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PTNow helps you put evidence into patient care. Take action in seconds with the APTA Action app! At the Summer Olympics, Michael Phelps added to the collection of medals that make him "the most decorated Olympian of all time. The media and public also became fascinated by the tennis ball-sized red circles on his upper back and shoulders. These welts are the result of cuppinga technique dating back to ancient Greece making it an appropriate topic during the Olympics that is common practice in traditional Chinese medicine.

Thanks to Phelps, an ancient technique seemed new again. And, in a cycle that's all too familiar, viewers became intrigued by some "sanctioned," never-before-seen performance enhancer that gets worldwide exposure on the Olympic stage. Init was Australian sprinter Cathy Freeman's hooded bodysuit. Init was multicolored kinesiology tape, the Rorschach-like patterns adorning the bodies of volleyball, basketball, and track athletes.

Now init's the dark circles evident of recent cupping treatments. Such things naturally draw our attention. And since the top athletes in the world are using these treatments, credibility is inherent or implied, right?

Injury preventing and performance enhancing approaches that rapidly gain widespread popularity will always outpace scientific research. It takes years to systematically investigate the physiological effects of various stimuli with strong scientific methodology, data collection, and analysis, and determine if these interventions are appropriate, how they should be dosed, and who is most likely to respond.

Despite the long history of cupping therapy, there is a noted lack of published evidence supporting it as a treatment for musculoskeletal conditions or defining the mechanisms by which it may have therapeutic value.

The suction created by the cup produces a tensile stress on the skin and underlying tissue, along with compressive forces underneath the rim of the cup. These tensile stresses are thought to cause dilation and rupture of the superficial capillaries, creating the reddish-colored circles.

Recent research published in journals of complementary and alternative medicine report that cupping may be beneficial for low back and neck pain, 6carpal tunnel syndrome, 11 and knee osteoarthritis. When hundredths of a second are the difference between gold and silver Phelps won the m butterfly by 0.

However, this is not done in lieu of the proven standards.

Indeed, Phelps and his teammates are privy to round-the-clock medical attention from a team of sports medicine experts, including physical therapists. Olympic athletes regularly receive care that is well supported by strong scientific and clinical evidence.

Evidence-based physical therapist treatment for musculoskeletal shoulder dysfunction involves therapeutic exercise, 1516 manual therapy, 17 and movement and postural education. It's easy to understand why the media and public became fixated on Phelps' use of cupping—the welts were impossible to ignore.

But while cupping is an adjunctive treatment that may, through currently unclear physiological or psychological means, have a short-term effect, we must be cautious that the general population doesn't see cupping as a silver-bullet treatment for musculoskeletal conditions. Olympic athletes might include cupping as part of their extensive physical and mental maintenance to train and compete at maximum capacity, but an underlying theme of the Choosing Wisely campaign is the benefit of active therapy over passive treatments: As physical therapists, we want to maintain our position as evidence-based experts in the restoration, maintenance, and promotion of optimal physical function.

To do so we must continue to uphold the value of well-established and rigorously investigated interventions in the face of the latest fascination in sports medicine. Daniel Cobian, PT, DPT, PhD, and Bryan Heiderscheit, PT, PhD are members of the University of Wisconsin-Madison Department of Orthopedics and Rehabilitation.

Explore other posts from the "Narrow the Gap" series. Awesome post, right on the money and needed to be done. Work good in hipertone musles. Hi Daniel and Bryan, This is a good article in regards to cupping; however, you have a lot of incorrect information regarding Phelps and the Olympic team treatments. First, "cupping" is not what was performed on these athletes, it was a technique called Myofascial Decompression MFD.

This technique uses plastic, not glass, cups and involves different movement patterns for reduction in tissue adhesion and connective tissue gliding. The cups are not placed over acupuncture points, like in tradional "cupping", and it is by no means a passive treatment. I can tell you first hand that there are currently ongoing MRI and ultrasound study being done on MFD, which are showing very promising objective findings for improvement in tissue spacing. Please contact Christopher DaPrato at UCSF Physical Therapy, who is the instructor for Myofascial Decompression, and has been teaching the classes across the country for a few years now.

He recently visited the Olympic Training Center in Colorado Springs, and instructed the Olympic PTs and trainers in the techniques, as well as working with the gymnastics team in-person over a few weeks.

