Kneippen is one of the best-known natural healing methods in Germany. The best-known example is water treading: a short walk through cold water in which the legs are immersed to just below the knee. It is simple, needs hardly any equipment and can be tried out in a stream, a bathtub or a Kneipp pool.
In this article you will find out what is behind Kneipp therapy, how water treading works step by step and what has been scientifically established about its effects. The article also states what has not been established, and names contraindications. The article does not replace medical advice.
What does Kneipp therapy involve?
Kneipp therapy goes back to the Bavarian priest Sebastian Kneipp (1821–1897). He was not a doctor but, as the Apotheken Umschau reports, a priest who took up water treatments after a serious illness. According to the German UNESCO Commission the first Kneipp association was founded in Bad Wörishofen in 1890. Today there are more than 600 Kneipp associations in Germany with around 160,000 members.
Kneipp therapy consists of five elements named by the Inventory of Intangible Cultural Heritage in Germany, in which Kneipp's teachings were included in 2015:
- the power of water
- a balanced diet
- medicinal plants
- exercise
- a balanced way of life
Water applications are therefore only one part of the concept, albeit the best-known. Besides water treading, they include, for example, affusions, alternating showers and arm baths.
Water treading: step-by-step guide
The following guide is based on the leaflet “Das Wassertreten” from the Kneipp-Bund and on a guide from ZDFheute.
How to proceed
- Warm up: Cold-water applications should only be done when the body is warm. Your feet must be pleasantly warm beforehand.
- Choose the water: A stream, a shallow lakeshore, a Kneipp pool or the bathtub are suitable. The water should reach to just below the knee.
- Stork walk: Walk slowly through the water and lift one foot completely out of the water with each step.
- Get out after 1 to 3 minutes: According to the Kneipp-Bund, it becomes uncomfortable after this time. Get out as soon as the cold becomes too much for you.
- Do not towel dry: Wipe the water off with your hands and walk around until your feet are warm again.
The Kneipp-Bund does not give a water temperature in this leaflet. The cold is the stimulus, but it should never hurt. If you are freezing or feel unwell, stop and warm up.
Sauna and water treading: keep your distance
The Kneipp-Bund expressly recommends leaving a two-hour gap before and after water treading from other temperature extremes, such as the sauna or an arm bath. If you plan both on the same day, you should arrange the order accordingly. You can read how to cool down after a sauna session in the article Sauna rules for beginners.
Other simple Kneipp applications for home
- Alternating foot bath: According to ZDFheute, about 38 degrees warm and about 18 degrees cold, two rounds, always finishing with cold.
- Alternating showers: Start warm, spray the legs with cold water and finish with cold (Apotheken Umschau).
- Knee affusion: Cold water from the shower head over the lower legs (Apotheken Umschau). For getting started, ZDFheute gives around 16 to 18 degrees for affusions.
Effects of Kneipp therapy: what has been established?
The Kneipp-Bund describes water treading as beneficial for nervousness, stress, exhaustion, sleep problems or tired legs. These are statements by the association. Scientifically, the picture is more restrained.
A systematic review in the journal BMJ Open (Ortiz and colleagues, 2023) evaluated 20 randomised controlled trials with a total of 4,247 participants on Kneipp hydrotherapy. The results at a glance:
- The findings were clearest for varicose veins. There were also positive results for menopausal symptoms, fever in children and sick days caused by upper respiratory tract infections.
- For high blood pressure and mild heart failure, only isolated studies were available.
- Of 132 comparisons, 46 favoured the Kneipp treatment, 81 showed no difference and 5 favoured the comparison group.
- The strength of the evidence is weak: the quality of the studies was mostly low and the risk of bias mostly unclear. Combining the figures in a meta-analysis was not possible because of the large differences between the studies.
The authors therefore consider it difficult to determine treatment effects reliably and call for further high-quality studies. In other words: there are indications of benefit, but no clear proof yet. As part of a healthy lifestyle with exercise, sleep and relaxation, Kneipp therapy can nevertheless be a pleasant habit. Blanket health promises cannot be made responsibly on this basis.
Who is Kneipp therapy not suitable for?
Cold applications put a strain on the circulation. Therefore: if you have pre-existing conditions, speak to your family doctor beforehand. The Kneipp-Bund writes that Kneipp applications should only be used after consulting a doctor, and urges caution in cases of menstruation, kidney and bladder diseases and certain circulatory disorders.
ZDFheute and PTAheute name further cases in which caution is advised or medical advice is needed:
- coronary heart disease or other circulatory disorders
- acute infections, for example of the kidneys or bladder
- peripheral arterial occlusive disease and cardiac arrhythmias
- open wounds
Stop if you feel very cold, unwell or dizzy, and warm up again afterwards (PTAheute).
Kneipp therapy at the Wellnesshotel Sonnenhof & Sonnhalde
Our spa area in Ühlingen-Birkendorf includes a Kneipp water-treading pool. There you can try out, following the guide above, what the stork walk feels like. Take it slowly and observe the contraindications.
For relaxing, our sunbathing lawns “Garten” and “Waldblick”, two wellness tea stations and several relaxation rooms are at your disposal. If you would like to combine time outdoors with the forest, you will find ideas in the article Forest bathing: guide and beautiful places in the Southern Black Forest. You can read more about saunas and warmth in Is sauna healthy?. An overview of our area is given by the page Peace and relaxation in the Black Forest. You book your stay directly through us Book page.
Frequently asked questions
How long should you tread water?
The Kneipp-Bund gives 1 to 3 minutes. After that it becomes uncomfortable. Leave the water as soon as the cold becomes uncomfortable, and walk around until your feet are warm again.
How cold does the water have to be for water treading?
In its leaflet, the Kneipp-Bund does not give a temperature. What matters is that your feet are warm beforehand and that you leave the water when the cold becomes sharp.
How often can you practise Kneipp therapy?
There is no fixed, established recommendation for frequency. In its leaflet, the Kneipp-Bund writes: “The more often you do it, the better you will feel.” That is a statement by the association, not an established dosage recommendation. Discuss the amount with your doctor.
Is Kneipp therapy scientifically established?
For individual complaints, such as varicose veins, there are indications of benefit. Overall, however, the authors of a review in BMJ Open rate the evidence as weak, because many studies are small or methodologically limited.
May you practise Kneipp therapy before or after the sauna?
The Kneipp-Bund advises leaving a two-hour gap between water treading and other temperature extremes such as the sauna.
Sources
- Kneipp-Bund e.V.: Water treading (health tips): guide, duration, notes, precautions
- German UNESCO Commission: Kneipp therapy (Intangible Cultural Heritage): inscription in 2015, five elements, associations and members
- BMJ Open 2023: Clinical effects of Kneipp hydrotherapy – a systematic review of randomised controlled trials: state of the evidence
- ZDFheute: Kneipp properly – how water treading can work in everyday life (17 May 2025): guide, temperatures, contraindications
- PTAheute: Kneipp therapy for healthy ageing – what is behind it (16 September 2026): life dates, caution with pre-existing conditions
- Apotheken Umschau: Healing with Kneipp (updated October 2022): background on Sebastian Kneipp, alternating showers, knee affusion
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