The 2016 Olympics, which showed Michael Phelps, the ultimate Olympic swimmer of recent years, with perfectly round circles on his upper back and shoulders, may have popularized cupping therapy overnight. As pictures of him appeared on the news and internet, many people took notice and wanted to learn more about it. The red round circles all of a sudden became a symbol of style. It also dramatizes the illusory idea of competitive advantage and winning, never mind the fact that Phelps trained for thousands of hours. One may not do what Phelps can do in swimming but hey, cupping therapy is something we all can get. I have patients that looked at me with wide eyes just a year ago when I offered to do cupping therapy as a form of myofascial decompression. They are now calling Ambient Physical Therapy in Princeton (www.ambientphysicaltherapy.com) to say they were “en vogue” before anybody knew about it. My objective of course, aligned with my plan of care with no thought or regard of fashion. As a medical professional, I was simply performing myofascial decompression therapy (MFD). Although I must admit, I am enjoying the attention it is getting. Hopefully, the next time I mention it to a patient I will no longer see a blank stare.
This ancient healing technique was thought to heal lung diseases, bodily pain, fever, and a gamut of internal diseases proven only with empirical evidence from word of mouth from generations of people. It was not called Medicine. It was simply called Healing. While many of its purported effects are beyond the realm of practice for a physical therapist like myself, I do know by experience that when one is plagued with recurrent pain, the method becomes irrelevant for most people. That is not to say that all methods are acceptable or scientific. Today, after decades of the evolution of science and medicine, a person suffering from pain or illness still only desires one thing—and that is healing.
Indeed as medicine embraced more synthetic pharmaceuticals and modern technology in the last two hundred years, the Western world departed from many ancient healing techniques in the name of science. As a human race we made remarkable leaps in medicine to heal illness and understanding its causes. There is no denying how it helped humanity in profound ways. This is thanks to the dedication of scientists, academicians, physicians, thinkers and society at large for the support it required to arrive at a monumental success, albeit a continuing elusive goal. In recent years, however, we have seen more and more people move away from taking drugs and medications in favor of herbs, relaxation, meditation and natural methods of healing. People started embracing body healing arts such as acupuncture, massage, reflexology, and cupping to alleviate disorders. In turn, fitness enthusiasts and competitive athletes embraced preventative measures through body works for competitive advantage, if the ancient healing has any value at all. In fact, many patients have come to opt for the no-drug approach of physical therapy to relieve pain for this very reason. Time and again, patients express their concerns about taking medications with more damaging side-effects. Physical therapy offers the scientific bridge between medicine and the world of mind and body healing arts. Interestingly, as physical therapy evolves into a doctoring profession, it is also embracing more and more manual therapy and holistic approaches to healing. A number of physical therapists around the world including myself, have braved to tread these waters in the name of healing. So, how did cupping therapy entered into my realm?
A few years ago after having worked for over 25 years as a physical therapist in various settings, I decided to open Ambient Physical Therapy in the Princeton area. My philosophy of healing is more holistic. Every patient that entered my door realized the difference compared to their previous physical therapy experience. While it is founded with solid science and evidence-based practice, I learned from years of experience working as a life span practitioner that neurology and orthopedics are not separate entities in body healing. Sensory integration, neuroplasticity and the bones and fascia are all governed by mind and body. The patients pretty much have a tremendous role in healing. Their own bodies speak to them first, and no matter how much their perception of pain or trauma is reduced or dismissed, the brain, the muscles and the fascia retain this memory.
With keen full body evaluation for movement syndromes that caused the injury in the first place, as well as listening to patients, I have seen tremendous success even with patients who have failed to recover anywhere else. So, despite what the region of the body the doctor prescribed to be treated in physical therapy, my practice is centered around lookingat the whole body, and thereby seeking the best treatment available. That led me to study techniques that complement my manual therapy practice. One of these is the concept of myofascial decompression using cupping therapy. So, how does physical therapy apply science into this healing art?
We have re-purposed this ancient technique by utilizing negative pressure technology to elicit a gentle and sustained decompression of the fascia in areas where horizontal, vertical or multi-directional glides are not enough. I first learned this technique through Dr. Christopher DaPrato, an assistant clinical professor at University of California San Francisco College of Physical Therapy. His many years working with professional athletes, including Olympic athletes, necessitated a search for an additional protocol in order to restore injured players and put them back in the field as quickly and as pain free as possible. Since then, I have gleaned from that learning and slowly evolved it to encompass treatment of clients who are normal people.
Some people get injured by simply doing basic activities of daily living. Others get injured while in the gym trying to get fit. Others get injured by just bending over to retrieve a file at work or by just getting out on the other side of the chair instead of their usual routine. Many young people get injured in running, swimming, rowing, playing baseball and dancing by simply doing what they practiced for years. This is true for weekend gardeners and home painters, machine hobbyists and regular folks who are suddenly changing patterns of movements. The list is long and in 25 years I have seen them all. This does not include those that have incurred vehicular accidents, whiplash injuries, concussions and aftermath of recent illness. The majority of these people have been told they are already healed based on the radiological results despite residual nagging complaints of pain. They are often told there is no longer evidence of illness. Therefore, there should have been no more pain. But the patient knows their body and they know what pain is like when it deprives them of their sleep and enjoyment of their life.
Many patients have shed tears while telling me their stories as their insistence of telling their medical practitioners about persistent unexplained pains has reduced them to being told they need to see a psychiatrist, only to realize a couple of years later after working with me that there is nothing wrong with their minds when they finally experience healing. Doctors are premised in science and they rely in the science that is currently available. Their intention is altruistic yet as we all know, medicine is not done yet. There is still a lot of research, many illnesses to be solved, and corresponding technology to help unravel the mystery.
In the meantime, therapists proceed with caution in using our hands as the undisputed technology of healing arts. After all, we are not only heavily educated in anatomy and physiology, we are educated in medicine as well. A lot has to be said for why in centuries, healing through the use of touch and grip evolved into the concept of manual therapy, a generally evidenced-based approach. So, how are we able to make a science out of our touch? Science happens when there is evidence. At this point existing evidence is plenty. On the therapist’s end, our hands are filled with receptors that can feel the slightest “give” a myofascia produces as it releases. The patient can certainly feel and sometimes see the subtle physiologic change.
Why is myofascial pain or dysfunction often missed? Myofascial problems are often misdiagnosed, ignored or dismissed because they do not show up in X-rays, MRI, CAT scans or myelograms. However, the patient in pain usually knows something is not right as he or she physically feel the pain or restrictions that seem to limit motion. Many times the patient can even express in detail in what positions or activity they feel the increase of pain despite the lack of verifiable diagnosis. A growing number of doctors in fact, go ahead and refer patients to physical therapy with suspicion of myofascial dysfunction for the goal of alleviating the pain.
About the author:
Desiree Gibbs, PT, MHA, ABDA
Ambient Physical Therapy is an experienced private practice in the Princeton area, New Jersey.