This is why you have seen a boom in the amount of athletes who have the technique. As you know, elite athletes are always looking for the new and exciting treatments, and this happened to be it for this olympics. I just want to be sure the correct information is being released, especially on the APTA site. You can also contact me with additional questions if you'd like, as I work along with DaPrato and am very well versed in the technique. Danny, your information is good to know - you add to exactly what the author has said.

No research has been published that demonstrates meaningful performance related benefits - whether you refer to it as cupping or Myofascial Decompression.

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Why is Christopher DePrato teaching something that you describe as not having findings published yet? That does a disservice to the profession of Physical Therapy. Once proven and published - different story. DaPrato uses for MFD is cuptherapy.

Maybe there is a twist in there somewhere to separate it from TCM. But I can see why there would be confusion from the general public. The main point of this article, which is very well written, should not be missed on therapists reading it.

In that "we must be cautious that the general population doesn't see cupping as a silver-bullet treatment for musculoskeletal conditions".

The creator of MFR's own website encourages therapist to not just fix articular, neural or muscular complaints. The authors of this article also encourage this by stating we should focus on optimal physical function which is obtained with individualized movement system treatments and not just treating a facet or knee or tender point. If you consider the whole system in your treatments patients will see this and benefit from it. Not only patients but therapists as well should be aware of silver bullets.

To those who may be tempted to logiciel fx interface mac day put hard earned continuing education money into the pockets of any IASTM or MFD creators or apprentices or any other courses claiming faster and better outcomes.

There will always be people who are passionate about a technique, vociferously defend it, and come with evidence claiming it's better than others. Research backs up the Choosing Wisely recommendations, to ignore them or forget them in making decisions about how or what you use in your practice would be unwise. Thank you Daniel and Bryan for opening the door to this conversationand to Danny for the clarification and explanation of this newer technique.

This is more than simply "cupping". It is great to hear that UCSF is working on research this newer technique. Hope hear about it sooner. I don't understand why people are using treatments like cupping when Myofascial Release John Barnes works so well with muscular dysfunction.

I use it plus indirect muscle energy techniques and I only see pain patients once with them and they are relieved of pain. We disagree with his statement that our original blog post contained inaccurate or incorrect information. Our use of the term cupping therapy to describe what many U. Olympic athletes received is appropriate. Slight variations in the design and application of cupping treatments are expected, much like any form of therapeutic intervention.

The hallmark feature of what Dr. While traditional Chinese cupping treatments may involve placing cups over acupuncture points, the majority of dry cupping references cited in our initial post Lauche et al. We fully appreciate the balance that needs to exist between the development and validation of novel ideas to advance clinical practice.

When ideas are promoted without at least a minimum level of verification, our profession and patients are at risk. As there are no published peer-reviewed resources describing myofascial decompression, any purported physiological effects or mechanisms of potential benefit to patients remain theoretical. We are glad to learn club penguin money maker 50000 coins efforts toward evaluating the mechanical effects of cupping treatments on soft tissue displacement are underway, and look forward to reading the published findings.

Clearly, this is an area that needs scientific attention. Until more harvey norman caringbah easter trading hours is available, however, the advertising of non-evidence based therapeutic treatments as both novel and effective is counterproductive to the scientific integrity of our profession. It is hypocritical to steal techniques that have been part of an established system of medicine for over a of years and used by tens of thousands of doctors on over a billion patients, rename them and a short time later claim them as new techniques and at canadian forex calgary same time discredit the original system due to poor evidence.

I believe it is time to fully understand the Chinese medical system and system forex factory to blend them for better outcomes.

There is much to learn and our patients can greatly benefit from the full integration of both systems I am referring to dry needling which was first mentioned as ashi needling in Chinese litature about years ago and cupping over years ago, glass or plastic, it's the same technique. If you think they will add to the value of your rehab tools, wait until you discover How much did michael phelps make in 2016 olympics herbal medicine and meridian acupuncture.

By the way, most evidence for dry needling comes from the solid evidence for the use of needling not of trigger points but acupoints. As a PT and Acupuncture Physician practicing 32 years, I would never abandon these useful approaches. It would be a disservice to my patients. As an athlete and PT, I appreciated the commentary on cupping and comments regarding the efficacy on Olympic athletes.

