Even with great form, the repetitive motion of running places significant pressure on joints — especially the ankles, knees, and hips. This causes inflammation, pain, and stiffness, often made worse by more running, and can ultimately lead to injury.

Not surprisingly, runners explore a full range of treatment options, including some that venture outside of common go-tos, like ice baths and massages. Three of these lesser-known treatments are cupping, dry needling, and scraping.

Key to their perceived effectiveness is the idea that blood flow to muscles following exercise helps decrease inflammation and relax fascia, the connective tissue around muscle. This allows the microscopic tears in muscles to heal better and more quickly. But that’s not to say any of the treatments should be used on their own, in isolation of any other recovery method.

“All of these tools are integral parts of the healing process and treating tissue,” says Graeme Lauriston, vice president of physical therapy and sports medicine at EXOS. “The essence of what we do is making sure we’re keeping our holistic treatment plan sound. This requires understanding where and when each of these treatment interventions are indicated.”

So understanding each of the following unconventional treatments is just a piece of the recovery puzzle, here’s a quick look at what they are and how they work.

Cupping
You might remember the 2016 Rio Olympics, when Michael Phelps and other swimmers had dark red, circular marks on their upper bodies — those are telltale signs of cupping.

During the treatment, glass or plastic cups are put on the body to create suction with heat or air. Unlike compressive techniques such as massage, foam rolling, or trigger point therapy, cupping decompresses the fascia to create a vacuum effect that allows for fascial release.

Athletes find cupping helps improve mobility, stimulates blood flow, and jump-starts recovery. Cupping sessions last three to 15 minutes with athletes experiencing mild discomfort. The bruise-like marks disappear in a few days.

“A lot of running injuries come from loading the tendons and joints to the point where they can no longer tolerate the forces,” Lauriston says. “Cupping provides a different stimulus to the body than most other manual therapy techniques, and anything that can increase blood to tissue is a positive as it relates to the healing process.”

In addition to massage and ice baths, holistic recovery plans can also include less-common treatments, such as cupping, dry needling, and scraping.

Anything that can increase blood to tissue is a positive as it relates to the healing process.

Dry needling
If cupping treats a fairly large section of tissue, dry needling is a more local approach. The therapist inserts thin needles, similar to those used in acupuncture, into tissue to create a neurological response in which the muscle twitches, desensitizes, and then relaxes.

Dry needling creates a localized lesion in the tissue, Lauriston says, which stimulates blood flow and releases muscle tension. “We can use our thumbs or hands with trigger point therapy, but, in many cases, it can be more efficient to impact a tissue twitch response and release with a dry needling approach,” Lauriston says.

The needles are very fine, so there’s minimal discomfort. Most athletes have more experience and thus tolerance with needles than the general public and can handle up to a dozen at once, says Cruz Romero, a performance physical therapist at EXOS. Typical treatments last five to 20 minutes.

The goal of cupping is to help the fascia relax and increase blood flow to specific areas around muscles.
Dry needling aims to help muscles recover by triggering a twitch and release response.
Scraping is used to bring more blood to muscles and stimulate recovery.

The essence of what we do is making sure we’re keeping our holistic treatment plan sound.

Scraping
Unlike cupping and dry needling, scraping focuses on the surface level and the connective tissue just underneath. Also called gua sha after the traditional Chinese practice, it involves scraping the skin with a metal massage-like tool to improve circulation.

Scraping can be effective in alleviating delayed onset muscle soreness, the phenomenon where an athlete is sorer the second day following training than the first. Sometimes an athlete will display redness in certain scraped areas. This isn’t because of the scraping device, which is not especially sharp, but rather a symptom of inflammation or dysfunction.

Though scraping only hits the surface, it has a deep impact. “You have the ability to bring blood to the area, break up adhesions, and stimulate healing,” says Lauriston.

Did you know that EXOS now offers physical therapy and sports medicine services throughout the country? Find a location near you.

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