After running a nearly 20-mile event with friends this Memorial Day weekend, I was talking (read: complaining) about my chronic, never-ending upper back pain to my physical therapist friend. Prior to this, we had been using her set of silicone suction cups to keep blood flowing through our tired, swollen legs. She had me lie on my stomach while she skillfully ran these cups across the fibers of my back muscles. By doing this, she was performing something called "cupping therapy," which is a form of myofascial decompression. Myofascial decompression pulls on your skin to loosen up the stagnant, rigid, "knotted" tissues below.
I was a skeptic at first (as I am with most "alternative" treatments), but after noticing how different my shoulders felt following some cupping and massage, I wanted to know more. In true INTJ fashion, I spent a few hours after my cupping experience learning everything I could about this practice that improved my range of motion. I watched videos. I read descriptions from physical therapists. I found research about fascial structure and function on PubMed. And now, I'm sharing what I learned with any fellow skeptics out there
The first part of understand how cupping and myofascial decompression (MFD) work is understanding fascia (a connective tissue that encloses and stabilizes the muscles and organs). If you're a meat-eater, you've probably seen it on the chicken you've prepared or eaten. It resembles a plastic wrap covering the muscle. Fascia is omnipresent within your body, and its everywhere-ness means that its health has an impact on your entire body. MFD specifically targets the fascia associated with muscles (hence the prefix "myo-"). "Cupping" claims to facilitate improved function of the musculoskeletal system by improving the health of the fascia.
While my friend was demonstrating cupping therapy, she explained to me how it works by comparing the fascia to a shirt. If your shirt is tight and knotted near your bottom left hip, it will affect the way your shirt rests on your body elsewhere. If the knot is tight enough, it can have effects all the way up by your right shoulder. Think of your muscular fascia in the same way. If it is tense and inflexible in one area, it will pull on other neighboring areas.
Healthy fascia is elastic and pliable. Stiff fascia restricts the movement of muscles and joints, while healthy fascia allows the body to move the way it should. Cupping therapy decompresses the stiffened fascia to improve its mobility, encouraging it to return to its healthy state. While massage applies pressure to the muscles and fascia, cupping pulls them outward. Some people describe this sensation as the opposite of a massage. I said that it feels like a little elf is behind my muscles pushing out on them. Oh, and if you have really tight areas, you might end up looking like this:
Don't be alarmed; the marks don't hurt. My friend said that only about 5% of her patients react this strongly, so you probably won't look like you let a lamprey feast on your back. They did last for almost a week, though, so don't try this if you have an upcoming event for which you'd like unmarked skin.
Practitioners of Traditional Chinese Medicine will often use cupping therapy in conjunction with acupuncture. They claim it can treat a wide variety of conditions that extend beyond musculoskeletal dysfunction: infertility, lung congestion, and digestive problems. When used by physical therapists, it is more often partnered with massage techniques strictly for treating muscle issues. There are some claims that cupping can be used cosmetically for treatment of cellulite and wrinkles, but I have not found any evidence that supports the cosmetic uses of this therapy.
What I did find is an Under Armour commercial featuring Michael Phelps getting a cupping treatment (it is shown at about 0:44), which led me to learn that it is very popular among swimmers around the world. When considering the benefits that cupping practitioners assert, this makes sense; healthy fascia will improve range of motion, which is something very important in swimming.
Several studies have shown that cupping is effective in treating pain, but there is debate over whether it actually heals the pain-causing offense, or just treats the pain. It is difficult to run a well-designed study on cupping. Determining whether it is simply a placebo effect is not easy to accomplish, since a blind study is seemingly impossible. Furthermore, since physical therapists and athletic trainers use it as a supplemental procedure, not a standalone practice, it is difficult to isolate the effect of cupping.
Cupping sets are readily available for purchase on Amazon, so of course, I bought one. Some people choose to keep a set at home to use along with lacrosse balls, tennis balls, foam rollers, and other self-treatment tools. You should be careful before you just dive into the world of cupping, though.
I bought a four-cup set that included a smaller cup for use on the face. When it arrived, I slathered some lotion on my legs and started practicing getting the suction levels correct and gliding it around the surface of my skin. I found some sore spots and let the cup sit there for a few minutes. While I waited, I picked up the face-sized cup and suctioned it to my forehead. Then, I plucked it off and re-attached it on the other side of my forehead. I did this a few times, mostly out of boredom, but also because it felt kind of nice. I crinkle my forehead when I'm thinking, so I suppose I carry a lot of tension there. The decompression was helping me relax.
The next morning, I woke up and walked into my bathroom, where I saw this:
I should have thought about this risk before absentmindedly playing with the small cup on my forehead. I knew it was possible, since I had such a strong reaction to the back cupping. Fortunately, I was alone at the office that day, so I didn't have to explain to anyone why it looked like I was about to sprout a unicorn horn out of my forehead.
After doing some digging and experimenting with my own set, I do recommend trying out cupping therapy if you are interested. The risks are mostly harmless, assuming you don't have a contraindication like bleeding disorders. Or, you know, you don't accidentally bruise your forehead. Please keep in mind that if you hate massage, you probably won't appreciate cupping therapy. While there is not yet conclusive evidence on the effectiveness of cupping therapy, the truth is, it actually does feel nice. It feels nice in the "hurts so good" kind of way. Maybe I felt better because of a placebo effect. But hey, if it makes you feel better, do it! I will be using the cups as long as they keep making my back feel better.