Spa Procedures PDF

Spa Therapies: Bath and Shower Techniques, Exfoliations, and Specialized Methods SPA A spa is a place where water therapies are administered. The common denominator for both massage and spa therapies, according to international spa expert Robin Zill, is that the “skin is the portal of entry” for bot...

Spa Therapies: Bath and Shower Techniques, Exfoliations, and Specialized Methods SPA A spa is a place where water therapies are administered. The common denominator for both massage and spa therapies, according to international spa expert Robin Zill, is that the “skin is the portal of entry” for both. Spa therapies include a variety of body treatments administered in spas that may or may not incorporate massage. Water is at the heart of the spa experience. The origin of the word spa is uncertain. Some scholars believe the term is derived from the Walloon (Wallonia, Belgium) phrase espa, meaning “fountain.” Other scholars believe that the word comes from the letters S-P-A that were scribbled on the marble walls of ancient public baths of Rome. This is translated from the Latin term sanus per aqua, meaning “healing through water” or “cure of water.” In those times, the spa was more than a place to relax; it was a sacred space—a place to experience nurturing, transformation, and healing on spiritual and physical levels. Another possible word origin is that in the sixteenth century, people traveled to the town of Spa, Belgium, to “take the waters” as a way to rest, retreat, find lost health, preserve vitality, and rejuvenate. Spa esthetics and ambiance play an important role because beauty and art go hand in hand with the spa experience. Most spas offer their own signature treatments. Types of Spas There are four main types of spas. They are day spas, medical spas, hotel or resort spas, and destination spas. Day spas offer health, wellness, and beauty services on a day-use basis. Clients arrive and stay for a few hours or for the entire day, but overnight accommodations are not available. Services are often a combination of hair, nails, and skin salons with a variety of massage sessions. In fact, some days spas are not actually spas at all; no hydrotherapeutic services such as whirlpool baths or Vichy showers are available. Medical spas are a type of day spa that integrates medical esthetics and spas services. The environment is often a blend of medical clinic and spa resort. Medical treatments may include Botox injections, laser therapy, and skin resurfacing procedures. These services are provided by or are supervised by doctors or nurses or by individuals who receive specialized training and proper licensure. Hotel or resort spas are located within a hotel or resort. These facilities provide professionally administered spa services, fitness and wellness components, and spa cuisine menu choices. Destination spas are places clients who come to relax, rejuvenate, or to begin or improve their Copyright © 2023, by Elsevier Inc. All Rights Reserved. lifestyle choices. The length of stay varies from a long weekend to several weeks or longer. Services are administered by a highly trained staff and may include a dietitian, personal trainer, or lifestyle coach. Education is often a central theme of destination spas. Safety Issues To increase safety in a spa area, take steps to reduce risks for slips and falls, electrical shock, and the spread of infection. To reduce risk of slips and falls, the spa area should contain nonslip walking surfaces and hand grip bars next to the entrance and exit areas. You may also provide waterproof shoes or sandals for clients. The spa area should be evacuated during power outages and during floods. Any spa equipment located outdoor should not be used during electrical storms. Long hair should be secured or within a cap when they enter tub or pool because it may become trapped in water pumps. Although spa therapies are relatively safe, there are some circumstances when they should not be used. These include the aforementioned contraindications when spa therapies include hot or cold water. It is vital that water temperature is confirmed with a reliable thermometer before your client enters the water. If needed, adjust the water temperature by added cooler or warmer water until the desired temperature is achieved. If using a pool or tub that is not drained between uses, be sure to filter and sanitize the water with chemical additives to kill water-borne pathogens. Common chemical additives are chlorine and bromine. Be sure spa areas are well-ventilated as clients with asthma