The Evidence for Common Nonsurgical Modalities in Sports Medicine, Part 2: Cupping and Blood Flow Restriction

Overview

Journal J Am Acad Orthop Surg Glob Res Rev

Specialty Orthopedics

Date 2020 Jul 17

PMID 32672728

Citations 4

Authors

David P Trofa

Kyle K Obana

Carl L Herndon

Manish S Noticewala

Robert L Parisien

Charles A Popkin

Christopher S Ahmad

Affiliations

Soon will be listed here.

Abstract

Objective: There are a number of nonsurgical modalities used by athletes in attempts to improve performance or prevent, treat, and rehabilitate musculoskeletal injuries. A concise review of available evidence on common nonsurgical modalities used today is necessary, so that practitioners may appropriately counsel patients.

Methods: A comprehensive review of relevant publications regarding cupping and blood flow restriction (BFR) from 2006 through 2019 was completed using PubMed and Google Scholar.

Results: There have been numerous investigations evaluating the efficacy of nonsurgical modalities for a myriad of musculoskeletal conditions. Cupping may be an effective option with low risk in treating nonspecific, musculoskeletal pain. Studies comparing BFR with non-BFR controls suggest that it may increase muscle strength and endurance for individuals undergoing rehabilitation or sport-specific training by mimicking the low oxygen environment during exercise.

Conclusions: Nonsurgical modalities are low-cost treatment strategies with rates of adverse outcomes as low as 0.008% that will likely continue to increase in popularity. Despite the paucity of recent research in cupping and BFR, evidence suggests benefits with use. High-quality studies are needed to effectively evaluate these treatments, so that care providers can provide appropriate guidance based on evidence-based medicine.

Citing Articles

Using texture analysis of ultrasound images to assess the effect of cupping therapy on muscle quality of the triceps.

Hung I, Jan Y PLoS One. 2024; 19(3):e0301221.

PMID: 38536801 PMC: 10971507. DOI: 10.1371/journal.pone.0301221.

Effects of a Perioperative Blood Flow Restriction Therapy Program on Early Quadriceps Strength and Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction.

Okoroha K, Tramer J, Khalil L, Jildeh T, Abbas M, Buckley P Orthop J Sports Med. 2023; 11(11):23259671231209694.

PMID: 38035216 PMC: 10683393. DOI: 10.1177/23259671231209694.

Effect of durations and pressures of cupping therapy on muscle stiffness of triceps.

Li Y, Mo P, Jain S, Elliott J, Bleakney A, Lyu S Front Bioeng Biotechnol. 2022; 10:996589.

PMID: 36466351 PMC: 9712727. DOI: 10.3389/fbioe.2022.996589.

Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain.

Berger A, Liu Y, Mosel L, Champagne K, Ruoff M, Cornett E Anesth Pain Med. 2021; 11(2):e113627.

PMID: 34336626 PMC: 8314077. DOI: 10.5812/aapm.113627.

References

Yasuda T, Ogasawara R, Sakamaki M, Ozaki H, Sato Y, Abe T . Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and size. Eur J Appl Physiol. 2011; 111(10):2525-33. DOI: 10.1007/s00421-011-1873-8. View

Luebbers P, Fry A, Kriley L, Butler M . The effects of a 7-week practical blood flow restriction program on well-trained collegiate athletes. J Strength Cond Res. 2014; 28(8):2270-80. DOI: 10.1519/JSC.0000000000000385. View

Michalsen A, Bock S, Ludtke R, Rampp T, Baecker M, Bachmann J . Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial. J Pain. 2009; 10(6):601-8. DOI: 10.1016/j.jpain.2008.12.013. View

Yamanaka T, Farley R, Caputo J . Occlusion training increases muscular strength in division IA football players. J Strength Cond Res. 2011; 26(9):2523-9. DOI: 10.1519/JSC.0b013e31823f2b0e. View

Manimmanakorn A, Manimmanakorn N, Taylor R, Draper N, Billaut F, Shearman J . Effects of resistance training combined with vascular occlusion or hypoxia on neuromuscular function in athletes. Eur J Appl Physiol. 2013; 113(7):1767-74. DOI: 10.1007/s00421-013-2605-z. View

