How To Best Use Massage, Dry Needling and Cupping In Your Physiotherapy Treatment

When you book in your physio consult there are some expectations on the type of treatment you will receive. Historically you’ll come to get assessed, then receive some form of hands on manual therapy and then be provided with some exercises. The past 5 years though has seen a big push in the evidence towards active based therapies and exercise. But clinically it’s important to remember that there will always be a place for hands on manual therapy as it plays an important role in the road to recovery. We call these adjunct treatments and today’s blog is going to explore why there is still a need to have these as part of the full treatment plan, along with your active based long term solutions.

What are Adjunct Treatment Modalities?

Adjunct treatment modalities are considered complementary therapies used in conjunction with other physiotherapy interventions like mobility, strength and stability exercises. They aim to enhance the overall treatment plan by addressing acting as symptom circuit breakers, desensitising specific areas of the body, promoting healing, and improving functional outcomes. 3 of the main types you’ll see used at BeFit Training Physiotherapy Coogee are Massage, Dry Needling and Cupping.

The Role of Adjunct Therapies in Rehabilitation

In the early phases of an injury through to managing flare ups during the recovery journey, adjunct therapies serve various crucial roles:

1. Pain Management:

Massage: Evidence supports the efficacy of massage in reducing pain and muscle tension. It aids in increasing blood flow, promoting relaxation, and alleviating discomfort associated with injuries.

Dry Needling: This technique involves the insertion of fine needles into trigger points in muscles to stimulate blood flow and relieve pain. Research indicates its effectiveness in managing musculoskeletal pain by targeting muscle knots or trigger points and helping to desensitise areas of pain at the source and referring to other areas of the body.

Cupping: Although its mechanisms are still under investigation, cupping also helps to increase blood flow across broader superficial areas of the body you target and help to reduce muscle tension, contributing to pain relief in certain conditions.

2. Tissue Healing and Recovery:

Enhanced Blood Circulation: Modalities like massage, dry needling and cupping can facilitate improved blood circulation in specific and broad areas, aiding in nutrient delivery and waste removal from injured tissues, thus promoting tissue healing.

Trigger Point Release: Dry needling or trigger point therapy targets are better to target more specific points of muscular tension, aiding in the release of trigger points and facilitating muscle relaxation and recovery.

3. Facilitating Active Rehabilitation:

Improved Tissue Extensibility: with increases in blood flow, these adjunct therapies can help improve tissue extensibility and flexibility, allowing for more effective engagement in active rehabilitation exercises.

Pain Reduction for Better Exercise Tolerance: By reducing pain and muscle tension, these modalities can enhance clients’ tolerance for active rehabilitation exercises, allowing them to engage more effectively .

So for the 3 main modalities of massage, dry needling and cupping, you can see the similar effect: Increase blood flow and desensitize the area first which then acts as an important circuit breaker to help reduce pain so you can implement more active based approaches. After utilising these adjunct treatments you often can see a client achieve more range of motion, less pain through the available range and improvement with specific muscle activation.

Integration with Exercise and Active Rehabilitation

While adjunct therapies offer these valuable benefits, it’s important to remember that they are most effective when seen as one piece to the puzzle of a comprehensive treatment plan that includes exercise and active rehabilitation.

Synergy with Exercise: Adjunct therapies prepare the body for exercise by reducing pain and improving tissue function, allowing clients to engage more effectively in their prescribed exercises.

Complementary Effects: When used alongside exercise, these adjunct modalities amplify the effects of rehabilitation by facilitating better tissue healing, reducing pain, and promoting improved functional outcomes.

Evidence-Based Practice and Considerations

It’s crucial to emphasize evidence-based practice when incorporating adjunct therapies into treatment plans. Current evidence supports the effectiveness of modalities like massage, dry needling, and cupping in specific conditions. However, individual responses may vary, and their application should be tailored to each client’s needs. Always considering client preferences, safety considerations, and any contraindications is essential when administering adjunct therapies into treatment plans.

So what’s the key take away here?

Adjunct treatments like massage, dry needling, and cupping play a significant role in enhancing the efficacy of physiotherapy interventions and the overall treatment of a client. By effectively managing pain, promoting tissue healing, and complementing active rehabilitation, these modalities are a key piece to a comprehensive treatment approach aimed at guiding individuals from acute injury to full recovery. When tailored to individual client needs, they can hold the key to achieving optimal long-term outcomes on your physiotherapy and rehabilitation journey.


Joel Adelman – BeFit Training Physio Coogee

Joel Adelman – BeFit Training Physio Coogee

Joel Adelman is a physiotherapist based in Coogee in the Eastern Suburbs of Sydney. Joel has successfully treated musculoskeletal problems on the basis of a thorough assessment and diagnosis coupled with evidence-based rehabilitation programs tailored to the needs and goals of each individual. To book a consultation, click the link below.

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