Gout
pain and gives a sense of well-being. Endorphins can be A disease of the joints, primarily of the toes, ankles, and
released during activities such as hard exercise, laughter, knees, triggered when sodium urate crystals collect in
and some hydrotherapy treatments. the fluid around the joints. This causes inflammation,
irritability, and attacks of excruciating pain. Gout is
Endothelium
primarily an inherited disorder, but lead exposure can
The inner lining of blood vessels.
induce it in susceptible people.
Evaporation
Heatstroke
The process of changing water, a liquid, into water vapor, a
A condition produced by exposure to excessively
gas.
high temperatures, especially when the person is
Fibrin exercising vigorously: symptoms include a rise in body
A protein made up of long, sticky fibers. temperature, hot dry skin, headache, confusion and
vertigo. In extreme cases, when the person’s body
Fibromyalgia
temperature rises very high, there can be vascular
A musculoskeletal pain and fatigue disorder, with these
collapse, coma, and death.
symptoms: chronic pain in muscles and the soft tissue
surrounding joints, tenderness to pressure at specific Hematoma
sites in the body, stiffness after rest, low pain tolerance, A localized mass of blood which has leaked out of broken
sensitivity to cold, non-restful sleep and chronic fatigue. blood vessels, usually clotted or partially clotted.

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 GLOSSARY continued

Homeostasis placed on the client’s body, it remains cold for as long as

The ability or tendency of a living organism to keep the 20 minutes.
conditions inside it the same, despite outside conditions: a
Intermittent claudication
state of internal balance. Warm-blooded animals achieve
See Claudication.
temperature homeostasis by adjustments of the nervous
and circulatory systems. Kidney stone
Small stones caused when certain natural chemicals, such
Hydropathy as uric acid, crystallize in the kidney. Kidney stones may
The treatment of all disease by the internal and external
have a variety of causes.
application of water. Formerly known as the “water-cure.”
Lateral epicondylitis
Hydrostatic (synonym: derivative) Inflammation of the wrist flexor tendons at their insertion
Hydrostatic effects cause blood to either migrate towards
on the lateral epicondyle of the humerus.
one area of the body from another area, or to shift away
from one area of the body to another. Lower leg compartment syndrome
Increased pressure within a muscle compartment resulting
Hydrostatic pressure from bleeding or edema, the pressure being high enough
The force which water exerts on a submerged body: the
to damage the nerves in the area. Mainly caused by leg
deeper you go, the higher the pressure.
injuries.
Hydrotherapy Lymph
The therapeutic application of water for the treatment
Lymph, or lymphatic fluid, takes its name from the Latin
of musculoskeletal disorders and promotion of general
word lympha, which means clear spring water. Lymphatic
wellness.
fluid is a largely clear liquid which carries white blood cells
Hypermobility (leukocytes); a few red blood cells (erythrocytes) may give
Some or all of a person’s joints have an unusually large it a slight yellow tinge. Lymph is carried in the vein-like
range of movement, sometimes leading to sprains, vessels of the lymphatic system.
dislocations, muscle aches, and arthritis, and often to
Lymphedema
chronic pain. Considered a genetic connective tissue
The accumulation of lymph in subcutaneous tissue which
condition, ligaments and tendons are longer (lax) and do
results when certain lymphatic vessels or nodes are
not hold joints together well. Prolotherapy may be helpful.
obstructed. People with this condition suffer chronic
Hypothalamus swelling in at least one arm or leg. The most common
A small part of the brain, located in the lower front brain, cause of lymphedema is mastectomy surgery for
that is considered the central controller of the autonomic breast cancer, when the surgeon removes numerous
nervous system. It monitors many visceral functions, such surrounding lymph nodes. Less commonly, lymphedema
as skin temperature, blood temperature, and the amount can be caused by trauma, radiation therapy, mechanical
of water in the blood. constraint (such as a tightly fitting cast), and some types
of tumors.
Ice massage
A method of cooling tissues by applying an ice cube or ice Macrophage
cup over an area with a rotating motion. A type of white blood cell.
Ice stroking Mechanical treatments
Stroking the length of a muscle with ice in order to Friction treatments such as salt glows and percussion
temporarily release muscle tension and suppress pain. treatments such as sprays or jets of water.
Iced compress Medial epicondylitis
A wet towel which has been placed in a resealable plastic Inflammation of the wrist flexor tendons at their insertion
bag and then frozen; when removed from the freezer and on the medical epicondyle of the humerus.

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