and other respiratory disorders may be sensitive to chlorine fumes. Ozonators may also be used, which use ozone to sanitize the water. Clients with bowel or urinary incontinence may not be immersed in water that will be used by other clients because of increased risk of water contamination. Be sure clients bathe or shower with soap beforehand and have been screened for contraindications such as skin infections and incontinence. (See Infections That Spread in Water section.) All chemicals used to sanitize pool water should be kept in original containers and in a locked cabinet. BATH AND SHOWER TECHNIQUES Balneology is the art and science of bathing for therapeutic and relaxation purposes. Bathing can be done by immersion of the whole body or parts of the body, or by spraying or pouring water onto the body. For centuries, cultures worldwide have enjoyed the benefits of bathing. Romans Copyright © 2023, by Elsevier Inc. All Rights Reserved. and Japanese constructed bathhouses that were used as social gatherings and for religious rites. In the late nineteenth century, areas of natural springs became popular destinations across Europe and later in the United States. These were the beginnings of the modern day health spas, a place where people came to relax and rejuvenate. In the 1940s and 1950s, water played a role in rehabilitation of diseases such as polio and tuberculosis. It was found that water’s unique properties such as buoyancy helped individuals recover faster from debilitating illnesses than was possible on land. Be sure to check your state laws regarding draping during spa therapies, such as full immersion baths, saunas, steam baths, and Vichy showers. Immersion Baths Immersion baths are full or partial immersion in a tub filled with water. Larger tubs are usually made of fiberglass. Immersion baths are best used before a massage session, or they can revolve around the massage itself, as in underwater massage. Water temperature ranges from tepid, neutral-warm, hot, to very hot, depending on the client’s therapeutic goals. The most common goals of immersion baths are relaxation, pain and inflammation reduction, and soft tissue extensibility. Tepid water, which is between 79° F to 92° F (26° C to 33° C), is used to reduce local inflammation when ice or icy water is not well tolerated. This temperature range is also used when water is used solely for exercise. Neutralwarm is used for Watsu treatments, with the ideal temperature range between 95° F and 98° F (35° C to 36° C). Hot water [between 99° F to 102° F (37° C to 38° C)] is recommended for relaxation and very hot water [between 103° F to 110° F (39° C to 43° C)] is recommended for pain reduction or to increase soft tissue extensibility. If very hot water is used, limit treatment time to approximately 5 to 7 minutes. Water temperature should not exceed 110° F (43° C) because this temperature may cause burns. Additives such as minerals, herbs, or milk, can be added to water. Epsom salts (named for the mineral springs in Epsom, England) or preparations such as Batherapy create a mineral bath. Blended herbs, herb extracts, or essential oils create an herbal bath. Goat or cow milk creates a milk bath. These additives should only be used in tubs that are drained after each use. Common types of immersion baths used in spa settings are whirlpools and spa tubs. Some spa facilities also have hot tubs, footbaths, and underwater massage. Copyright © 2023, by Elsevier Inc. All Rights Reserved. A whirlpool is a tub filled with hot water just before use and drained after each use. A pump circulates water under pressure through a series of jets that are positioned along the sides and sometimes the bottom of the tub. The pressure and direction of the jets can be adjusted. A spa tub is not drained after each use. Water temperature is maintained by a heating element and the water is sanitized for multiple uses. Similar to a spa tub, a hot tub is not drained after each use and the temperature of the water is maintained by a heating element. Traditionally, hot tubs are made of wood and are in the shape of a barrel. See the Chat Box entitled “Cooperage” for more information. Contraindications for Full Immersion Baths Unlike hydrotherapy treatments that cover small areas of the body, full immersion baths cover most of the body and have a few additional contraindications. These are discussed next. Poor Thermal Regulation Persons who have poor thermal regulation have increased risk for thermal shock when large areas are immersed in hot water. If a small area is immersed, the