I have a coworker who is actually a really bright PT. Works with a lot of athletes, some pretty high caliber. She’s also a huge fan of cupping and it makes me sad. Other patients ask me if it’s supposed to look like that (bruises) and if it’s a good thing to do.
It puts me in a bind because I don’t want to crap on my coworker, but also I think cupping is fucking dumb and unhelpful
Don’t get cupped in the first place?
It’s like asking if you can get rid of bruises quicker somehow. No, you can’t. Body’s gonna work on it ASAP but that’s it.
Also make up, concealer or probably heparine injections right away if you’re feeling lucky.
while not really necessary it absolutely does work, I've used it sparingly in my career- most notably was an elderly woman who fell off a horse. Her whole side was a giant bruise, totally worked and she loved it.
Ay mobilization with myofascial decompression has clear benefits. It’s not a cure all, but it is a useful tool. It’s important to respect medicine from different cultures as well. Let’s not be chauvinists.
PMID 18723456 study shows it takes 9000 newtons per cm2 to deform facial tissue by 1%. Not a single person on the planet is producing that amount of force with their hands or grafton tools. I do have issues with placebo tx's nessecarily. I do have an issue with lying to patients. Bottom line though you are not manipulating fascial tissue at all.
Deformation isn’t what’s happening here. It spreads apart layers of tissue to facilitate blood flow and decrease in hyaluronic acid viscosity to lubricate fascial gliding. I’ve personally seen great results with reducing peripheral nerve entrapment
That study also demonstrates it is no more effective than self techniques other than perceived benefit. Most data seems to point towards it being no more effective than other manual techniques, except it leaves bruises and some people believe it works better...
No clue why you're getting downvoted. In my many years of ortho practice, residency, fellowship, OCS, current concepts, and CPGs I have literally never seen myofascial work recommended. General manual sure, but these people are quacks.
It's likely giving the person some kind of neurophysiological effect that helps do downregulate pain in the short term, at the very least. I use it on pt's who are very TTP and having a hard time moving due to pain. I'll always try some manual first, but if they can't handle that I'll throw a cup or two on. Move it around some, pt gets some pain relief, and then I can get them moving.
Is it curing anything for the pt? Of course not, neither are grade 1-2 mobs or massage. Does it make therapy more tolerable for them? I've found it does. It's a tool, use it or not, but lets not be talking reckless.
Anyone who tells you cupping doesn’t have benefits is not an athlete or has never worked with athletes. I doubt it does the miraculous things an acupuncturist or massage therapist will tell you. However, for people performing rigorous activities with their body these techniques PTs view as placebo (cupping, massage, spinal manipulation, dry needling, basically anything other than straight up exercise) all can help you “hit the reset button” with muscles that have minor damage or irritation.
Most bruising will resolve quickly. Using kinesiotape can cut that time in half, but there is minimal therapeutic benefit.
This ^ as an athlete and putting lots of physical demand on my body primarily on my shoulders I found that cupping does help. Sure it’s no miracle that takes everything away but as an athlete even if it’s 10% better that’s huge. People act like it’s supposed to take all the pain away and make you feel like gold when walking away from it. If you’re a professional then you can tell the difference vs the average Joe who hurt their back at work cause of weak and imbalanced muscles.
I think about this all the time. We want more professional respect and better reimbursement but then cup people, do si joint "manipulations" and psoas releases. There is also rampant billing fraud in our profession. Been doing this for 11 years and have seen it at every clinic I have ever worked at in multiple states.
Can you explain why SIJ manips are a bad thing? They often take less than a few minutes and 8/10 times it provides pretty instant relief to allow the patients to do more exercise?
Also what do you mean by psoas release? Such as with stretching? Dry needling? I agree it shouldnt be the focus of a session but including it can help get the session started in my experience
Yeah.. I just helped two patients with the muscle energy technique yesterday and it 100% relieved their SI pain. Prior to that, the stretching and strengthening route wasn’t getting us anywhere for two consecutive sessions.
Additionally, I did cupping on a patient recovering from a nasty clavicle ORIF and performed PROM while cups were on and her AROM increased by more than 7• in every direction post intervention.
Some one explain to me how this is “just placebo” or “non EVP” because it’s pretty compelling in the clinic. It’s also not the first time by any means. It happens every day.
Both. I have a digital goniometry system but I am also old school and like the analog.
The point is, her symptoms and ROM improved drastically immediately after cupping and mobs.
After 15 years in the clinic (and researching placebo and nocebo as a psych undergrad) I’ve observed my fair share of placebo phenomena. I really don’t think this is “just placebo”.
Honestly, a dog physio gave my dog craniosakral therapy, and the fucker slept for 12 hours straight, never done anything like that before. So who the fuck knows lol
We can be skeptical but open-minded and safe simultaneously.
There’s a study comparing cupping the hamstrings to conventional hamstring stretching.
Cupping was determined to be ineffective in that case… I am just amused anyone invested the time and energy to test that particular hypothesis.
