We’ll be discussing the manual therapies of the modality world today: dry needling, scraping and cupping:

• Cupping – this works great to restore blood flow and reduce pain
• Scraping (IASTM, Graston, all the same thing) – this gives the same result as cupping but through a different method
• Dry needling – stimulates growth and promotes healing

Cupping

Cupping works via myofascial decompression. This leads to improved circulation and decreased pain. This is a fancy word for saying the tissue is lengthened; the opposite of massage. There are three types of cupping:

1. Dry cupping
2. Fire Cupping
3. Wet cupping

Dry and fire cupping work the same way; one just makes you look cooler. They just use a different medium to create a vacuum to pull on the tissue. Dry cupping involves using a suction device to create a vacuum. Fire cupping (hint it uses fire) allows a chemical reaction to create a vaccum.

Wet cupping involves throwing dry cupping on for a few minutes, removing the cups and making a small incision with a scalpel. The cups are then put back on and blood pools in the cup. The concept of wet cupping is similar to blood letting and leeches. Studies show that wet cupping can lead to a decrease in heavy metal in the blood; similar effect to giving blood

However, all of the data and studies indicate that cupping is no better than a placebo when it comes to
an effective treatment. This is likely because people can visually see it “working”

This is the cupping set I use in my practice (link)

Anecdotally, I get good results in pain reduction

Scraping

This is the opposite of cupping; myofascial compression. Scraping works by introducing a small amount of trauma to an area. This in turn causes some mild inflammation. This is a good thing as inflammation is the first step in the healing response. To read some more on inflammation and why you don’t want to decrease it, read here. This can help to improve circulation and restore ROM.

It will NOT break up scar tissue

Anyone claiming this is lying or an idiot. It takes 1,000lbs/square inch to break up scar tissue. Find me a person that can apply that much force in addition to a person that can also tolerate it (you won’t)

This is the scraping set I use in my practice. You do not need to spend thousands on an official Graston set to efficiently work on soft tissue. (link)

Dry Needling

This also works by stimulating circulation (notice a trend?) It is typically applied to a spasm to get a twitch response from the muscle. The nervous system then releases endorphins as a response which then leads to a decrease in pain

Do manual therapy modalities work?
Can they decrease pain?
Do they restore ROM?

The answer is yes. But it may not be for the reason you think. Any stimulus applied in addition to pain will decrease pain. Recall the gate control theory

Are all modalities placebo?
Maybe

Does placebo work?
Absolutely

At the end of the day, if something works for you, don’t stop doing it. For additional info on other modalities like K tape and Vudu floss, check it here.