client may still be able to dissipate heat by conduction or evaporative cooling. In general, poor thermal regulation is more common in the elderly and the very young. Cardiac Instability Hot immersion baths should be not be used by clients with uncontrolled hypertension or congestive heart failure as the heart may be unable to adapt sufficiently to circulation changes. Copyright © 2023, by Elsevier Inc. All Rights Reserved. Infections That Spread in Water Clients with infections that may spread in water should avoid immersion baths until the infection has resolved. Types of infections include urinary tract infections, such as cystitis; fungal infections, such as athlete’s foot; viral infections, such as plantar warts; and any infection present in wounds. Infections can spread more easily in hot or very hot water. Seizure Disorders Full immersion baths should not be used if clients have seizure disorders because they are at increased risk of drowning if they have a seizure while in a tub of water. Procedure 1. Because the tub is a soaking rather than a cleaning vessel, ask clients to shower before entering the tub. A body shampoo can be performed rather than a shower (see later discussion). 2. Instruct the client on how to enter and exit the tub safely. Assistance may be required. 3. While the client is in the tub, offer a cup of water in a nonbreakable cup and a cool compress for the face and neck. 4. Soaking time ranges from 5 to 20 minutes, depending on the water temperature and client’s comfort level. 5. If desired, the client can take a 2- to 3-minute tepid shower after bathing. 6. When the client is dry and wrapped in a warm towel or robe, escort him or her to a warm, quiet place, to rest and drink water or tea for 10 to 20 minutes. Pool Plunge A pool plunge consists of a brief submersion in a cold, deep water pool (usually a chilly 54° F to 65° F). The plunge is invigorating following an immersion bath, sauna, or steam bath. Procedure 1. Direct the client to quickly submerse him or herself in the cold pool water. A 30-second dip is recommended. 2. Once out of the pool, dry off immediately. Sauna A sauna is a dry heat bath in a wood-lined room. Humidity is set between 10% and 20% with temperatures ranging between 160° to 210° F. A Finnish sauna is a type on which most modern Copyright © 2023, by Elsevier Inc. All Rights Reserved. saunas are based. In a Finnish sauna, a fire using birch wood heats a pile of stones. The radiant heat from the stones warms the air in the sauna. Water can be thrown on the hot stones to create occasional steam. In a traditional Finnish sauna, the person’s skin is gently slapped with leafy birch twigs to stimulate circulation after the initial sweat. Procedure 1. Ask the client to remove all metal jewelry and to shower before treatment. 2. Assist the client into the sauna. 3. Offer a cup of cool water in a nonbreakable cup and a cool compress for the face. Because of water lost during sweating, clients should be well hydrated before, during, and after treatment. 4. After the initial sweat, which may take from 5 to 15 minutes, suggest that the client take a tepid shower or pool plunge. 5. If desired, the client may reenter the sauna for a second sweat. 6. After the session, allow the client to take a brief tepid shower or pool plunge. 7. When the client is dry and wrapped in a warm towel or robe, escort him or her to a warm, quiet place, to rest and drink water or tea for 10 to 20 minutes. Steam Bath Steam baths are vapor baths taken in a ceramic-tiled room for multiple clients or in a special cabinet or canopy for individual clients. Water vapor fills the bathing area at 100% humidity with temperatures ranging between 105° F and 120° F. Essential oils may be added to the water before it begins to vaporize from the heat. Because high humidity creates dense air, clients with respiratory disorders should avoid steam baths in an enclosed room because it may be difficult to breathe easily. In these circumstances, use a steam cabinet or canopy because the client’s head remains out of the steam bath during treatment. Procedure 1. Ask the client to shower before treatment. 2. Assist the client into the room, instructing him or her to sit on a towel placed there for comfort and sanitation. It is also a good idea to show your client where the steam pipe is and avoid it. 3. Offer a cup of cool water in a nonbreakable cup and a cool compress for the face. Because of the water lost during sweating, clients must be well hydrated before, during, and after treatment. 