THINGS TO KNOW WHEN YOU START WITH NMK...
2 possible treatment options:
Pump Induced Vacuum
Able to accurately induce the exact degree of vacuum “dosage”
No need to used flame in the clinical situation.
Edge is not as smooth as a glass cup
No thermal effect
Flame induced Vacuum
Smooth and usually thicker edge
Slight thermal effect from the flame contacting the glass
Need to use open flame in the clinical situation.
More difficult to accurately induce the exact degree of vacuum “dosage”
Some clients will have a preference so it is best to check.
Defining the parameters For Myofascial Vacuum Cupping
The Clinical Context of which cupping is commonly utilised during a remedial treatment is to mobilise the Myo-fascial system specifically.
You can achieve the clinical outcomes you desire with a rather conservative approach without having to result to an aggressive and often detrimental approach.
With respect to the Chinese Medicine origins of cupping therapies, our clinic is not a Traditional Chinese Medicine (TCM) clinic and the way in which we operate is more reflective of the principles of western remedial massage practices. With the exception of therapists that hold a TCM qualification and can explain the principals and treatment rational to the client, the expectation is that whilst performing work at No More Knots all cupping treatments will be performed in a manner which does not harm the client and enhances their wellbeing without causing any avoidable soft tissue damage.
Treating within these parameters is essential to maintain both the reputation of you as a therapist and to protect the public image of the clinic. As a large clinic with a diverse referral network that has been built on hard work and exceptionally high levels of professionalism it is vital that we maintain the trust of these practitioners.
These practitioners may well be “put off” if they see patients with circular bruises caused by the “stronger”, more aggressive applications of vacuum cupping. They are not seeing the patient through the same eyes as a Chinese Medical practitioner so they may not have an understanding of the technique and its philosophical basis.
If you have any questions or queries surrounding this and would like to discuss the matter further please contact your training coordinator or clinic management.
Why is cupping useful?
Cupping can effectively mobilise dysfunctional components of the myofascial tissue to restore its mobility and function.
The technique is especially targeted to the superficial fascial layer and the Epimysium which surrounds the muscles.
Less load and stress is placed on the therapist by using a treatment tool such as vacuum cupping which will allows a greater potential for longevity within the industry whilst still achieving results for our clients.
How does Myofascial Vacuum Cupping positively change tissue mobility?
There are a number of theories as to how external force like that applied from Myofascial Vacuum Cupping positively impacts on soft tissue.
The following are 4 examples:
1. The Stimulation of Fibroblast activation:
2. The Disruption of excessive collagen cross linkages:
3. The Thixotropic-like nature of connective tissue and
4. Through the Activation of mechano-receptors
The following are examples:
1. The Stimulation of Fibroblast activation: The applied force may stimulate the fibroblasts within the connective tissue to maintain an ideal level of glycosaminoglycans.This may permit optimal retention of water molecules to allow the ground substance to maintain an ideal volume. By maintaining this volume there will be less likelihood of adjacent collagen fibres binding to each other by the formation of unwanted cross linkages.
2. The Disruption of excessive collagen cross linkages: The external force supplied may also disrupt any unnecessary collagen cross linkages that may already exist that are binding adjacent collagen fibres together. This disruption may allow the tissue to optimally elongate and stretch.
3. The Thixotropic-like nature of connective tissue: (or the Plastic deformation model)
The founder of the Rolfing technique, Ida Rolf, used this explanation to account for the changes evident in fascial tissue after treatment – If something is thixotropic it means that it is capable of changing its state, for example, from a dense thickened form to a more fluid “plastic” form when external energy is applied. Many now discredit this concept in relation to connective tissue however if we advance an explanation of delayed thixotrophy where the effect occurs over time and NOT instantaneously post treatment it may still be a relevant concept.
4. Through the Activation of mechano-receptors: Clinician & researcher Robert Schleip in particular has thrown doubt on the above theories in favour of a more neurological explanation where mechano-receptors are activated by the application of external force. Schleip stresses the need to treat the tissue from a number of directions to maximize the positive effect.
As the arguments continue and research develops our understanding more clearly, all the above theories may offer a component of the complete multifactorial, ultimate answer. What is certain is that Myofascial Vacuum Cupping has to potential effect changes in connective tissue and all the above theories provide a possible explanation of why that positive outcome is achieved.
Contra-Indications to Vacuum Cupping
Skins lesions, skin fragility, Myofascial attachment sites to bone.
History of Vascular disease e.g. previous incidents of Deep vein thrombosis varicose veins
Vulnerable regions of the body such as the anterior and lateral cervical region, femoral triangle of the groin, Medial upper arm, Popliteal & Cubital fossa and the abdomen are also contra-indicated to cupping.
Gross fascial dysfunction does not occur in these locations. Specific fascial dysfunction does occur and can be easily treated more precisely with hands on techniques.
Pregnancy. The release of Relaxin and other hormones during pregnancy, to allow the connective tissue in the pelvis to elongate and allow the child to move through the birth canal, may also cause the general fascia structure to change with less external force than the tissue in non-pregnancy mode. It is therefore wise, as with any technique during pregnancy, to be conservative and watch the tissue carefully to ensure adverse reaction doesn’t occur.
Specific Medications, which may increase the risk of bruising:
E.g. Blood thinning medications like Aspirin and Warfarin.
This fact doesn’t prohibit Myofascial Vacuum Cupping but it is wise to be aware of the potential adverse reactions and to be conservative in your application of the technique. Long term users of Steroid medications may also be more susceptible to bruising. Cupping can also cause excessive stress on the tenoperiosteal junction, where the muscle attaches to the bone, and even avulsion injury where a portion of the periosteum is pulled away from the bone, for example, on the medial shin (Soleus attachment to the medial tibia) and the lateral knee (Vastus Lateralis attachment to the lateral patella) hence the reason to stay clear of attachment sites to bone.
Steps to applying vacuum cupping
The 4 Vital Signs to minimise bruising
1. Watch and monitor the colour of the tissue being treated and do not allow the tissue to become a red/purple colour keep it to a pink colour. As soon as the colour changes to a red/purple remove the cup.
2. Don’t leave the cups on for more than 2 minutes initially.
3. Be aware of your patients’ skin type: Fair skin will bruise more easily than “olive” skin
4. Monitor the degree of Vacuum inside the cup by watching the degree of Skin raise within the vacuum cup to ensure it is not excessive.
Preparing a Client for Vacuum Cupping
1. Have the cups and pump CLEAN and within easy reach.
2. Ask Approval From The Patient Prior To Cupping:
3. Explain that it would be effective for their particular presentation to use vacuum cupping.
Show the patient the cup and apply it to your arm to demonstrate the procedure.
Explain that it MAY produce some minimal bruising.
Do they have a situation where any degree of bruising might need to be avoided?