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VooDoo Flossing, Kinesio Taping and Cupping, Oh My!

If you play sports or exercise regularly you probably have experienced some sort of injury. Hopefully yours was just a minor muscle strain, joint sprain, or soreness after a workout. Sports-related injuries are common, and most people who exercise report some type of injury in a given year. Thankfully, most are not serious enough to prevent continuing an exercise program, especially if minor injuries are addressed before they progress to cause more lasting damage. If you do sustain a muscle or joint injury you will probably ice the affected area to help it heal. But there are also several other techniques that can help speed recovery.By Brian B. Parr, Ph.D. ACSM Certified Clinical Exercise Physiologist

The most common recommendation for treating a minor exercise injury is to use ice to reduce swelling and speed healing. For example, an ankle sprain might be treated by sitting with the injured leg elevated while applying ice; later the joint might be wrapped with athletic tape to provide support and further reduce inflammation. This combination is called RICE - rest, ice, compression, elevation - and makes intuitive sense. Staying off the injured limb prevents further injury and allows healing to begin. And it seems reasonable that reducing inflammation through cold therapy, compression, and elevation can reduce pain and enhance repair of the injured muscles, tendons, or ligaments. It is also something that people can do at home without medical guidance. For most of us, RICE is how we have been told to treat minor injuries.

Other Techniques on the Treatment Menu

In recent years, many athletic trainers and athletes have begun to use several other treatments for sports injuries. These techniques have become more visible, thanks in part to their use by professional and Olympic athletes. Their popularity is in part due to the realization that inflammation is a key component in tissue repair and in some cases reducing it with ice therapy might actually hinder injury healing. More and more sports medicine professionals are using modalities other than (or in addition to) RICE to treat many injuries. Let's explore a few alternative treatments for sports injuries - voodoo flossing, cupping, and kinesio taping.

Do That VooDoo

The benefits of compression for injury healing can be achieved by tightly wrapping an injured area with a rubber band, called "floss," for a short time, usually less than a minute. This technique, commonly called voodoo flossing, is used to increase joint mobility and speed healing of minor injuries. Tightly wrapping a joint has several potential effects which can help improve movement and reduce pain. When voodoo floss is applied to a joint it presses the skin, muscle, and fascia (the layers between the skin and muscle) together. Then, moving the joint forces these tissues to slide past each other, breaking adhesions between the layers. When the floss is removed, the tissues can move more freely. Compressing the tissue also reduces blood flow which, paradoxically, results in even greater blood flow when the floss is released, providing nutrients to the injured area.

Cupping gained much attention this past summer when swimmer Michael Phelps appeared at a race in the Olympics with large red welts on his back. He wasn't hurt, as many feared. Rather, he was using cupping as a technique to treat injury and improve performance. Cupping literally involves the application of glass or plastic cups to the skin for several minutes, typically 5-15 minutes. Using either vacuum or heat, the cups pull the skin away from the underlying muscle tissue, increasing blood flow and improving movement. Athletes and trainers who use it tout its effectiveness, despite the painful red spots that remain on the skin. While cupping may be new to most of us, it is far from a modern technique. In fact, cupping has been used since ancient times and factors prominently in traditional Chinese medicine. Its use by athletes is more recent, and is becoming more widespread among amateur, professional, and recreational athletes.

Roll Tape - Kinesio Tape that is

While voodoo flossing and cupping have a role in treating injuries and improving performance in the training room, there is a relatively new modality that can be used during exercise to enhance performance. Kinesio tape, also called K-tape, is applied over specific muscles to reduce pain and improve movement. The tape actually pulls the skin away from the underlying muscle, which increases blood flow and enhances movement, much like cupping. The difference is that kinesio tape can be used during exercise, as many people first saw on the shoulders of beach volleyball players in the 2008 Olympics. The fact that kinesio tape actually improves movement distinguishes it from the taping or bracing that many athletes use to stabilize joints to prevent injury during exercise.

DIY Injury Prevention and Care

While many sports medicine professionals still recommend RICE as a first line of treatment for minor injuries, they are increasingly utilizing other techniques as well. With a little training, is it possible for athletes to use some of these less traditional methods at home to treat their own minor injuries so they can get back to the road, pool, field, or gym? Obviously, it is important to learn how to properly use these methods. Also, it may be difficult for someone who is not a professional to evaluate whether they are working. Improper treatment can delay healing and may make some injuries worse. Before trying one of these alternative paths to treatment, it may be wise to check with a trained professional. Your injury could be more serious than you realize and require attention by a sports medicine professional or physician. That said, if you are looking for an injury treatment beyond RICE, voodoo flossing, cupping, and kinesio tape might be worth consideration.

Something to Consider

Well-Being spoke to Mike Wilkinson, MS, ATC, who is the director of athletic training outreach services for Mississippi Sports Medicine and Orthopedic Center, about his thoughts on the newer treatment techniques discussed in this article, from his perspective as an athletic trainer.

"These are all typical modalities used to increase circulation," notes Wilkinson. "They all work to some extent, although research about their effectiveness has been varied, with some showing success and some not. However none of the three discussed are covered by insurance, so they are primarily used by high level elite athletes who can afford to pay cash for their treatments. That is why you do not see them in a typical PT clinic.

Brian B. Parr, Ph.D., is an ACSM Certified Clinical Exercise Physiologist and Associate Professor in the Department of Exercise and Sports Science at the University of South Carolina Aiken.