If you’ve been around any sort of barbell athlete, namely CrossFit Athletes, you’ve probably noticed perfectly round hickey-looking bruises on their shoulders, backs, legs, etc. While it may look like they've been assaulted by an octopus or giant squid, the bruising is relatively normal.
While some of these athletes may resemble pepperoni pizzas, the debate (one of many) that rages within the PT profession is whether the cause of these marks/bruising actually does anything. The “cupperonis” (I wish I could claim that nickname as my own) are marks caused by applying a suction device to the skin. The purpose of said suction devices is to offload tissues, providing relief to both various tissues and the nervous system itself.
But does it actually work?
Cupping has been around for a literal millennia and has seen a large-scale resurgence in the last 10-15 years thanks to Michael Phelps presenting his record gold medals and "cupperonied" shoulders to the world. While freshly back on the scene, it carries with it a certain degree of controversy in the healthcare and sports worlds. Many within those professions make the claim that it offers no benefit as there is no research to support its use, while others cite ancient or other more holistic wisdoms. Most clients and patients simply state that they don't give a darn about the research and where it came from and simply use the fact that they feel better as the driving reason behind its preferred use.
To be clear, a lack of evidence is NOT the same as evidence against something. This being said, often useful techniques and modalities almost always appear in practice long before research has a chance to come around to prove efficacy or wag a disapproving finger at them.
Most lend the idea of cupping to Traditional Chinese Medicine (TCM) and while those practioners have been using it for a long time this is actually incorrect. The practice of cupping can be traced back as far as the ancient Egyptians, Greeks and was quite wide spread amongst Arabic cultures.
Getting its start as ‘wet cupping’, it involved the use of a suction device being placed over small cuts in the skin which would then draw the ‘bad blood’ out.
Similar to bloodletting or sucking venom from a snake bite, the act of applying negative pressure (sucking outwards) via a suction device draws the skin out, up and away from deeper tissues. The deeper tissues do also travel upwards as well and the resulting 'tissue travel' allows for decompression of neighboring tissues. This decompression allows for better sliding and gliding between tissue surfaces which permits a greater ease of movement in general.
The fascinating concept that is still in its relative infancy is the concept of cupping WHILE moving. Most are familiar with the idea of laying down and being treated with a clinician's hands, dry needling, cupping, scraping (Gua Sha), etc. All very effective but passive in nature, in that someone is doing something TO YOU - it doesn't teach your brain anything new about the tissue length (real or perceived), position or what to do with it. The idea of cupping with movement turns that passive treatment into an active treatment meaning your involvement. Now this may not sound appealing and having someone work on you while you relax may sound significantly better but let's be honest, you were going to have to get involved in your recovery at some point, right?
As with all things at Southeast PT, context is key. If we're going for relaxation for recovery purposes, you better believe you're going to lie still and get those spicy tissues worked on. But if we're trying to get your stiff quads to loosen up, you're going to get some cups applied to the quads and all forms of knee bending/straightening will occur.