Cup Her? I Barely Know Her!
Fun fact: I don’t actually practice in modalities and myofascial release. I work in Acute Care, and that’s seen more in Outpatient and (sometimes) Inpatient Rehab. However, I am very frequently on the receiving end of specifically cupping and dry needling—I’m not going to talk about massage here, though. because I do not want to put it in anyone’s head that therapy is only good for massage. Spoiler alert: we are so much more!
Let’s talk about the elephant in the room: the evidence is split as to whether the modalities are more effective than any other type of treatment. In fact, if you head over to PubMed, the literature does not paint a clear picture as to whether modalities actually provide patients with much additional pain relief, and there are so many different modalities out there, each paper focuses on a different one! Obviously, it’s a lot to filter through.
Here are some of the more common modalities used in the therapy world:
Thermotherapy
Therapeutic application of heat.
Elevates pain tolerance; decreased muscle spasm; collagen extensibility improves, and tissues can be better stretched.
Includes:
Paraffin bath, Hot packs, Fluidotherapy, Ultrasound, Diathermy
Electrical stimulation
Transcutaneous Electrical Stimulation (TENS), Neuromuscular (NMES) or Functional (FES).
Can be purchased for everyday use.
Generally used in a clinic setting to:
Produce a motor response through nerve or muscle stimulation.
Stimulate sensory nerves to help treat pain.
Create an electrical field in biological tissues to stimulate the healing process.
Phototherapy
Aka, laser therapy.
Light exposure can help tissue repair and pain control.
Cryotherapy
Cold therapy (superficial application of physical agents to lower tissue temperature):
Cold packs, ice massage
Can reduce pain by elevating pain threshold.
Should be used in conjunction with compression for best anti-inflammatory effects.
Here are the modalities that I like for myself:
Cupping
PTs, OTs, massage therapists, and acupuncturists all use cupping in practice.
My particular therapist uses cups that have a bulb on the end. She squeezes the bulb to create a suction. She controls the vacuum, and she will move the cup around on my skin until she finds an area of high tension-slash-overuse, then she will target that area.
That’s where the cups are generally applied:
Areas of high stress, such as origins and insertions, as well as areas of fascial convergence.
Cupping works to manipulate soft tissue, improve blood flow, and promote overall healing. How it works though, well… that’s not exactly known. Per a Harvard Health Blog post, there is just no biological reason that cupping should be able to consistently provide the results that it does. And yet… those that receive cupping continue to swear by it. I mean, I love it. Do I know that it’s not a placebo effect? No. Do I necessarily care? Also no. I receive my cupping in tandem with my massages, so I enjoy the thoroughness of the treatment. But to each their own.
Dry needling
Wow. Another day, another time to be annoyed with the state of our leadership. Of course, this is a state-by-state issue, but still… per this website (which seems to be the more organized and up-to-date) Scope of Practice - OT - Integrative Dry Needling: almost every state allows PTs to practice dry needling once they finish their practice hours and complete their coursework. But the opposite seems to be true for OTs: most states don’t have any statutes on the books about whether OTs can practice dry needling, period. Well, that’s frustrating. We’ve got the right to learn—now we just need to earn the right to practice.
At any rate, dry needling can also be called intramuscular stimulation.
The therapist places the needles (which aren’t very big) in your trigger points—areas of knotted or hard muscle. Then… they move it around. It isn’t very much, (so they say anyway), but H O L Y C O W, you guys… it is the literal definition of hurts so good. For me, it’s a quick, fire-y jab (it’s a 10/10 fire, but it is so fast) and then I melt into a puddle. And I rest there while my endorphins fire away.
The science behind dry needling is when your muscle is overused, it goes into an energy crisis and your muscle fibers aren’t getting enough blood supply. Because of this, your muscle can’t go its normal resting state, and the tissue near that trigger point becomes acidic: your nerves become sensitized, making the area painful. When you stimulate the trigger point with the needle, you draw the normal blood supply back to the area and release the tension.
I hope you learned about the practices of cupping and dry needling! And maybe you should consider trying it out *wink*—but make sure to let me know in my Insta comments if you do!
Sources Consulted:
· Integrative Dry Needling. (n.d.). Integrative Dry Needling. Retrieved May 7, 2023, from https://integrativedryneedling.com/
· Radomski, M.V., & Trombly Latham, C.A. (Eds.) (2014). Occupational therapy for physical dysfunction (7th Ed.), Baltimore: Lippincott Williams & Wilkins.
· Salvador Bondoc, O. T. D., BCPR, C., & Feretti, A. M. (2018). Physical Agents and Mechanical Modalities. The American Journal of Occupational Therapy, 72, 1-6.
· Shmerling, R.H., MD. (2020, June 22). What exactly is cupping? Harvard Health Publishing. Retrieved May 7, 2023, from https://www.health.harvard.edu/blog/what-exactly-is-cupping-2016093010402#:~:text=It%E2%80%99s%20an%20ancient%20therapy%20that%20left%20multiple%20circular,removed%20by%20making%20small%20cuts%20in%20the%20skin.%29
· Stanborough, R., PT, DPT, MHSc, MTC, CMTPT, FAAOMPT. (2016, September 21). The Use of Cupping as a Treatment in Athletes. The University of St. Augustine for Health Sciences. Retrieved May 7, 2023, from https://www.usa.edu/blog/the-use-of-cupping-as-a-treatment-in-athletes/
· What Is Dry Needling? (2023, February 20). Cleveland Clinic. Retrieved May 7, 2023, from https://my.clevelandclinic.org/health/treatments/16542-dry-needling