As athletes we demand a lot from our bodies. Whether you are training for a specific event, active as a weekend warrior, or striving to attain a level of general fitness, you are an athlete. Athletic endeavors provide a sense of accomplishment and physical enrichment, however, there also exists the possibility of injury from time to time. As a marathon runner, I unfortunately found myself on the injured reserve list on more than one occasion. This is how I discovered two promising therapies that have recently become more popular among athletes for both recovery purposes and injury relief. You may recall a few years back during the Olympics when swimmer Michael Phelps showed up with round markings all over his back. He was taking advantage of the cupping technique and his tremendous Olympic performance brought the cupping technique to the forefront of beneficial therapies. I recently took some time to delve deeper in to the science and reasoning behind these two therapies to determine what they offer with Ryan Goodman MPT, SCS of Goodman Performance Therapy (Goodmanperformancetherapy.com).
1.) What is cupping? Cupping is a technique that utilizes negative pressure to stretch structures in the human body including, skin, fascia, and muscle tissue. This technique can help increase circulation to the area enhancing the healing process.
Photo from Goodman Performance Therapy
2.) What is dry needling? Dry needling is an intervention that uses a thin needle without medication (dry) to penetrate the skin. By penetrating the skin, the needle can affect how the brain handles/interprets pain signals and can release chemicals in the area to promote relaxation and healing. It’s a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue. It can also diminish pain, reduce or restore impairments of the body structure and function leading to improved activity and performance.
Photo from Goodman Performance Therapy
3.) What are the benefits of each therapy? Cupping and dry needling work to provoke change in the tissue being worked on. Cupping is non-invasive, meaning the skin isn’t pierced to elicit this change and dry needling does pierce the skin going into the tissue being treated. I’ve found dry needling to yield improved results in general when compared to cupping, thus I tend to use it more frequently. I tend to use cupping instead of needles in areas of the body where piercing the skin has a higher risk of complications.
4.)Can they be used as recovery tools? Absolutely! While most people think of treatment as an intervention to assist with pain or recovery of function, both cupping and dry needling can be used for recovery and relaxation. In fact, many patients when completing a dry needling/cupping session may feel relaxed or drowsy and report they had the best sleep they’ve had in a long time. Also, the studies support that improved sleep reduces risk of injury. Outside of the systemic effects that these treatments have on the body, they can also add directly to the muscle/tissues being treated assisting with post workout muscle soreness or tightness.
5.) What is the difference between the two?(when is one used over the other?) As mentioned earlier, I tend to use dry needling more often due to improved results (invasive direct treatment of the tissue) compared to cupping (non-invasive,more indirect treatment to tissue), however in areas of higher risk (around the internal organs, lungs, etc) I will use cupping to eliminate the risk of needling to these areas. I will also use cupping strategies for specific injury presentations. For example, in patients that have IT-band symptoms, using a cupping strategy of slowly pulling the cup along the IT band and lateral quad can help with adhesions in this area. In patients that have tightness in shoulder movement, cupping with arm movements can yield large increases in range of motion.
6.) How does it help with injuries and what type of injuries have most success using either? In my practice, I see a mix of acute and chronic injuries. In order to have success in improving each, I see my job as a Physical Therapist is to create an environment for the body to heal and recover. I often use the analogy of recovery from an injury being similar to driving from point A to point B and there are roadblocks in the way that is limiting the body’s ability to recover. Dry needling and cupping are tools to assist with eliminating or minimizing these roadblocks. With any treatment, this is combined with other treatment techniques and require patients to change/modify their activity or behaviors to assist in the recovery. So as a patient, you rely on the skill and training of the therapist to first identify the roadblocks, determine the best treatments to help eliminate/reduce them, and then help guide you activity progression to safely navigate the new environment. In most injuries, I feel like either dry needling and/or cupping can be useful in addressing the roadblocks. Some of the most common areas that people experience pain is unfortunately the neck, back and shoulder. Dry needling is VERY effective in reducing pain and tension in the tops of shoulders, assisting in headaches caused by neck muscle tension, and reducing muscle knots often associated with shoulder pain allowing rapid increase in shoulder strength. As mentioned previously, cupping can also yield big range of motion improvements in the shoulder region.
7.) Are these methods safe for everyone? These techniques shouldn’t be used for everyone. Prior to treatment, patients are screened at my practice for major health conditions (i.e. diabetes, heart/lung/vascular disease), and specific conditions including infectious skin diseases, HIV/AIDS, systemic viral/bacterial infections, current or history of cancer, hemophilia, hepatitis, aplastic anemia, blood thinner use, metal allergies and pregnancy. These conditions are either contraindication or precaution for treatment. If none of these conditions apply to you, then the methods are generally safe for most everyone in trained hands. Laws and practice acts vary by state, but in general these techniques require additional training to perform and it’s important to go to a practitioner that is experienced and not rushed when performing. In the prior questions, emphasis has been on safety when comparing dry needling and cupping. I don’t perform “high risk” procedures in my practice as there are many ways to address the region without putting the patient in harms way. I educate everyone about what I am suggesting we do, where I’m suggesting we do it, the reasons its indicated, and the possible risks associated with the procedure and allow the patient to proceed if comfortable.
8.) How often should these therapies be used? This is more challenging to answer. There isn’t necessary set of written rules and like in many situations, “it depends” is the correct answer. When performing dry needling or cupping, there is a change in the tissue and the body must react to this. In individuals who are generally older, with more health complications, the body is slower to react and the post-treatment soreness may be increased for a longer period of time. This may be minimized by not using as may cups or needles and reducing the number of treatment areas addressed, but the time between treatments may need to be increased to allow the individual to appropriately respond. Generally in younger, healthier patients, the time between sessions can be minimized and there is less concern about the number of areas or the number of needles/cups being used as their bodies can respond quicker. In my practice, I generally space patients 7-10 days between sessions as they are usually performing exercises in the new tissue environment prior to re-assessment and another treatment. You could however receive either cupping/needling much more frequently if your results are favorable.
Our bodies are capable of doing amazing things, but sometimes need a little help with recovery or overcoming injury. With the advancement of dry needling and cupping, athletes can continue doing what they love. If you are interested in utilizing either of these methods, be sure to look for a trained and certified professional. Locally in the Columbus area Goodman Performance Therapy (goodmanperformancetherapy.com) treats athletes of all ages and sports.