Insider's Guide to Spas

Spa Etiquette

The Wonders of Water Therapy

Mary Bemis

The healing power of hydrotherapy works wonders for both physical and emotional health. Here are the best places to soak, shower, and float.

I was wading through icy cold water—willingly—and it felt great. I wasn’t at a spa with soft candles, pleasing scents, and fluffy robes—I was in an old windowless tiled room in a hospital-like setting that was worn-around-the-edges in the tiny, tranquil town of Bad Worishofen. I had come to Germany, to the Kneipp Institut in particular, to research hydrotherapy—and I was cold and happy as a clam. For this is where it all began.

Father Sebastian Kneipp had originally come to Bad Worishofen, idyllically situated at the foothills of the Alps, as the Father Confessor to the Dominican Convent. As a young man studying theology, he had contracted tuberculosis—and he had managed to cure himself of it. He did this with the help of cold-water baths and a healthy diet, and he went on to document this in his book My Water Cure, published in 1886.

A man with a mission, Kneipp was a healer who had a stupendous influence on the hydrotherapy movement (which morphed into naturopathy.) In addition to cold baths, he was a big believer in the health benefits of walking barefoot through the snow. Back then, a typical water cure lasted 24 weeks and consisted of many different hydrotherapies, including immersing oneself in water up to the neck for at least three hours a day, twice a day—three days a week. My brief stay in Germany involved a lot of cold water, hoses, buckets, fresh air and good food and didn’t include the above, but since then, I have gone on to experience hundreds of hydrotherapy treatments at spas both here and abroad.

Spas are traditionally places of healing—and water is at their very core. But a funny thing happened on the way to the spa not so long ago—hydrotherapy nearly disappeared off of spa menus across the United States. You can thank the emergence of a true-blue business that boomed in the 1990s. This was the decade that gave birth to and commercialized the spa industry in the United States, and in doing so, waved goodbye to what was once a spa culture.

Spas are traditionally places of healing—and water is at their very core.

During the 1990s, when spas were being built at every turn and when budgets were fat and spending frivolous, all manner of spanking new gleaming spa equipment—namely gargantuan hydrotherapy tubs and sleek Vichy showers—were being installed. But there was one little problem: spa staff were not educated in how to work them and the average American spa-goer wasn’t sure exactly what they were for. Slowly but surely the tubs and showers were taken out in favor of additional massage tables. Wet rooms turned into massage rooms at many spa facilities across the country, and water took a back seat to a plethora of trendy spa treatments, thanks to consumers who would rather be slathered with honey, chocolate, and all kinds of goo during lavish body treatments bearing long names and big price tags but little to no healing value. (Kind of brings to mind the Romans, who turned the art of bathing into a lavish, pleasurable, and very social pastime. Case in point: The largest baths that were ever built in Rome were The Baths of Diocletian. They made up 32 acres and could accommodate up to 3,000 bathers. The ruins of this enormous establishment were later turned into a church by Michelangelo that still stands today.

Fast-forward a few decades (and economic and healthcare crises) and people are happily seeking out water therapies that are slowly making their way back onto spa menus. And for good reason: they’re healing (often used to treat a variety of aches and pains from arthritis to poor circulation to sore muscles); they’re rejuvenating (hydrotherapies help to reduce stress, stimulate blood flow, and energize); and they’re fun (spas with dedicated co-ed water facilities are popular places for friends to gather and socialize).

Hydrotherapy, put simply, is the therapeutic use of water—and we’ve been relying on it for its healing properties since ancient times. This translates to baths, saunas, steam rooms, showers, and the like. Here, we’ll dip our toes into some of the best water treatments available at today’s spas.

Hydrotherapy Baths

There’s something about the weightlessness of water that just works wonders. Submerging oneself in a warm bath is sure to cure what ails you—from washing away one’s woes to providing relief from sore muscles and the stress of daily living. In ancient Egypt, pools were built in temples for priests to bathe in and for ceremonial reasons. Many of today’s day spas, hotel spas, and destination spas offer a variety of relaxing, warm baths in hydrotherapy tubs. Large, deep, and with various numbers of nozzles and mechanical stimuli, these can be programmed to address different physical concerns. (More difficult to find on spa menus is the underwater pressure massage. This is done in a warm hydrotherapy tub by the spa technician who uses a hose of varying water pressure to massage.)

The Huichica Creek Bath is one of the more creative baths I’ve come across, and it’s on the spa menu at the Carneros Inn. Nestled between Napa and Sonoma valleys, the property takes its design inspiration from the surrounding countryside—think barns, silos, and the like—and is situated on 27 acres of beautiful farmland dotted with apple orchards and grapevines. The spa features two private outdoor hydrotherapy baths that overlook the surrounding hills where the Huichica Creek rambles. Built side by side (there’s a reason the Inn is consistently rated a top getaway for couples), the two tubs feature a steady stream of water that flows over you while soothing jets massage your body. In this 30-minute treatment, you’re offered a variety of salts and powders to choose from to add to the bath, including warm goat milk powder that has anti-inflammatory properties mustard seed powder, helpful for boosting the immune system. Hydrotherapy baths are a great precursor to massage. 888-400-9000.

