Hot-Cold Therapy: Everything You Need to Know About Contrast Therapy

by Jon Miksis
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Are you looking to optimize your wellness routine and enhance your performance in all aspects of your life? Do you want the key to improving your mood, bettering your sleep, and reducing inflammation? While there is no one magic formula to enhance your life, here’s the next best thing: hot-cold therapy. It requires a little extra work beyond waving a magic wand, but the benefits can be life-changing.

Utilizing hot and cold to benefit the human body is hardly a new invention. Even ancient civilizations recognized the benefit of these types of therapies. For example, Egyptians used cold temperatures to treat inflammation and injuries as early as 2500 BCE. And ancient Greeks used water of various temperatures to ease muscle fatigue and treat ailments. 

Just think about the last time you had a strenuous workout. Can you picture anything more relaxing than soaking in a hot bath with Epsom salt to relieve your achy muscles? 

On their own, cold therapy and hot therapy are great for recovery. But to achieve the optimal benefits, you might want to try doing both together to experience the benefits of hot and cold therapy. 

Are you ready to take your wellness and recovery to the next level? Here is everything you need to know about hot-cold therapy and its many benefits. 

Hot-cold therapy: everything you need to know text overlay above a picture of an infrared sauna
This post on everything you need to know about hot-cold therapy contains affiliate links, where I may receive a commission at no extra cost to you.

What is hot and cold therapy?

If you have been doing research on your road to maximizing your recovery and overall wellness, you know that there are many benefits to ice baths and infrared saunas. But what happens when you combine the two? Hot-cold therapy, also called contrast therapy, is the process of alternating between hot and cold therapies to maximize your recovery benefits. 

Other names for this process include the “Nordic Cycle,” the “Viking Bath,” and hydrotherapy, to name a few. No matter what you call it, the gist remains the same: it is a restorative transition from one extreme temperature to another. 

For some, hot-cold therapy is a test of fortitude, a challenge to overcome for both the mind and body. In addition to the many physical benefits we’ll touch on later, it is also worth noting that this challenge – remaining in temperatures too hot or too cold – gives the same euphoria as increasing your training max for deadlifts or finishing the Boston Marathon for the first time. 

In other words? Hot-cold therapy can be life-changing. So let’s take a deeper dive into the process. 


 
 
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Contrast therapy: the process

Historically, Nordic cultures would stay in a sauna until their bodies were heated, and then they would go outside and plunge into a glacial lake or roll in the snow. Then, they would return to the sauna’s heat and repeat the process several times. 

Modern contrast therapy can be as simple as the original Nordic Cycle or far more complex, thanks to a wide variety of cold plunge tubs on the market today, as well as saunas with infrared light technology. Your lifestyle, wellness goals, and budget can all be determining factors in “how” you participate in hot-cold therapy. 

That is to say, hot and cold therapy is a different process for everyone. No two people are exactly alike. Therefore, it’s easy to understand that bodies recover differently. People also have different processes that work best for them. 

For example, you can alternate between hot and cold showers or follow up your time in a sauna with cold water immersion, as was historically done in Nordic countries. If you’re trying to recover a specific portion of your body, hot-cold therapy also includes alternating between ice and hot packs. 

When it comes to the duration of hot-cold therapy, you can also alternate every few minutes or several times throughout the day. Generally, the rule for injuries is to do ice first and then follow up with the heat. The ice will reduce swelling while following it up with heat will promote blood flow and stimulate soothing relief. 

Additionally, some people benefit from always starting with ice and ending with ice, following a cold-hot-cold process. The best thing you can do is find what feels good for your situation and create a hot-cold therapy ritual that works best for you. 

Hot-cold therapy interval examples

As mentioned, everyone is different, and your preferred intervals for alternating between hot and cold may vary from your best friend, spouse, or training partner. Generally, the hot intervals typically last anywhere from 1 to 5 minutes, while the cold intervals run about 60 seconds. 

However, long-time cold plungers may find it more therapeutic to plunge longer than a minute. At the end of the day, it’s important to do what feels the most restorative to you.

The other important factor is temperature. On the hot end, aim for around 104°F (40°C). You want to be hot, but you don’t want to burn yourself. As far as the cold intervals, you want to go as cold as possible. Most cold water therapy occurs in cold water below 58°F (14°C).  

If you’re looking for inspiration on how to start hot-cold therapy, here are some examples of popular contrast therapy cycles. 

A diagram showing the three steps of hot-cold therapy inspired by the Nordic Cycle
A popular practice for hot-cold therapy based on the Nordic Cycle.

