Cupping, Myofascial Release, Myofascial Decompression
Myofascial decompression or cup therapy is a form of myofascial release. To understand release of the fascia we must understand fascia and it’s role in the body.
We have extensive information about the myofascial tracks or trains (Anatomy Trains1) by the work of Thomas Myers. His definition of fascia is “ all the collagenous-based soft tissues in the body, and the cells that create and maintain that network.” 1 This includes all the fascia that is in and around the muscles (endomysium, perimysium and epimysium), ligaments, and tendons. It also includes the fascia in and around the organs, the chest cavity and the tissue surrounding the brain, spinal cord and the nerves. It is everywhere throughout the body and thus connects distant regions. For instance, your plantar fascia (in the foot) is connected to the muscles and tissues of the scalp, by lengthy lines of fascia.
The idea that everything is connected is also found in the word “tensegrity” or “tensional integrity.” Tensegrity is a word that was coined by Buckminster Fuller (from the idea of artist, Kenneth Snelson). It is, “a structural principle based on the use of isolated components in compression inside a net of continuous tension, in such a way that the compressed members (usually bars or struts) do not touch each other.” 2 We can extend this idea to the human structure, as Dr Stephen Levin has done, calling it, “biotensegrity.” The musculoskeletal system is a synergy of muscle and bone. The fascia provides continuous pull while the bones present the discontinuous compression.2
History of Cupping:
Cupping is a form of therapy where cups are placed on the skin using suction. It stems from traditional Chinese medicine (TCM), dating back at least 2,000 years. But there is also evidence that cupping was used in ancient Egypt and in Europe in the 1800’s. 3
Types of cupping include static cupping, flash cupping, moving cupping, wet cupping, medicinal cupping, and needling cupping. The cup can be made of materials such as bamboo, glass, silicone or earthenware. The suggested mechanism of cupping therapy is not clear, but some researchers suggest that placement of cups on selected acupoints on the skin produces increased blood flow. 4
A review of the cupping literature in 2012 found that cupping may be beneficial for herpes zoster, acne, facial paralysis, and cervical spondylosis when used in combination with other treatments such as acupuncture and medications. 4
There are different ways that cupping might be applied. In more traditional Chinese medicine a flammable substance such as alcohol, herbs, or paper are placed in a cup and set on fire. As the fire goes out, the cup is placed upside down on the patient’s skin. As the air inside the cup cools, it creates a vacuum. This causes the skin to rise and redden as blood vessels expand. The cup is generally left in place for five to 10 minutes.
Modern Cupping and Where Does it Fit in to All of This?
A more modern version of cupping uses a rubber pump to create the vacuum inside the cup. The cup is made from a medical-grade silicone. These can then be moved from place to place on the skin to assist with massaging the tissue.
In the physical therapy world, we call cupping, “cup therapy” or “myofascial decompression.” Most physical therapists performing cup therapy, do so by this more modern version with the pump and silicone cups. Cup therapy is a means to work with the tension that is present in the fascia. We see patients that have increased tension on the fascia due to repeated postures, trauma, surgery and injury. In these instances, the biotensegrity is affected and the structure is likely to be pulled out of place. Pain and loss of function may be a result of this loss of structure.
Myofascial decompression works to decompress adhesions for improved flow of blood and nutrient exchange. In a Western medical perspective, the cups are used for the following:
– Mechanical connective tissue change
– Trigger point release
– Improving myofascial lines of movement
– Releasing scar adhesions and scar tissue
– Increase blood flow
– Ultimately pain relief and return to function
How do I use the cups in therapeutic treatment?
I use the more modern version with the pump and silicone cups. After a full assessment, I may choose to apply the cups for any of the above reasons. I will have the patient perform a motion that is restricted or painful, then apply the cups for 1-3 minutes while you are in a stretch or active movement. I may slide the cups over the region being treated to allow for more myofascial release. Then the cups are removed and we re-try the positions. If there is still pain or restricted motion, I may apply the cups again.
The cups do leave a red/purple marks on the skin for up to 2 weeks. They look like bruises but are not tender and don’t hurt (though they look like they should). I recommend not icing them immediately after treatment, as the one of the results can be increased blood flow and by applying ice you could cause the blood vessels to constrict.
Some form of neuromuscular re-education always follows the treatment. Once the restrictions are removed, we must work to support your structure once again in a healthy, pain-free way. This may involve some manual resistance work or use of resistance bands or other exercises aimed to re-train your new mobility.
Conditions likely to help:
– Adhesive capsulitis (frozen shoulder)
– Stiff knees post-surgical
– Scar tissue post-surgical
– Plantar fasciitis
– Tight cervical myofascia (upper trapezius, levator scapulae, etc)
– Stiffness or tightness in the upper/lower back
I welcome your feedback and hope that if you find this helpful, you will share with your colleagues and your friends. Click here to Contact Tianna to see how she can help you with improving your fascial mobility and decreasing pain.
- Myers, T. (n.d.). Anatomy trains. Retrieved from http://www.anatomytrains.com/fascia/
- Wikipedia tensegrity. (n.d.). Retrieved from http://en.wikipedia.org/wiki/Tensegrity
- Web MD. (n.d.). What is cupping therapy. Retrieved from http://www.webmd.com/balance/guide/cupping-therapy
- Huijuan, C., Xun, L., & Jianping, L. (2012). An updated review of the efficacy of cupping therapy. PLOS One, doi: 10.1371/journal.pone.003179
- DaPrato, C., & Kennedy, C. (2013). A movement based myofascial course. In (Ed.), Myofascial Decompression Techniques
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