4. Allow the client to remain in the steam room, canopy, or cabinet for up to 20 minutes. 5. After the steam bath, suggest that the client take a brief tepid shower or cool pool plunge. Copyright © 2023, by Elsevier Inc. All Rights Reserved. 6. When the client is dry and wrapped in a warm towel or robe, escort him or her to a warm, quiet place, to rest and drink water or tea for 10 to 20 minutes. Vichy and Swiss Showers Vichy and Swiss showers are popular at high-end spas. These showers are used as part of contrast bath regimes or to remove products after body wrap and exfoliation procedures. The main difference is the client is lying down in a Vichy shower and standing up or sitting in a Swiss shower. In a Vichy shower, water comes from multiple down-facing showerheads situated along the length of a horizontal pipe that runs the length of a wet table. Some Vichy showers are equipped with a separate hand-held shower hose. Vichy shower gets its name from its city of origin, the renowned spa town of Vichy, France. Copyright © 2023, by Elsevier Inc. All Rights Reserved. During a Swiss shower, water comes from multiple showerheads that are situated vertically along the walls of the shower stall and one large showerhead positioned on the ceiling. Swiss showers get their name from its country of origin, Switzerland. Procedure 1. Instruct the client how to lie on the table or enter the stall. 2. Assist your client with draping (i.e., genitals and female breasts are covered at all times). 3. Turn on the shower and adjust the temperature and water pressure according to the desired result. For a traditional Swiss shower, begin with the water temperature at about 100° F. Increase the temperature to 110° F within 30 seconds. This is maintained for a full minute, Copyright © 2023, by Elsevier Inc. All Rights Reserved. and then switched to 70° F for 30 seconds, then back again to 100° F. This cycle is repeated two more times, for a total of three times. 4. After treatment, assist the client from the table or stall. 5. When the client is dry and wrapped in a warm towel or robe, escort him or her to a warm, quiet place, to rest and drink water or tea for 10 to 20 minutes. Swedish and Turkish Body Shampoos Body shampoos involve gentle scrubbing of the client’s skin using a cloth or brush dipped in warm, soapy water. The main difference between a Swedish and a Turkish shampoo is the water temperature of the final rinse. A Swedish shampoo includes pouring a pail of hot water (105° F) over the client’s skin as the final rinse. A Turkish shampoo adds a tepid pail pour (90° F) after the hot pail pour (105° F). Body shampoos may be administered indoors or outdoors while the client stands, sits on a water-resistant stool, or lies on a wet table. Procedure 1. Dampen the client’s skin. 2. Using a mild liquid soap, generate a thick lather. 3. Gently scrub the client’s skin. Use circular massage techniques around joints and linear techniques over larger body areas. 4. Remove the lather with a shower, hose, or a pail of water poured over the client’s skin. Water temperature varies according to whether you are providing a Swedish (105° F) or Turkish (90° F) shampoo. 5. Dry the client’s skin immediately. Underwater Massage Underwater massage combines an immersion bath with massage therapy. Water temperature is a comfortable 97° F to 101° F. The massage is provided by a stream of water under pressure from a hand-held hose. Procedure 1. Ask the client to shower before entering the tub. A body shampoo can be performed rather than a shower (see previous section on shampoos). 2. Instruct the client on how to enter and exit the tub safely. Assistance may be required. 3. While the client is in the tub, offer a cup of water in a nonbreakable cup and a cool compress for the face and neck. 4. Soaking time ranges from 5 to 20 minutes, depending on the water temperature and the client’s comfort level. Copyright © 2023, by Elsevier Inc. All Rights Reserved. 5. Using a hand-held hose, massage the base of the neck, shoulders, back, hips, thighs, legs, and feet with a moderate-pressure stream of water. The client is supine and occasionally rolls onto the left or right sides to access the back of the body. Both linear and circular movements of the hose can be used. The hose can be operated by the client for self-massage or by a therapist. 6. The water massage typically lasts 20 to 30 minutes. 7. If desired, the client can take a 2- to 3-minute tepid shower. 