By DAVE O’SULLIVAN
When Ryan Buccafurni, a physical therapist at Integrity Physical Therapy & Wellness in Northfield, saw Michael Phelps competing at the Olympics, he knew what the odd looking circular bruises were all over Phelps’ back and shoulders. He also knew he and his staff needed to be prepared for the influx of phone calls the rehab center was going to get on Monday morning.
It quickly came to light that Phelps — perhaps the most decorated and famous Olympian ever — was using an ancient Chinese rehab technique called cupping. The Chinese used the method of creating a vacuum on a patient’s skin to dispel stagnation — i.e., static blood — to treat respiratory diseases such as the common cold and bronchitis. In modern athletics, cupping is used as a way to release tension and improve range of motion in a muscle or group of muscles.
“It stems from an ancient Chinese method. They used it for a lot of things, to cure disease, to take toxins out of the body. From a physical therapy standpoint, we look at it from a biomedical perspective. It’s a different way to modulate pain, reduce tension and take away muscle spasms. It’s been around for thousands of years, but it’s become hot in the PT world probably within the last 10 years,” Buccafurni said. “It has a little bit of a witchcraft connotation, but if you think about it medically, everything we’re doing is compressing tissue and sometimes tissue needs to drawn outward and away from the skeleton.”
“Every patient that came in, that’s all I was talking about — cupping. Cupping, while it’s been a craze this month, is actually an ancient acupuncture technique. I deal with a lot of soft tissue issues as it is, so for me it’s just a tool to support that. With a lot of my patients, I just have to explain why cupping could also help. With the bruising, a lot of patients are kind of nervous about it, but it’s not that bad. It might look bad, but you don’t really feel it that much,” Rick Carlson, owner of Optimal Health Chiropractic in Egg Harbor Township, said during a recent interview on 97.3 ESPN FM. “You have to love the Olympics. A couple of Olympics ago, it was the KT tape. The Olympics brought a lot of that to light. The cupping and the KT tape help support issues. They are tools that have their time and place. At the Olympic level, when you are talking about tenths of a second, every little bit helps. The tape is nice because it gives you support without limiting your range of motion. The cupping will help you recover more quickly and assist in breaking up any stiffness in the muscles.”
Buccafurni said cupping is just one technique a physical therapist or chiropractor might use to help an athlete loosen up a muscle that has been overworked, such as a shoulder in a swimmer or baseball pitcher. He said it certainly helps when a star athlete is using a technique because it gives instant credibility to it.
“We’ve been doing it for awhile, but (Michael Phelps) gives it some credibility. It would be hard to even give the sell on it because people might think you are nuts. There’s been a crazy amount of interest lately. People have seen the marks on Phelps’ body and they think of us (at Integrity). So it’s definitely brought a ton of interest,” Buccafurni said. “It’s a pretty simple procedure. Mostly what we are doing it for is to modulate or decrease pain, or improve range of motion. So if somebody is having a shoulder issue, we’re going to look at all the muscle tissue that may be limiting their shoulder mobility, then we are going to target those areas. For instance, if their shoulder elevation is limited, we’re going to look at their lats. If we are finding some trigger points in those areas — just like we do with dry needling — we’re going to treat the tissue along those areas to try to improve motion. We’ll do shoulders in swimmers and pitchers all day long, because those are the areas that tend to get overworked.”
Hunter Rich, a rising sophomore at Mainland Regional High School, has been getting the cupping done for a few months to deal with a lower back strain. He said the technique helped him get through the grind of the summer Babe Ruth baseball playoffs with his Atlantic Shore team.
“I originally came to see Ryan when I broke my ankle, around March after I had surgery. So after I got all the rehab done for my ankle, I started having some back pain, and that’s when he introduced me to cupping. I had never heard of it before, but when I first did it, it was cool. It was weird because I had never seen anybody doing it. I thought it would hurt, but it didn’t hurt at all. When the cups come off, you feel a lot of relief. It helped a lot with my back pain,” Rich said. “It was a weird idea to me at first, but once we started doing it I thought it was pretty cool. When my friends first saw (the bruises) it looked very alien to them. After I told them what it was they thought it was cool. And now everyone sees Michael Phelps does it and they are like, ‘OK, we understand what it is now.’”
