Spas and Saunas May Feel Great, but User Beware

Five minutes and you feel like Silly Putty; 10 and you’re more like Jell-O. Relaxing in a hot tub, steam room or sauna is a great way to unwind after a workout, particularly when you come in from an outdoor activity in the winter.

Used properly, these hot environments can reduce physical and mental stress and boost relaxation, which is increasingly being recognized as critical to well-being and peak performance. But used improperly, heat baths can have serious, and potentially fatal, consequences.

“Immersion in intense heat can carry some risk for certain people,” says cardiologist Paul Thompson, immediate past president of the American College of Sports Medicine. In extreme heat, the body tries to cool itself by shunting large amounts of blood to the skin, which can make it difficult for some people to maintain adequate blood-pressure levels.

Most healthy people can handle immersion in extreme heat for a short time, about 10 or 15 minutes. Because temperatures in such environments vary greatly, however, some people may be able to tolerate longer immersion in less extreme heat.

But people who are taking medications that dilate blood vessels or those who have compromised cardiac function may be advised to avoid hot environments altogether, says Thompson, who is director of preventive cardiology at Hartford Hospital in Connecticut. In addition, young children, some diabetics and pregnant women are cautioned to avoid immersion in intense heat.

But for the growing ranks of aging baby boomers suffering from back pain, aching joints and sore muscles, hot tubs are hot. Americans bought a record 300,000 hot tubs last year, says Jack Cergol of the National Spa and Pool Institute in Alexandria, Va.

“People between the ages of 45 and 54 account for the largest proportion of buyers,” Cergol says. “They’re looking to relieve aches and pains, reduce stress, relax, feel better and sleep better.”

The main benefit of heat immersion is relaxation, says Thompson, who calls the notion that hot environments sweat toxins out of the body “a myth.” Sweat lost in the process is mostly water, which the body soon replaces.

In some sports, including wrestling and boxing, athletes have been known to stay too long in saunas to prompt extreme sweating in an effort to “make weight” before competition.

“They are courting disaster,” says physiologist Michael Sawka, chief of the thermal and mountain medical division at the U.S. Army Research Institute of Environmental Medicine in Massachusetts. “This is not a form of weight control, it’s a method of dehydration,” Sawka says. Dehydration impairs performance and can lead to heat exhaustion and possibly heatstroke, which can be a life-threatening condition.

A common misconception about hot environments is that they help relieve acute injury. But cold, not heat, is the recommended treatment for a new injury. Heat may increase swelling and bleeding, while cold constricts blood vessels, decreasing inflammation, bleeding and pain. The general rule is this: ice for the first 48 to 72 hours, heat after. And when in doubt, apply ice. Although you may see injured athletes sticking limbs into whirlpools, the tubs are often filled with ice water.

Heat can help reduce the stiffness of an old injury or relieve pain from conditions such as arthritis. In a hot tub, the pressure from swirling water also can boost circulation of the lymphatic system, says kinesiologist John Blievernicht, a performance trainer at the High Altitude Sports Training Complex in Flagstaff, Ariz.

“A lot of the athletes I work with use their time in the hot tub to do imagery, like visualizing themselves making a great shot,” Blievernicht says. “I discourage people from reading their Wall Street Journal and checking their stocks in the hot tub. The idea is to reduce stress, not create it.”

To avoid the red, bumpy rash known as “hot-tub buns,” stay out of hot tubs that are not well-maintained, cautions Nebraska dermatologist Rodney Basler, chairman of the American Academy of Dermatology’s Task Force on Sports Medicine.

“The pseudomonas bacteria thrive in tepid water if the pH and chemical additives are not carefully regulated,” he says.

And to avoid excessive drying of skin, he adds, “be sure to rinse off afterward and apply bath oil to the body and a good moisturizer to the face to avoid drying out.”

To get the most from your heat bath, be sure to:

* Drink plenty of cool water before and after immersion to avoid dehydration. Never go in after drinking alcoholic beverages, which are dehydrating as well as disorienting.

* Cool down before you heat up. Don’t enter a hot tub or sauna immediately after exercise. Wait until you stop sweating and your pulse rate returns to normal.

* For hygienic reasons, lie on a towel in a steam room or sauna, and elevate your legs to avoid strain on the heart.

* Enter and exit a hot tub slowly and carefully. Start with your toes, then your legs, and ease in gradually. Get out with the same caution, since the sudden change in posture and temperature may cause some people to feel lightheaded.

* Check with your doctor if you are taking medication or have a health condition that may be affected by extreme heat.

* Use common sense. Don’t stay in too long, and if you start to feel uncomfortable, get out.

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Carol Krucoff writes a column on health and fitness issues for the Washington Post.