A contemporary Nordic Cycle

Here is an example of a contemporary Nordic ritual to inspire your own transformative journey to relaxation. 

Step one: heat exposure

The first step to a contemporary hot-cold therapy ritual inspired by traditional Nordic practices is exposure to a heat source. This can be from a sauna, hot tub, or steam room. You will want to stay here for 10-20 minutes, depending on your tolerance. 

While in this first stage, your body stores heat, and as you sweat, your body releases toxins. 

Step two: cold water immersion

Immediately after step one, expose your body to your source of cold water immersion. You can use a cold plunge tub, a cold shower, or even a cold lake if seasonally appropriate. Remain immersed in the water for at minimum 10 seconds, but ideally, you would like to stay in longer, up to several minutes. 

To experience the full benefits of cold water immersion therapy, it’s important to submerge your body in the water for as long as you can. The drastic change in temperature releases adrenaline. 

Step three: rest

It is important to rest at the end of your hot-cold therapy cycle. You should remain near your hot and cold sources because you will repeat the cycle after your heart rate settles. 

Wait 10-15 minutes before you repeat the cycle, and complete the circuit 2-3 times. 

Simple hot-cold interval

One of the most basic intervals for hot-cold therapy is the simple interval. For 10 minutes, alternate between one minute in heat and one minute in the cold. This is a great way to build up your tolerance to hot and cold temperatures if you are just starting. 

This is what the session will look like: 

  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold
  • 1 minute hot
  • 1 minute cold

12-minute hold-cold interval

For longer intervals, one of the most popular methods for hot and cold therapy is to alternate between three minutes hot and one minute cold. 

This is what the session will look like: 

  • 3 minutes hot
  • 1 minute cold
  • 3 minutes hot
  • 1 minute cold
  • 3 minutes hot
  • 1 minute cold
A woman standing outside in the snow waiting to get in a hot tub for hot-cold therapy
Going back and forth between a hot tub and the cold air can give you the same benefits as an ice bath.

What are the benefits of hot-cold therapy?

There are many benefits of hot and cold therapy, or the Nordic Cycle, which is why this technique is becoming increasingly popular among famous athletes, trainers, and celebrities.  

Here are some of the combined benefits of hot-cold therapy.

Hot-cold therapy increases blood flow

For many people, a cold water plunge after spending time in a sauna, hot tub, or steam room can improve blood flow. Alternating between two extreme temperatures will constrict and dilate your blood vessels, helping to increase blood flow. This helps give athletes higher performance and improves vascular and cardiac response.

Hot-cold therapy reduces swelling and inflammation

Individuals with swelling/inflammation often find relief from the hot and cold plunging technique. When you elevate your circulation within your cardiovascular and lymphatic systems, you can reduce swelling. Increased circulation can also help reduce chronic inflammation by washing out chronic inflammatory cells and promoting improved healing of damaged tissue.

Hot-cold therapy improves immune function

When you put your body through the hot and cold therapy cycle, it triggers the lymphatic system to circulate healing fluids. This process flushes the body of waste and has a detoxifying effect. Improved circulation and oxygenation give the immune system a healthy boost, improving your body’s overall wellness. 

a man preparing to cold plunge in a frozen lake
There are many benefits to cold plunging that are backed by science.

Hot-cold therapy can boost your mood

The experience of going from hot to cold elevates your heart rate, pumps your body with adrenaline, and releases endorphins. This process has been shown to not only ease your pain but also lighten your mood. This is important for anyone dealing with chronic pain or recovering from surgery because it can reduce dependency on pain medication and prevent depression. 

Other benefits of contrast therapy include 

  • Weight loss
  • Improves sleep
  • Skin rejuvenation 
  • Lower chance of scar tissue

Hormetic stress: what is hormesis?

One other important benefit that is worth expanding upon is stress. Now, while we normally consider stress a negative response to most situations (like work or travel), there are some instances where certain types of stress can actually benefit your health. 

When it comes to hot and cold therapy and specifically cold plunging, hormetic stress is one of the good kinds. 

To understand the benefits of hormetic stress, we must first understand the concept of hormesis. This term refers to something beneficial in small quantities but damaging or toxic in excess. These stressors range from vitamins and dietary restrictions to challenging exercises and extreme temperature exposure. 

A growing body of research suggests that exposing yourself to short bursts of hormetic stress is beneficial physically, mentally, and emotionally. HIIT (high-intensity interval training) is one of the most common examples. Still, temperature therapy (hot, cold, and when used in conjunction) is also growing in popularity thanks, in part, to Wim Hof (AKA the Ice Man). 