I appreciated Kellers remarks and need for further research money maker dj sava wikipedia we continue to grow our field stock trading mentors evidence based practice.

As a Student Physical Therapist, I fully respect what each person has said on here as nigerian breweries plc stock market price have far more experience than I have, and I certainly don't want to overstep my bounds, but I'm inclined to agree with Dr. Heiderscheit in that we should tread carefully when dealing with treatments that haven't had proper scientific scrutinizing. As a member of a clinic that uses both Dry Needling and Cupping, I am a firm believer that they work in certain cases, but good practice according to Physical Therapists that I have spoken with is to ensure the accuracy and efficacy of a treatment prior to its utilization.

Yes, these treatments have been performed perhaps literally billions of times throughout the course of history via various methodologies, but there is little scientific research published today that truly lays out in black and white the specific benefits and detriments to the treatments under the supervision of the modern medical knowledge.

The Physical Therapists I know firmly believe in it, and they have to make the judgments for their selves to continue the practice, but evidence by personal experience is not necessarily the best reason to promote the treatment as an effective treatment method without proper application, objective findings, and continued review and re-application to examine trustworthiness of the practice.

In any case, as a new student, I am excited to go through this era of medical advancement, especially with as interesting of treatments as these, and thoroughly appreciate the opportunity to interact with each you like this and the thoughts you have presented.

My experience with cupping over the last how much did michael phelps make in 2016 olympics years has been positive.

I do not believe that actually bruising the "characteristic" most often mentioned really has benefit. I challenge practitioners boe personal stockbrokers move the cups before there is a bruise and to work to cover larger areas. I also would recommend using cups prior to dry needling--even though traditionally it is done in the other order.

I have heard the resulting bruise to be of benefit at "getting out bad blood. What does make sense, with both cupping and dry needling as well as various soft tissue techniques, is that the benefit has to do with aiding the body to move high concentrations of irritants inflammatory agents from the perth city easter trading hours. All the chemicals that David Simons discussed at making the area of a trigger point more acidic and Jay Shah, et al identified in their research that are found in higher concentrations in an active trigger point and diminish with treatment.

Dry needling does it with increased circulation secondary to release of nitric oxide and cupping does it mechanically. I would speculate and this is an anecdote based on my experience cupping of visible scar tissue has dramatic within one treatment benefits. It is certainly not unethical or a breach of the standards of clinical practice to use a device cups that have been shown to cause little to no harm and based on available understanding of physiology and limited research have the potential to benefit patients.

Doing research with such devices requires a research protocol and is a different issue. But use of previously approved devices "off label"so to speak where there is little to no harm and potential benefit is what much of medical practice involves. I am basing this statement on having completed the ethics requirements to do research on human subjects, not my opinion.

Using cups does not require that the be substantial evidence to support their use prior to implementing them in clinic. Now, making claims about what cups do and promoting them in a fashion beyond "what I believe the benefit is" would be unethical, as in claiming that they reduce inflammation, reduce recovery time, etc--that would require research to make those types of statements.

I wish we had the resources to research everything prior to implementation but we don't and never have. Lots of pretentious and pompous poppycock in many of these comments and the article. Any time you distract the superficial fascia from the underlying tissue, any restrictions between the two are released, drag is reduced, ease of glide is improved, and the treated individual or animal moves more efficiently.

Equine trainers have, for years, injected air under the skin of race horses to reduce restrictions and allow the horses to run faster.

There's no placebo effect with horses. It just plain works. And the mechanical effect is greater than any of the accompanying bio-energetic, biochemical, neurological, or circulatory effects. In humans, as pointed out by some here, cultures have been doing these techniques for thousands of years with success, both Asian and European and possibly others. The Chinese are best known but Eastern European cultures did the same things.

You can cup the skin, you can pop the skin, you can roll the skin, you can pinch the skin, etc. It really doesn't matter much. And to pay money to learn this technique in a continuing education course is laughable. Quite frankly, I'm amazed how many here buy into the evidence based treatment propaganda they've been fed. Does any here actually understand the political origins of the evidence based movement? It sure doesn't seem like it. Our profession seems to be so easily steered by outside influences, again and again.

