Perfectly Round Bruises? A Brief Overview of Myofascial Decompression, AKA Cupping

Myofascial Decompression is perhaps better known as cupping. More recently, Michael Phelps made a splash with it by exposing his perfectly round and profound bruising, evidence of the therapy, while taking to the starting blocks in the 2016 Olympics. Hollywood stars have also been spotted with the tell-tale bruises, always causing a stir, and sometimes gossip and rumors.

Cupping is an ancient therapy developed around 280 CE as part of traditional Chinese medicine, and used for centuries in other parts of Asia as well. It’s roots could possibly trace back as far as 3000 BCE. Ancient cups were formed from pottery, horns and bamboo, while traditional cups are formed from glass. With these materials, suction is created with the use of a flame heat source. Modern cups are plastic and utilize a safer and more user-friendly pumping method to create the suction. Traditional practitioners place the cups along lines called meridians, channels upon which energy travels. They often pass through areas of any given injury, but are not necessarily aligned specifically along the targeted injury or ailment. There are several methods within traditional cupping that include scrapping, acupuncture, massage under strong suction, and even lancing to release blood (termed wet cupping).

While recent evidence-based scientific research has found that cupping significantly reduces pain to the joints and muscles that are treated, and boosts immune function, cupping has been used for centuries to sooth headaches, migraines, and toothaches. It has been used to lower stress, treat depression and anxiety, reduce cellulite and skin inflammation, clear congestion and chronic coughs, and even treat IBS. The list of assertions goes on even longer. As far as Western medicine is concerned, there is much more research to be done in order to confirm these claims and bring this intriguing practice into mainstream treatment for any one or group of illnesses in this list. Therefore, because of the multiplicity of it’s approaches and expanse of claimed benefits, it is useful to separate general cupping from modern myofascial decompression and it’s application for sport participants as it relates to their activity.

Unlike the compression of a deep tissue massage, myofascial decompression lifts muscle tissue and fascia away, providing stretching and traction effects for the muscles and fascia. This suction response helps expand the capillaries to increase blood flow within the tissues, and creates a thixotropic effect that increases the amount of fluids entering and leaving tissues. As a result, tense muscles are relaxed and the tissues receive much needed nutrients and oxygen as they concurrently release adverse toxins. These effects safely and immediately reduce pain and increase mobility. In many cases, the need for medicinal or herbal pain medications is eliminated.

Methods of modern cupping also vary. Cups may be placed in a static position or, with a little more lubrication and a little less suction, they may be moved around in a general massaging motion. The cups may also be smoothed along specific paths to promote lymphatic drainage. The areas may also be manipulated by movement through a technique called flossing, which is a flexing and extending of the joints, just as athletes are familiar implementing during other mobility stretching exercises.

The pressure from cupping can reach a maximum that is equivalent to approximately 1/3 of a tire, with the greatest force located just under and around the area of the cup rim. Maximal force does not necessarily reap greater benefits, and can restrict the individual’s ability for the movement of flossing. For these reasons, as well as for safety and protection of the skin, force is applied according to level of tolerance. Cups are left on any given area for a minimum of 30–90 seconds, but generally no more than 5 minutes. In some cases cups may be left for up to 20 minutes at very light, tolerable pressures creating a relaxing experience. Recommendations for the strength of the suction relate to the goals of the session, as well as patient’s age. In traditional application, suction is also determined according to the strength or weakness of an individual’s Chi. Due to these considerations, as well as variables in sensitivity to bruising, not all cupping causes bruising. However, for this same reason, anyone participating in myofascial decompression must be aware of the potential visual side effect. In order to minimize the risks and complications of bruising, cups are never placed on existing bruises, and treatments are generally scheduled at least a week apart. There are additional and greater risks when using some of the other traditional methods, especially in wet cupping, and for these reasons cupping has stubbornly remained controversial.

I first tried myofascial decompression as a complement to additional therapeutic techniques in healing a hamstring tear in the summer of 2014. My first treatment brought immediate pain relief and a measured increase in range of motion. After several regular sessions in conjunction with exercises aimed at my weaknesses (typical runner gluteus medius weakness), I was able to conservatively continue my running streak and get back on track to my normal milage. Much to my delighted surprise, I completed my marathon at my same PR pace that autumn despite my recent injury. Treatments have had a similar result on a more recently diagnosed calf tear that I otherwise would have battled for a much longer time, and following an ankle turn that left me on the verge of a more serious injury. I have also turned to cupping as therapy on sorenesses that have medically gone undiagnosed but otherwise fit the criteria of treatment. Myofascial decompression has literally saved my run streak, an athletic dedication that brings me immense satisfaction.

Being a safe treatment as conservatively practiced according to Western medical recommendations, I am able to study and assay the practice as an athlete simply looking to continue doing what I like to do each day at a rigorous pace. I was fortunate to have a wonderful teacher in performing Western style myofascial decompression, and gratified to be able to continue to learn more so I can pass this therapy on to others. Unfortunately, there are very few sound resources able to separate myofascial decompression from the broader scope of cupping, and it’s trappings of concern. It is therefore up to amateur and professional athletes alike to pursue the basic principles of the practice that are therapeutic to our needs, and share our success stories, in order to progress it’s legitimacy in the repertoire of our disciplines.