Some of the many benefits of hormetic stress include improving your mood, focus, and immune function, boosting your resiliency to other stress, and weight loss. Hormesis may also prevent premature aging thanks to the effect is has on mitochondria (you know, the powerhouse of the cell). 

Saunas are a common element to hot-cold therapy
Saunas provide dry heat, but you can use water to create soothing steam.

Types of cold therapy

We’ve talked about the benefits of hot and cold therapy combined, but there are many benefits to cold exposure on its own. Cold therapy has a positive impact on the body’s immune, digestive, and circulatory systems. It also taps into the body’s natural healing powers, activating the nervous system and hormones, which can significantly change our physiology.

I have had a great experience since I started cold water immersion. Not only did it help me overcome “Long Covid,” but it also helped me overcome many fears and anxieties I had in life. While attending wellness retreats, I have also had the fortune to witness others spontaneously enter remission of their chronic health conditions. 

Cold showers

Perfect for beginners, cold showers are the simplest and quickest way to immerse yourself in cold temperatures. They are also the easiest to add to a routine because you’ll take a shower anyway. While they are not typically as cold as other forms of cold exposure, they can be just as challenging. 

Outdoor swims in nature

If you are looking for a natural approach to wellness, you can achieve cold exposure by swimming in rivers, lakes, and the ocean. This is a great solution for those who live in cold climates during the winter months and want a deeper experience than a cold shower can provide.

Cryotherapy

This cold therapy is relatively new and requires you to go to a special gym, spa, or wellness center. Whole-body cryotherapy entails entering a chamber with liquid nitrogen, nitrous oxide, or argon gas at extremely cold temperatures (typically around -200°F or -129°C). Just a few minutes is all it takes to retain the optimal health benefits.

Cold plunge pools

These are also typically found at gyms, wellness spas, and retreats. Many are like a larger ice bath kept at a constant temperature with a water filtration system that moves around the water, making it feel colder. 

Ice baths

For the most popular form of cold exposure right now, ice baths are it. To achieve the health benefits, you sit in an icy water container for a short period. The typical temperature range for an ice bath is between 35°F and 60°F (2°C and 16°C). Ice baths can range from filling your bathtub or a container with ice to specialized tubs with built-in temperature controls and filtration systems. 

A man sitting in an Edge Theory Labs cold tub near the coastline
I frequently use cold tubs as part of my wellness routine.

The best cold tubs 

Because I so thoroughly believe in the power of cold exposure, I’ve been testing and reviewing some of the most popular cold water immersion tubs on the market. My goal is to remove the guesswork and barriers when it comes to you finding the right cold tub for your lifestyle and needs. 

Here are some of the best cold tubs I’ve found: 

Best budget ice bath: Ice Barrel 

Best cold tub for outdoors: Polar Monkey 

Most durable cold tub: Cold Plunge

Most luxurious ice bath: Renu Therapy

Best cold tub for apartments: The Edge Tub

Cheapest cold tub: G Ganen Foldable Ice Bathtub

Types of hot therapy 

Just like with cold therapy, there are many benefits to heat therapy. One of the most common benefits is the positive impact it has on chronic pain. Warmer temperatures aid in muscle relaxation, alleviating pain and stiffness in sore muscles and joints. 

There are many different types of heat therapy you can try. Chances are some will work better for you than others, so it’s important to test out various options to find your favorite. Wellness revolves around finding out what works best for you and your body. 

Generally speaking, heat therapy can be broken down into two main types: dry heat and moist heat. Here are some examples of both types. 

Dry heat therapy modalities 

Dry heat, or conducted heat therapy, includes sources like heating pads, dry heating packs, and saunas. This type of heat is easy to apply and, with the exception of saunas, is primarily used to treat isolated pain rather than overall body wellness.

Moist heat modalities 

Moist heat or convection heat includes more “wet” sources of heat. These include hot tubs, baths/showers, steam rooms, steamed towels, and moist heating packs. Moist heat therapy may be slightly more effective compared to dry heat therapy. It often encourages more overall feelings of relaxation that can help lessen pain.

a woman enjoying a soak in a wood hot tub outside during a snow storm
Moist heat therapy, like a hot tub, is a very relaxing and therapeutic experience.

How to do hot-cold therapy at home

With so many benefits to hot and cold therapy, you’re probably ready to jump right in and test out these benefits for yourself! But where do you start? 

You don’t need an at-home cold tub and sauna to use contrast therapy. While I personally believe they’re an excellent investment for someone who wants to do this weekly, I know not everyone has the space or budget right now, and that’s ok. You don’t need to make a big investment if you’re just dipping your toes into hot and cold therapy, so to speak. 