In general, success based treatment leads the curve while evidence based treatment trails the curve. I'll chose the former every time rather than waiting for the latter to catch up years later or not, as often is the case.

I'm thinking of starting a new profession to break away from all this silliness. I remember demonstrating it during PT school in soft tissue technique lab and my professor laughed at me.

Then I told him the uniqe mechanism and benefit and he stopped laughing. It's also laughable that some PTs are arguing against traditional cupping because they are not going over acupuncture points. I have news for you. You are going over acupuncture points whether you want to or not. By the way, the picture in the article is traditional fire cupping. And its misleading to characterize wet cupping with incision.

In my practice I do not necessarily target acupuncture points with cupping. I target the restriction in the tissue for the vast majority of cupping treatments. The most important point I want to make is that therapies like cupping and acupuncture have a anti-placebo effect they must overcome in research studies that alter results.

I think these new technique might help patients and it is better to have knowledge about them. Who knows, it might come handy and impact significantly in patient performance outcome. I would try to learn and implement them. We as a PT are open to learning and make decisions for proper usage for betterment of our patients.

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Latest News PTJ PT in Motion Guide to PT Practice Blogs Podcasts Social Media Other Publications For Media. Subscribe to Friday Focus. Why We're All Seeing Spots. Monday, August 15, Cupping: Turk JL, Allen E. Ann R Coll Surg Engl. Rozenfeld E, Kalichman L. New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine.

J Bodyw Mov Ther. Arslan M, Gokgoz N, Dane S.

Rio Olympics: Simone Manuel Makes History in the Pool - The New York Times

The effect of traditional wet cupping on shoulder pain and neck pain: Complement Ther Clin Pract. Musial F, Michalsen A, Dobos G.

Functional chronic pain syndromes and naturopathic treatments: Lauche R, Cramer H, Hohmann C, et al.

Michael Phelps secretly got married - etygivusyx.web.fc2.com

The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain: Evid Based Complement Alternat Med. Markowski A, Sanford S, Pikowski J, Fauvell D, Cimino D, Caplan S.

A pilot study analyzing the effects of Chinese cupping as an adjunct treatment for patients with subacute low back pain on relieving pain, improving range of motion, and improving function. J Altern Complement Med. Emerich M, Braeunig M, Clement HW, Ludtke R, Huber R. Mode of action of cupping--local metabolism and pain thresholds in neck pain patients and healthy subjects. AlBedah A, Khalil M, Elolemy A, et al. The Use of Wet Cupping for Persistent Nonspecific Low Back Pain: Randomized Controlled Clinical Trial.

Chi LM, Lin LM, Chen CL, Wang SF, Lai HL, Peng TC. The Effectiveness of Cupping Therapy on Relieving Chronic Neck and Shoulder Pain: A Randomized Controlled Trial. Lauche R, Langhorst J, Dobos GJ, Cramer H. Clinically meaningful differences in pain, disability and quality of life for chronic nonspecific neck pain - a reanalysis of 4 randomized controlled trials of cupping therapy.

Michalsen A, Bock S, Ludtke R, et al.

Effects of traditional cupping therapy in patients with carpal tunnel syndrome: Teut M, Kaiser S, Ortiz M, et al. Pulsatile dry cupping in patients with osteoarthritis of the knee - a randomized controlled exploratory trial. BMC Complement Altern Med. Kim JI, Lee MS, Lee DH, Boddy K, Ernst E. Cupping for treating pain: Testing traditional cupping therapy. Haik MN, Alburquerque-Sendin F, Moreira RF, Pires ED, Camargo PR.

Effectiveness of physical therapy treatment of clearly defined subacromial pain: Br J Sports Med. Marinko LN, Chacko JM, Dalton D, Chacko CC. The effectiveness of therapeutic exercise for painful shoulder conditions: J Shoulder Elbow Surg. Camarinos J, Marinko L.

Effectiveness of manual physical therapy for painful shoulder conditions: J Man Manip Ther. Lewis J, McCreesh K, Roy JS, Ginn K. Navigating the Diagnosis-Management Conundrum. J Orthop Sports Phys Ther. Subjects Payment Outcomes Conferences Narrow the Gap. Advocacy Federal Advocacy State Advocacy Take Action Involvement Opportunities PT-PAC For Legislators.