Rich’s father, Jim, owns Island Gym and is pretty athletic himself, and Hunter said Jim and Hunter’s mother, Kristina, were all for any technique that might help Hunter get back to the field more quickly.
“For the most part, nobody really knew what it was regarding Michael Phelps. People didn’t know it was physical therapy related. One of my friends who is into the Olympics asked me about it and whether or not he should try it. I told him it worked for me, so it would probably work for him,” Hunter said. “My dad will go for anything. If it works, he’s willing to try it. Right after the cupping, I feel about 90 percent better. I’ve been doing physical therapy since I was about 11 years old, but it was more simple chiropractic stuff. But this is on a different level. I think more people will start opening up to these types of things, especially with Olympic athletes getting into it.”
Buccafurni also employs a technique called dry needling, which he prefers, but said he understands why cupping is so popular right now.
“There’s a lot of debate about what cupping does. I definitely think it brings some blood flow to the area, and just by pulling the fascia it modulates pain, so it gives an athlete a feeling of less pain. By actually suctioning the trigger point, it helps the muscle release, or let go. So that mechanical stress on the trigger point allows (the muscle) to let go, and when it lets go you get immediate range of motion,” Buccafurni said. “Dry needling and cupping are kind of just two different ways to skin a cat, so to speak. Cupping is less invasive, but I think needling is much more effective. Cupping is easier to do and you can do it with movement a lot easier than you can with dry needling. Both are ways to reduce spasm and modulate pain — it’s just that one is doing it invasively with a needle while one is creating a suction effect, which resets the muscle. The difference is the cupping will definitely leave some marks.”
Carlson and Buccafurni are quick to point out that cupping isn’t a cure-all, and that athletes must be patient and willing to put in the rehab work in order to feel better and maximize their athletic potential.
“I see a lot of cross-fit athletes. Everyone is a little different. I like to get it done before a workout or a competition, but I do have athletes who like it as a part of recovery. It does take time,” Carlson said. “Any manual therapy technique — whether it’s rehab, chiropractic, or any soft tissue technique — usually I tell my patients it’s going to take about six-to-eight visits to see any lasting effects to fix these muscle or tendon issues that are going on.”
“We get a ton of high school athletes. Hunter is going into his sophomore year at Mainland and plays baseball, and he’s somebody I’ve been treating with it for a while because he was playing with a back strain. He says he’s seen a lot of benefit from it. High school kids seem to be a lot more willing to try it,” Buccafurni said. “It’s not a cure-all. It’s used in conjunction with other things, such as dry needling, exercise and massage. It’s another tool in the therapist’s tool box to help decrease pain and increase range of motion. Usually, people like the way it feels afterward. It’s another soft tissue technique. It works well in conjunction with other things therapists are doing. It’s not like you just come, get cupped and leave.”
Perhaps the biggest hurdle therapists need patients to get over is the fear of having highly visible bruises left behind after cupping. But, Buccafurni said, more and more athletes are willing to endure strange looking bruises if it helps them recover more quickly — particularly amateur athletes who are into cross fit and get involved with competitions and mud runs. Cupping bruises have become sort of a badge of honor for an athlete who does a lot more than just take a jog every morning.
“In the past, that’s why people would say no, because of the cosmetic aspect. It’s definitely changed with Phelps. People are becoming aware of what it is and they don’t care so much (about the bruises) anymore. Phelps justified that it works,” Buccafurni said. “There might not be a ton of research on it because it’s tough to gauge its effects, but Phelps gave it a ton of credibility. People said, ‘hey, if it’s working for him, I don’t care what it looks like, I want to try it.’ A lot of the athletes I treat don’t care about the marks cupping leaves. They just say, ‘hey, I’m an athlete, make me feel better no matter what it takes.’ Hardcore athletes don’t care (about bruises). They just want to feel better.”
Contact Dave O’Sullivan: email@example.com; on Twitter @GDsullysays
By DAVE O’SULLIVAN