Soaking Tubs

“Ofuro” is Japanese for bath, and this is also how one refers to this style of tub. Traditionally a wooden bathtub that is short and steep, they are made specifically for relaxing rather than washing. Modern versions are also crafted from acrylic, as well as stainless steel. I first started seeing the ofuro pop up in urban day spas in the early 2000s. Kabuki Springs in San Francisco’s Japantown, is a terrific day spa that offers traditional Japanese-style communal bathing, as well as private bathing areas. The ofuro may be booked here with a massage or certain body treatments. This is a lovely and unassuming spot with some unique design touches, including light fixtures crafted from vintage kimonos. 415-922-6000.

Swiss Showers

The first basic showers can be traced back to India, Egypt, and Mesopotamia where people washed by simply pouring buckets of water over their heads. In the homes of the wealthy, servants, positioned and hidden behind a low wall, would serve as human showers, and would do the pouring of the water. The Greeks are credited with inventing showers with plumbing, and they piped in water that showered down on bathers through fanciful showerheads, in some instances shaped like the faces of boars and lions. There are many showerheads and showers available today, but the Swiss shower is a spa staple. This intense and invigorating vertical shower is traditionally comprised of 16 needle-spray shower heads that create either a gentle or more vigorous rain shower from the shoulders down to the ankles, alternating in temperatures. A wonderful sore-muscle reliever, this form of water massage is great for stimulating blood circulation, as well as lymph circulation.

At the Coeur d’Alene Resort in Idaho, one can find a most unusual version of this in the form of the SilverTAG Shower. Designed by architect Tag Galyean, this over-the-top (no pun intended) computer-controlled shower system features 18 showerheads that work simultaneously on six zones of the body through varying water temperatures and up to 30 shower frequencies. This precise and personalized hydrotherapy program is meant to address stress reduction, body contouring (as in slimming) and much more. This pricey piece of equipment doesn’t come cheap—each costs $100,000 (there are two at this spa). You may book in 5-minute increments at $25 a piece. Galyean also designed the spa and drew on the lush wilderness and water of the region in its design details. The 30,000-square-foot spa with abundant river views features river rock pebbles, cut stone, and fresh Western red cedar planks (regularly replaced at the spa’s entrance so that the scent of fresh-cut cedar greets guests). The dramatic focal point here is a waterfall that falls from the second story down to the first-floor reception area. 800-688-5253

Vichy Showers

The French city of Vichy with its five natural mineral springs is the inspiration behind the Vichy shower. This piece of spa equipment features five to seven water jets lined up in a horizontal shower bar that is positioned over a cushioned table. During a typical treatment, the water showers the back of the body in a pulsating massage while you are lying prone. The therapist will position each showerhead accordingly, as well as adjust the pressure and temperature of the water. This is a stress-reducing treatment that many describe as a feeling of floating on water, and is also beneficial for stimulating lymph circulation, chronic fatigue, and simply exfoliation. Many spas use this to remove the product from a body scrub or wrap.

Of the many Vichy showers I’ve encountered, the treatment that really stood out from the rest was the 30-minute Vichy Shower Rain Therapy I experienced at Spa Montage Beverly Hills. This was an excellent “pick me up” after arriving jet-lagged, thanks to the contrasting warm and cool water of the jets. The spa offers an innovative super-customized “Surrender” wellness experience that shouldn’t be missed. Of special note: This is the first hotel in Southern California to receive LEED Gold certification. It’s part Spanish Revival in style and part 1920s and ‘30s glamour, and it manages to be classically elegant and unstuffy. 310-860-7800. 

Water Circuits

The ancient Greeks were the first to create public baths, and their bathing facilities evolved into places with individual tubs, a central large circular pool, saunas, primitive showers, and even footbaths. They believed in a trio of massage, exercise, and hydrotherapy for ideal health (don’t forget, it was the Spartans who loved taking cold plunges to keep themselves hale and hardy). The Romans, naturally, took it to a whole new level (noted above), creating huge pleasure palaces where one went not only to bathe but to socialize (that only led to trouble and disease, but that’s another story).

One of the first resort spas in the States to create an elaborate water circuit, was Spa Grande at Grand Wailea on Maui. The dedicated hydrotherapy space here is huge and includes Swiss showers, a cedar sauna and luxurious steam room, a 35-foot wide Roman whirlpool tub, a cold plunge pool, and a relaxing cascading waterfall massage (a specially designed whirlpool with jets that massage your hips, calves, and feet while a waterfall cascades over your neck and shoulders from 10 feet above). As if this weren’t enough to float your boat, there are also five specialty baths to choose from (Aromatherapy, Moor Mud, and Seaweed are the most popular), and an ofuro tub. 800-888-6100.

Mary Bemis

Mary Bemis

Mary Bemis is editorial director of She is an award-winning spa journalist, honored with Folio's Top Women in Media Award, and the distinguished ISPA Dedicated Contributor Award. In 1997, she launched American Spa magazine, and in 2007, Mary co-founded Organic Spa magazine. A pioneer in the sustainable spa and beauty worlds, Mary is co-curator of Cosmoprof North America's Discover Green Pavilion. She sits on the board of Wellness Warrior, is a Global Wellness Day Advisor and a co-founder of the Washington Spa Alliance.