Lee J, Cho J, Jo D . Cervical epidural abscess after cupping and acupuncture. Complement Ther Med. 2012; 20(4):228-31. DOI: 10.1016/j.ctim.2012.02.009. View

Suga T, Okita K, Morita N, Yokota T, Hirabayashi K, Horiuchi M . Intramuscular metabolism during low-intensity resistance exercise with blood flow restriction. J Appl Physiol (1985). 2009; 106(4):1119-24. DOI: 10.1152/japplphysiol.90368.2008. View

Schiaffino S, Reggiani C . Fiber types in mammalian skeletal muscles. Physiol Rev. 2011; 91(4):1447-531. DOI: 10.1152/physrev.00031.2010. View

Ohta H, Kurosawa H, Ikeda H, Iwase Y, Satou N, Nakamura S . Low-load resistance muscular training with moderate restriction of blood flow after anterior cruciate ligament reconstruction. Acta Orthop Scand. 2003; 74(1):62-8. DOI: 10.1080/00016470310013680 . View

10.

Saltin B, Radegran G, Koskolou M, Roach R . Skeletal muscle blood flow in humans and its regulation during exercise. Acta Physiol Scand. 1998; 162(3):421-36. DOI: 10.1046/j.1365-201X.1998.0293e.x. View

11.

Suga T, Okita K, Morita N, Yokota T, Hirabayashi K, Horiuchi M . Dose effect on intramuscular metabolic stress during low-intensity resistance exercise with blood flow restriction. J Appl Physiol (1985). 2010; 108(6):1563-7. DOI: 10.1152/japplphysiol.00504.2009. View

12.

Lauche R, Cramer H, Choi K, Rampp T, Saha F, Dobos G . The influence of a series of five dry cupping treatments on pain and mechanical thresholds in patients with chronic non-specific neck pain--a randomised controlled pilot study. BMC Complement Altern Med. 2011; 11:63. PMC: 3224248. DOI: 10.1186/1472-6882-11-63. View

13.

Takarada Y, TAKAZAWA H, Ishii N . Applications of vascular occlusion diminish disuse atrophy of knee extensor muscles. Med Sci Sports Exerc. 2000; 32(12):2035-9. DOI: 10.1097/00005768-200012000-00011. View

14.

Yang C, Hsieh C, Wang N, Li T, Hwang K, Yu S . Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial. Clin J Pain. 2009; 25(4):327-33. DOI: 10.1097/AJP.0b013e318190511c. View

15.

de Castro Moura C, Chaves E, Cardoso A, Nogueira D, Correa H, Chianca T . Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem. 2018; 26:e3094. PMC: 6248735. DOI: 10.1590/1518-8345.2888.3094. View

16.

Tagil S, Celik H, Ciftci S, Hacievliyagil Kazanci F, Arslan M, Erdamar N . Wet-cupping removes oxidants and decreases oxidative stress. Complement Ther Med. 2014; 22(6):1032-6. DOI: 10.1016/j.ctim.2014.10.008. View

17.

Kim T, Kang J, Kim K, Lee M, Kim J, Kim J . Cupping for treating neck pain in video display terminal (VDT) users: a randomized controlled pilot trial. J Occup Health. 2012; 54(6):416-26. DOI: 10.1539/joh.12-0133-oa. View

18.

Kubo K, Komuro T, Ishiguro N, Tsunoda N, Sato Y, Ishii N . Effects of low-load resistance training with vascular occlusion on the mechanical properties of muscle and tendon. J Appl Biomech. 2006; 22(2):112-9. DOI: 10.1123/jab.22.2.112. View

19.

Al-Bedah A, Elsubai I, Qureshi N, Aboushanab T, Ali G, El-Olemy A . The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2019; 9(2):90-97. PMC: 6435947. DOI: 10.1016/j.jtcme.2018.03.003. View

20.

Lixandrao M, Ugrinowitsch C, Berton R, Vechin F, Conceicao M, Damas F . Magnitude of Muscle Strength and Mass Adaptations Between High-Load Resistance Training Versus Low-Load Resistance Training Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis. Sports Med. 2017; 48(2):361-378. DOI: 10.1007/s40279-017-0795-y. View