8. Provide a warm, quiet place for the client to rest for 10 to 20 minutes. Scotch Hose During a Scotch hose, the client stands approximately 10 feet from the therapist while he or she sprays the client with a strong stream of water. The hose often resembles a fire hose. The temperature of the water alternates from hot to cool at regular intervals to create a contrast bath. This treatment is also known as a Scotch douche, Scotch shower, jet blitz, or a blitz gus. Douche is a French word meaning shower. Procedure 1. Turn on the valve and begin with the water temperature at 90° F. Start at the feet and direct the water stream up the client’s leg, thigh, back, and shoulder; then down the arm, and switch to the opposite side of the body. Be sure the water stream is moving constantly. 2. While you are moving the stream over the client, increase the temperature to 110° F and maintain this for 1 minute. Turn the water temperature down to 60° F for 30 seconds. This cycle is repeated two more times, for a total of three times. End with the water temperature on 90° F. When the client is dry and wrapped in a warm towel or robe, escort him or her to a warm, quiet place, to rest and drink water or tea for 10 to 20 minutes. EXFOLIATIONS During exfoliation procedures, the client’s skin is stimulated by abrasion. This abrasion is achieved by using superficial friction applied with a textured cloth, a sponge, loofah, or a brush or a grainy product. Grainy products are applied to the skin using an open flat palm. Gentle to moderate pressure is used to exfoliate the skin; deep pressure can irritate the skin. Monitor the pressure and if the client states that the procedure is uncomfortable, reduce pressure and/or speed immediately or discontinue treatment altogether. One of the most popular exfoliating products is salt (noniodized); granule size ranges from fine to coarse. Other exfoliating products are sugar, cornmeal, or oatmeal; coffee; and ground Copyright © 2023, by Elsevier Inc. All Rights Reserved. herbs (the latter is popular in ayurvedic treatments). Ground nuts and seeds, which include almonds, walnuts, and other nut shells, as well as apricot and peach pits, are also used. Liquid soap can be added to the exfoliant to provide a cleansing effect. The procedure can be performed with the client standing, sitting on a stool, or lying on a wet or dry table. Avoid exfoliating skin that has been freshly shaved, waxed, or has a rash. Body Scrubs, Glows, and Polishes A body scrub uses coarse grainy substances as the exfoliant. A glow is a term used to describe a body scrub because it makes skin “glow” during and immediately after the procedure because of hyperemia. A body polish uses a fine, grainy substance as the exfoliant. These products are not as coarse or abrasive as scrubs and glows. Clients who have fair, ruddy, thin, or fragile skin should use a polish instead of a scrub. A crème-based body polishing agent is called a gommage. Procedure 1. Dampen the client’s skin with water or oil. 2. Use about a tablespoon of exfoliant and apply it to the skin. Replenish when you begin a new area or when needed. 3. Use short, brisk back-and-forth linear superficial friction to apply the exfoliant over the client’s skin. Use circular superficial friction around joints. 4. Rinse off the exfoliant with a warm shower, hand-held nozzle, pail pour, or damp washcloth. Dry the skin immediately. Some products can be brushed off with a towel rather than rinsed off with water. 5. Apply a skin moisturizer. Dry Brush Massage Dry brush massage uses a natural bristle brush or loofah to exfoliate and stimulate the skin. In most cases, this procedure is used before other spa services but it can be a stand-alone service. Garshana, an ayurvedic dry brush treatment, may be performed with a loofah, or gloves made of wool, raw silk, or textured cotton. Brushes and loofahs can be disinfected in a dishwasher by washing and drying with heat. Be sure to place them on the top rack. Procedure 1. Use short and brisk massage techniques directed upward toward primary lymph nodes to assist lymphatic drainage. a. Circular superficial frictioncan be used on the soles of the feet, palms, and hands, and on joints. Copyright © 2023, by Elsevier Inc. All Rights Reserved. b. Linear superficial friction is used on limbs, back, abdomen, and upper chest. c. Avoid the face and head. 2. Be sure to use mild to moderate pressure within the client’s tolerance level. If a burning sensation occurs, reduce pressure or speed. 3. Session time can range from 5 to 15 minutes. 