Myofascial decompression or “cupping” has been becoming more and more popular in western medicine, particularly after the summer Olympics in 2016 where several athletes had visible cupping marks during their events. Cupping has its roots in Eastern medicine starting around 3000 B.C. Traditionally it was used for a variety of ailments including gastrointestinal issues, pain, respiratory problems, and gynaecological disorders. In Eastern traditions, cupping was utilized to improve the flow of Qi, or energy in the body. This concept was often practiced as “wet cupping” where the skin would be lacerated before application of the vacuum to allow blood with stagnant Qi to be released. Today, myofascial decompression it typically utilized as “dry cupping” where the skin is left intact and no active bleeding is created.

Typically cupping is done on tissues on particular fascia lines, trigger points, and has similar effects to acupuncture. Myofascial decompression as described in this article is a particular cupping technique which movement is elicited under the cups to restore movement patterns and restrictions from nonfunctional to functional. Whereas cups were traditionally made from animal horn or bamboo, today they are typically glass or plastic. Traditionally suction was created by burning an alcohol soaked cotton ball to burn up the oxygen to create a vacuum. In today’s society, it is more common (and compliant with health and fire codes) to use a small hand pump to create the negative pressure inside of the cup instead of lighting a fire to create the suction. The cup is then applied to the problematic or restricted tissue, which then gently lifts the adhesions away from the tissue underneath.

Myofascial decompression is a useful technique for breaking up adhesions, scar tissue, and soft tissue restrictions through the use of negative pressure. This technique is particularly useful with stubborn adhesions and problematic movement patterns as most other techniques involve compression of the tissue, (ie massage, compression wraps, instrument assisted soft tissue mobilization, etc) whereas myofascial decompression creates a small vacuum over the tissue to gently lift the tissue away from the adhesions below.

 

Some physical therapist including those of Fusion Physical Therapy and Sports Performance have advanced training in myofascial decompression. While this technique is still relatively new to the United States there have been some promising results thus far. Early studies have indicated there is some evidence that there are both long term and short term improvements in tissue mobility and pain management. Many conditions will likely benefit from myofascial decompression, but from a personal note, the technique has been particularly helpful for shoulder impingement, neck/back pain, and Achilles/foot impairments. It also has been helpful with people who suffer from nerve compressions such as tennis/golfer’s elbow, or disc herniations.

Many patients approach the idea of myofascial decompression with some hesitations, especially wondering about how painful it is and what kind of side effects there are.The first question people ask is “Is this going to hurt?” In short, yes but it should not be excruciating. The cups utilized typically pinch the skin a little bit which is the source of the pain. The most common side effect is that the cups often leave red or purple welts which can last from a few hours to about a week. These welts tend to not be painful after the cups are removed, and most people forget that they are there. The areas that have the most discoloration are theorized to have the most adhesions or cross collagen bonding. These adhesions have their own blood supply from tiny capillaries, so areas that turn more red or purple are from these capillaries leaking or breaking down along with the adhesions. While the cups can be uncomfortable or somewhat painful while they are on, most people feel immediate relief from their pain and symptoms after the cups are removed. However, it is advisable that people perform what is called neuromuscular re-education immediately following a myofascial decompression session. This will allow the body to appropriately utilize the new and functional movement pattern that has been allowed by breaking up these restrictions.

Jason Cooper, PT, DPT, ART, CSCS