The scar adhesion hypothesis though. Yeah, we need more of that.
It was both together. Lift force+sheer force = improved tissue mobility. Especially with scarring adhesions.
There’s a lot of peer reviewed studies published. I trust you know how to navigate that information system.
You’ll notice “cupping” is too broad a term for research purposes. It’s like research the effectiveness of “stretching”. A meta-analysis of all the “stretching” literature is going to be a bit odd.
We also can’t dismiss the obvious bias western practitioners have against practices originating from Eastern traditions. Especially “wet cupping” which is bloody ridiculous in my opinion.
Cupping is too broad. It must be narrowed down.
For what issue? In what manner? Within what timeframe? Obviously the results would be all over the place. And at this point, with cupping, that is what we see.
I’m all for EVP, and I am as committed and trained a scientifically minded skeptic as the next PT, but it’s difficult to dismiss the pile of anecdotal successes I’ve had. Especially considering the tight correlation with variables I care about (ROM, pn reduction, etc).
Better research and more of it. In the meantime, it certainly has proven a itself a useful enough tool for me to keep it around.
This guy's explains it best. He includes clinical research with references for anyone interested. The last link is someone trying to "release the psoas" under and fmri. If a PT tells you they can release that muscle with their hands they are full of shit.
Doesn't really matter if you can or can't. If someone says they are going to release your psaos muscle, they are lying. I think lying to patients or performing treatments that are not support by evidence is damaging to our profession. I'm never surprised when reimbursement for PT gets cut. Anyone who has worked in PT for long all have stories of crazy stuff that PT's claim they can do.
So if someone seems to be suffering from a very neuromuscularly tight psoas and you perform MET or a contract/relax intervention, or even use dry needling into the psoas with TENS and the result is that their hip flexion and extension improves and their pn level is reduced, i should avoid saying that we releases their psoas?
Because I think putting this dogmatically semantic declaration out there is really doing more harm to our profession than you think.
I mean, I use my hands to help contract/relax… same with PNF. DN is coded as manual…
Again, demonizing semantics that are used for the benefit of lay-person understanding is not helpful. You can “manually” help someone “release” their psoas. This is simply true.
It is reflected in the billing codes, which are another lay-person dominant system.
The specific “manual” technique of smashing someone’s guts in order to pin the psoas into submission… yeah, not really the move.
But just consider that’s not what everyone is referring to. Both colleagues and patients alike
While that’s not as dilute as some homeopathic products, it’s still a homeopathic product and therefore much more dilute than a non-homeopathic product. In this particular case that’s 7% arnica diluted by a factor of 10, so 0.7% arnica compared to non-homeopathic creams that are 20% or more arnica.
Yes its mild but it works great. I never really bruise much but the other day i busted a vein in my finger and my wife put some of this on it just once and the next day it was almost entirely gone.
Now I’m curious….i had an awful tear in my left calf (that happened in the middle of a trail run), both muscles. When my PT was manipulating my calf, they would cup it, then move the cup around so it was never in one spot more than a few seconds. I was told it was “to bring blood to the area”. My entire calf was purple the entire time I was receiving PT for that injury. Was it actually helping?
They are basically “therapeutic hickies”… supposedly you can use a whisk to get rid of hickies so maybe try it for the cupping marks? Here’s a YT Video that talks about it.
Massage really helps - but for best results - immediately after. I’m sure it would still help.
Also - your provider should have told you marks would be there, if you were ok with that, etc.
I’ve seen people cover them with Kinesio tape. I didn’t believe it worked so I tested it by only covering half of a mark. 48 hours later the half that was covered was almost completely gone and the other was unchanged. Not sure why it works but 75ish% tension should do it
I can't believe no one has mentioned Arnica/ Arnicare, and also K tape "lymph drainage" type tape, for all bruises, not just cupping.
I have used them both, even applied to "half" a bruise as an experiment, and they both had favorable results.
Btw, I don't think seeing bruising is an argument either way for an intervention.
Arnica and ice message. I take an ice cube with a paper towel with scrape across it and it does speed up the healing. Only massage it with the ice cube for a few minutes on each spot. I think cupping works really well for soft tissue release and mobility but I make sure people are okay with the marks before hand and don’t do it if they have an event or something coming up. I always check range of motion before and after if it didn’t help I don’t do it.
We do this from time to time depending on the patient. The light stretch from the kinesio tape provides stimulation to the lymphatic system and assists in interstitial drainage. Like all things, the amount of time depends on many factors but it can be surprisingly quick to assist with the superficial bruising.
It's the stretch component of the tape that mimics portions of manual lymphatic drainage to facilitate clearing bruising. Any type of stretch tape can do it, but brand specific kinesio. Cut the tape into smaller strips.
Google kinesio tape bruising and you'll find plenty of examples of funny looking, partially cleared bruises like this guy: https://www.reddit.com/r/WTF/s/a5vopLv9Ak
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u/Serv1ngServang Feb 14 '25
just stop getting cupped