Move Better, Feel Better: A Movement Based Approach to Soft Tissue Mobilization for the Upper Body: Summary 35
Proposed Benefits: • Neurophysiological effect: May stimulate inhibitory neural pathways by creating a “counterirritation” that temporarily increases pressure pain thresholds: ○ Gait theory, DNIC or CMP, neuroplasticity (pain mapping) • Mechanical effects : Suction force produces a stretch and compression on the tissue, causing dilation and rupture of the superficial capillaries (reddish colored circles): ○ Marks are not bruises ○ Does not break up fascia adhesions
Application: • Different type of cups (plastic, glass, silicone): ○ Silicone is more gentle and glides better for dynamic treatments • Static cupping both with and without patient movement • Dynamic cupping both with and without patient movement: ○ Lubrication can be used for dynamic cupping ○ Tissue distraction with movement (TDM) • “Wet cupping” is not a part of clinical practice for PTs • Apply for 30 seconds to 2 minutes first to assess for tissue response then progress treatment up to 10 minutes
Upper Quarter Treatment Body Region
Cervical/Upper Thoracic Shoulder/Upper Arm Elbow/Forearm
Locations
Upper trap, levator scapula, paraspinals
Anterior and posterior line
Epicondyles, wrist flexors, wrist extensors Static without movement (epicondyles) Static with movement (over wrist extensors during wrist flexion) TDM over flexors/ extensors TDM with movement (proximal → distal or distal → proximal)
Treatment Techniques
Static cupping with and without patient movement (pin and stretch) TDM with and without patient movement (cervical flexion or side bending) Move in different directions
Static without patient movement
Static with patient movement (pin and stretch) TDM without patient movement (clocking, long strokes) TDM with movement (post shoulder during horizontal abduction/internal rotation/external rotation or triceps with overhead movement)
CASE STUDY
John is a 45-year-old male with neck pain that is worse with forward bending of his neck. At work he does a lot of reaching, which sometimes causes referred pain in his right upper arm. John has relief with IASTM but feels he needs something more “intense” to break up his pain. Would you do cupping and if so, what type? Answer: • Add TDM over the upper trap/levator area as well as along the paraspinals of cervical/thoracic junction • Could progress to adding side bending for upper trap and cervical flexion for paraspinals • Use static cups over the affected area and do active stretching of the cervical spine
Powered by FlippingBook