To start experiencing the benefits of full-body hot-cold therapy, you only need a shower. 

How to take a contrast shower

A contrast shower gives you the same therapeutic contrasting benefits discussed in this article but doesn’t rely on a sauna, hot tub, or steam room. In fact, you will find this method is very similar to the modern Nordic Cycle and is highly adaptable. 

Here’s what you need to take a contrast shower at home: 

1. Shower in hot water for 3-5 minutes. The water should be as hot as you can tolerate without burning you. 

2. Turn the water to cold and stand under the water for one minute. The water should be as cold as you can handle (possibly as cold as it will go).

3. Repeat 3-5 times, always ending on cold. 

While you can control the water temperature to what works best for you, ensure there is a large enough difference in temperature. Otherwise, you will not be able to reap the many therapeutic contrasting benefits of the shower experience. 

You can also adapt the time intervals to suit your preferences, just always make sure the duration of your hot therapy is longer than the cold water. 

Contrast showers are a easy way to to hot-cold therapy at home.
Contrast showers are an easy way to to hot-cold therapy at home.

Frequently asked questions about hot-cold therapy

Here are some popular questions (and answers) about hot-cold therapy, ice baths, and saunas. 

Is it healthy to go from sauna to cold water?

It is safe and healthy for most individuals to expose their bodies to heat and cold shock, like going from a sauna to cold water. However, it is important to respect your body’s limits. If you are new to contrast therapy, it is important to take it slow at first while your body adapts and you find what works for you. 

If you have any pre-existing health concerns, you should always speak to your healthcare professional before trying hot-cold therapy. Because the process intentionally puts stress on your body, it’s important to ensure you can physically handle it. Anyone with pre-existing cardiovascular or respiratory disease should opt for milder temperatures and avoid exposure to extreme temperatures altogether. 

Should you do hot therapy or cold plunge first?

Contrast therapy involves alternating between high temperatures and cold water, most often in a sauna or hot tub followed by an ice bath. Most hot and cold water therapy rituals start with heat followed by cold because it’s safer and more beneficial. 

Some hot-cold therapy methods will start with cold, go to heat, and then end with cold. Regardless of your chosen order, it is important to always end on cold. You should also always ensure your time in the heat is longer than your exposure to cold. 

A woman outside in a heating pool surrounded by steam and snow
With hot-cold therapy, always spend more time in a hot tub or sauna than in your cold water immersion.

How long should you stay in a cold plunge and a sauna?

While many hot-cold therapy routines recommend staying in a sauna, hot tub, or steam room for 10-20 minutes followed by 1-5 minutes in a cold plunge, these are not hard and fast numbers. You can do smaller increments, such as 3 minutes hot and 1 minute cold. If you’re just starting out, you may want to do even smaller increments as you find what works best for you. 

Don’t think that you have to spend all day performing contrast therapy to reap its therapeutic benefits. You want to start the process by building up a routine. You should not exceed these recommended time frames, however, because it can be detrimental to your health. 

What are the benefits of hot-cold therapy?

There are many benefits to hot-cold therapy, also known as contrast therapy. Here are some of the physical and mental benefits of hot and cold exposure: 

  • Increases blood circulation
  • Boosts the immune system
  • Accelerates healing
  • Fires up the lymphatic system 
  • Reduces swelling and inflammation
  • Relieves muscle soreness
  • Speeds up recovery
  • Rejuvenates the skin
  • Improves mood
  • Increases pain tolerance
  • Better sleep quality
  • Increased weight loss
  • Reduces premature aging 
  • Hormesis
  • Lower chance of scar tissue
  • Promotes feelings of peace, calm, and introspection 
A man relaxed while cold plunging outside as part of hot-cold therapy
In addition to physical benefits, hot-cold therapy also promotes feelings of peace.

How often can you do hot-cold therapy?

Like with cold plunging and enjoying hot baths, you can perform contrast therapy daily if you’d like. Some evidence suggests that frequent use promotes greater long-term benefits. You don’t have to do it every day, of course, but several times per week is better than every once in a while. 

For more information on ice baths and improving your wellness, bookmark these posts: 

– Edge Tub Product Review (2023 Update)

– 25 Benefits of Doing Cold Immersion

– Wim Hof Ice Bath Technique: Tips + Method

– Top Advantages of Taking Ice Baths

– Why You Should Take Cold Showers

– Ice Bath Recovery Tips

– Guide to Cold Water Swimming

– Coolest Retreat Centers in the World

– Why Sound Healing is Good For You

– Scientific Benefits of Grounding Barefoot

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