4. “Give me the power to create a fever, and I shall cure any disease.” —Hippocrates SPECIALIZED METHODS This section introduces the massage therapist to specialized methods used in spas across the country. They are typically not taught in school and may require additional training and Copyright © 2023, by Elsevier Inc. All Rights Reserved. certification beyond an entry-level massage program. These methods include body wraps, hot stone massage, Watsu, and shirodhara. Body Wraps A body wrap is application of therapeutic agents to the body, which is then wrapped in large wet or dry sheets and warm blankets. Therapeutic agents include seaweed, algae, muds, clays, fango (Italian for “mud” but can include peat and clays), paraffin, parafango (fango and paraffin), volcanic ash, charcoal, and honey. For wet sheet wraps, soak clean sheets in therapeutic liquids and wring them out before wrapping the body. When sheets are soaked in herbal tea, it is called an herbal wrap. Tea may be a decoction or infusion. A decoction is made from boiling parts of the plant (e.g., bark, roots, and seeds) and an infusion is made from steeping parts of the plant (e.g., stems, leaves). Sheets may also be soaked in coffee, milk, cider, or juice. For a dry sheet wrap, the therapeutic agent is applied to the skin with a clean brush or gloved hands before wrapping the body in a clean dry sheet. Copyright © 2023, by Elsevier Inc. All Rights Reserved. The client can receive a dry brush massage, an immersion bath, steam bath, or sauna before the body wrap. To wrap the sheet around the body, a technique called cocooning is often used to create uniform snug cocooning fit. If the client experiences claustrophobia-related anxiety during the body wrap, loosen the fabric around his or her neck and shoulders. If this does not relieve the anxiety, place the client’s arms on top of the wrap for the duration of treatment or discontinue treatment. A potential benefit of body wraps is to create an artificial fever by raising body temperature. This may activate sweating to cool the body. During this process, circulation and metabolism may increase, which may encourage absorption of the therapeutic agent. However, if the client becomes uncomfortably warm, loosen the fabric or uncover the feet and ankles and place a cool compress across the forehead. A slimming wrap or compression wrap is a type of body wrap that encases the body in plastic wrap or elastic bandages that have been soaked in a special solution. Therapeutic agents can also be applied to the skin. The objective is to contour the body and reduce fluids. The effects are temporary. Avoid misleading the client into thinking that compression wraps are a method of weight reduction. Procedure 1. Prepare the table. Be sure sheets, thermal blankets, and other layers are lined up at the head of the table. Copyright © 2023, by Elsevier Inc. All Rights Reserved. 2. Place a towel at the head of the table. Fold the towel lengthwise, tucking the sheets and blankets in between the towel layers. This towel will surround the client’s head and neck when the body is wrapped. 3. Lay the wet or dry sheet over the Mylar foil sheet. 4. Ask the client to lie supine on the sheet with the head positioned in the middle of the towel. 5. If a dry sheet wrap, apply product to the client’s skin using long gliding effleurage techniques. Apply product to the fronts of the legs. To apply product to the backs of the legs, flex the hip and knee. To apply product to the buttocks, flex the hip and knee, then rotate the hip medially to expose the buttocks. To apply product to the back, help the client into a seated position while maintaining the drape. Copyright © 2023, by Elsevier Inc. All Rights Reserved. 6. Wrap and cocoon the sheets and blankets tightly around the client. Keep the face exposed. Use the folded towel like a collar. 7. Place a bolster behind the knees because weight of the wrap may cause lower back hyperextension. Allow the client to remain in the wrap for up to 20 minutes. 8. Unwrap the client and then cover him or her with a warm towel or robe. If doing a wet sheet wrap, allow the therapeutic agent to dry on the skin. If doing a dry sheet wrap, remove the product with warm, wet towels; a Vichy, Swiss, or regular shower; or a hand-held hose. Apply moisturizer to the skin. 9. Allow the client to rest for 10 to 20 minutes. Hot Stone Massage Hot stone massage uses smooth, flat heated stones placed on the skin or used as massage tools. Cold stones can also be used, but are less common. Native Americans have used heated stones as therapy for centuries. Hot stone massage gained in popularity because of Arizonan Mary Nelson, who coined the term LaStone therapy. Hot stone massage is a now on spa menus across the country. Stones of various sizes are used for different areas of the body. For example, larger stones are used for the back and smaller stones needed for between the toes. Basalt is recommended for hot stones, and marble is recommended for cold stones. Stones should be cleaned after use with antibacterial soap and water. Some therapists add a little salt to the soapy lather. Isopropyl alcohol helps remove massage lubricant from stones. Water used to heat the stones should be replaced with fresh water. Memo: Hot stones and the heating unit can burn the skin. The water temperature to heat the stones is between 130° to 140° F. According to the Associated Bodywork and Massage Professionals (ABMP), the greatest number of lawsuits filed against massage therapists are burns from hot stones. The ABMP recommends that stones should never rest directly on the skin. Use two insulating layers, such as a sheet and towel, between the hot stones and the clients’ skin. Never place a hot stone beneath the client, even with insulating layers as the client’s weight increases heat transfer and risk for burns. Therapists have also burned themselves on hot stones. Watsu Watsu is a form of shiatsu massage that is received in neutral-warm water. During Watsu (a term derived from “water shiatsu”), the therapist stands in chest-deep water helping the client to float, sometimes with the aid of flotation devices. Techniques include the finger pressure of shiatsu, as well as compression, joint mobilizations, stretching, and deep breathing. Shirodhara Copyright © 2023, by Elsevier Inc. All Rights Reserved. Shirodhara is an Ayurvedic treatment where a steady stream of warm oil pours over the client’s forehead. During the procedure, the client lies on a table with the upper portion of the head over the table’s edge. Warm oil (usually sesame) flows from a vessel in a steady stream. This vessel is held in place by a support stand. Shirodhara (a term derived from “shiro” meaning head and “dhara” meaning flow) is usually combined with other spa treatments, such as body wraps, or massage, but is suitable as a stand-alone service. Chat: Cooperage and Hubbard Tanks The age-old tradition of barrel making called cooperage dates back thousands of years. Barrels have long been used to hold liquids, such as wines and spirits. Cedar and oak are the most popular woods as they have a natural resistance to decay. This led to the early development of wooden barrels used as tubs for bathing. When water immersion is combined with light exercise, a Hubbard tank is used. Named after its inventor, Carl Hubbard, this large tub is used in rehabilitation clinics. Chat: Sitz Baths Copyright © 2023, by Elsevier Inc. All Rights Reserved. More of a physical therapy modality than spa therapy, a sitz bath is a sitting bath with the water covering the hips and often coming up to the navel. This type of treatment requires a tub shaped as a chair designed so that the legs remain out of the water. Water temperature ranges from 90° to 102° F. If the water is cool for a tonic effect, then the bath lasts only 3 to 8 minutes. Warm water creates a sedating, calming effect, with treatment times ranging from 20 to 30 minutes. Healing agents such as salt or alum can be added to the water. A sitz bath is often indicated for relief of menstruation pain or postchildbirth pain; however, it is contraindicated in cases of pelvic inflammatory disease. One method for of taking a sitz bath uses a small pan placed over a toilet seat. A hose from a nearby faucet provides a constant flow of controlled temperature water to the front of the pan while the client sits. The excess water spills out an overflow notch in the back falling into the toilet bowl. This treatment is generally used following pelvic surgeries, such as episiotomy or hemorrhoidectomy. The etymology fans, sitz is the German word for “sit.” Chat: Thalassotherapy Thalassotherapy is the therapeutic use of sea and marine products, primarily seaweed. The term thalassotherapy comes from the Greek word for sea. Seawater and blood plasma are chemically similar. Proponents of thalassotherapy often cite this fact. Spa treatments that use thalassotherapy are seawater baths and body wraps. Chat: Value Added Service A value-added service is a treatment offered in addition to performed spa procedure to increase its value to the client. The most popular value-added services are reflexology and neck, face, and scalp massage. Copyright © 2023, by Elsevier Inc. All Rights Reserved.