About a month ago, All Blacks Center Sonny Bill Williams (SBW) stirred social media with this photo (to the right) of him receiving some type of odd treatment and the caption said “Detox Time”. The photo raised a number of questions on twitter and in the rugby world as to what SBW was doing and how that treatment worked. SBW was participating in a Cupping treatment called Hijama. To learn more about what this is, how it works and how it can be used by ruggers we reached out to our old friend Carlo St. Juste Jr. LAc to learn more.
St. Juste is a licensed acupuncturist who currently practices in the Azusa, California who has previously assisted our team with info about acupuncture (one of the first stories in our performance section). This time we spoke with St. Juste to learn more is about the difference between Hijama/Cupping and how we as ruggers can use it for our own benefit and performance.
St. Juste is trained and a practitioner of Cupping as well as acupuncture and acupressure (cupping is in the scope of many licensed acupuncturist). The overall basic practice of cupping goes back several thousand years and a variation has been reported to be used in ancient Egypt and China. St. Juste told us it’s a healing practice associated to ancient China and Chinese medicine, but is practiced in in South East Asia, South America, the Middle East, and the Caucasus region (Armenia, Georgia, Azerbaijan) as well. They all have the same goal St. Juste told us and that is to move Qi or stagnant blood. Now think how can blood be stagnant? Bruises? Injuries? Lack of movement? Inflammation/swelling? So that makes sense that improving circulation can help with health and healing. It’s at the core of some of what Kelly Starrett spoke to us about in our interview with him.
Cupping or the various forms are used to improve blood circulation and St. Juste tells us to also relax muscles. St. Juste said “In western or modern medicine there is no such things as “bad blood”, but it’s viewed as more a circulation issue, but in eastern medicine the stagnant Qi is blood that may be toxic, or blood that needs to be moved to have nutrients mixed back in”.
Cupping is basically the use of either special glass or plastic cups on the body to create suction to try and pull the blood closer to the skin and get it circulating. The heat helps warm the area and get the blood moving and (heat moves and cold holds) the suction or regulation of the air is what creates the pull. There is more to it than just that but that’s the basic of “cupping”.
Now the version SBW used is more of the Middle Eastern version that in addition to cupping also has some very small superficial cuts that help pull some of the blood out of the body. St. Juste told us he’s not trained in the Hijama version but the real difference between the cupping he does and the Hijama is the incisions. But the placing of the cups on the body and using suction helps “pull” the blood closer to the surface and just getting it to move.
St. Juste told us while the back is ideal for most forms of cupping; it’s not limited to the back. St. Juste told us where you place the cups has a lot to do with what is the patients need? “What is the ailment? What do we need to treat? Are we working to relax, or detox or heal? That should determine where the practitioner puts the cups” points out St. Juste. It can be placed on the foot, legs, limbs, etc. but St. Juste tells us “The back is ideal because it is flat and has more surface space. Even more, from the back we can get to the organs (blood in heart, or lungs, or kidneys, etc.) easier than the other parts of the body”.
There are specific points that respond or correlate to various body parts/functions as in acupuncture and other eastern medicine and cupping also looks to very similar points for specific treatments.
We were reminded by St. Juste that most of us are familiar with cupping from seeing the round welts or bruises that occur on the back or where the treatment took place. St. Juste says the bruising is normal and can last up to 7 days, but nearly all patients say there is no pain or discomfort from those marks. “It’s really more of a discoloration” St. Juste said. The color of the bruising or lack of color is also a tool that the practitioner can use to see how stagnant the blood is, or how toxic the blood is, etc.
Most patients have told St. Juste that the actual cupping is fairly relaxing and they compare it to a massage and find that it has a fairly quick response. The feeling is some tension and pressure but not in a negative way. It’s described by St. Juste as more of a warm gripping heat sensation that gets the energy flowing. The heat can be applied to the cups directly with a flame, or as St. Juste does using an inferred heater or a heat lamp.
Now, St. Juste did warn us about the importance of using a trained/qualified practitioner so you don’t have someone who ends up burring you in trying to do the cupping. St Juste shared experiences seeing people who tired to self apply cupping and end up with a 100 spots all over and aside from the crazy look, if the cupping isn’t being applied at the correct points for the specific aliment then they won’t get the response they want.
Depending on the actual injury St. Juste said you may not apply the cupping directly (again it depends on the injury and what you are trying to do with treatment). He did say the real exclusions for cupping is for women while they are pregnant or if someone has some significant health issues. That’s again why it is critical to work with someone who is trained to understand how to do cupping but also what/when it should be used.
With the use of the Hijama method (cutting) there is a bit of blood letting. St. Juste says there can be benefits to that but it’s really up to the practitioner. “Personally” says St. Juste “I don’t do the blood letting, as there is more hassle with it. You have to be trained to do that. There is the issue of making sure you clean the blood properly, clean and avoid infections, etc. Its easier and just as effective to do it without the blood letting for me. That’s just how I practice”. Licensed acupuncturist such as St. Juste do go through extensive training on dealing and cleaning needles, cups and other equipment to ensure safety and sanitary conditions.
The benefits that Cupping provides is that it is not a time consuming practice, that people can usually complete a session in under 20-mins (10-min of the cups being on). Cupping can also be done on a weekly base if that’s the treatment goal. It can also be done as a part of an on-going maintenance. Cupping may take time for muscles to relax and to respond to the sessions and it can take a few sessions, but then it does speed up. For athletes on the go, this is fairly fast!
Cupping can be done as a stand alone form of treatment, but the cupping can also be applied as a part of a whole treatment approach which can include cupping, acupressure and acupuncture. They are all part a of an attempt to stimulate blood circulation and muscle movement. St Juste says “Eastern medicine isn’t just either or, it can be a combination and we try and look at what is the issue, what is causing it and want you want to do about it”.
We asked St. Juste (who does treat a number of athletes) if cupping could be a good recovery option for us ruggers, based on the stress the body is placed under in play and training, the bruising, etc. He said “it can definitely help with general circulation which will help your body heal faster, it can relax your muscles so you can get them back to working at the levels you want. If cupping is done correctly and in the right place it can also aide in speeding up some injury recovery”. Another use for ruggers can be as a detox (as SBW used) which can help just clear out/clean out the body after a season, or before you go from your post season break into off season training. Some of the drop off in performance at times is the body being tired, having the bruises and injures and in getting the blood flowing you can “refresh” for muscles and organs, but also flush out some of those toxins.
This is not a scientific story! While we did speak with a trained expert this story is just a way for us to help some of you ruggers improve your play and as players. Many had questions after the SBW photo, and so we felt this is something we could do to help answer questions, but also provide you all with another option to help your bodies heal after these long season, to look at other options on how to take care of your physical health which is necessary to keep playing at a high level.
There are a number of articles about the use of cupping to assist athletes with injures and performance. We found a few written by Brandi Ross who is the athletic trainer for UC Santa Barbara who shares some specific examples of how she’s now using cupping to help her athlete’s with recovery and mobility. Those can be found on www.breakingmuscle.com (or just google Brandi’s name). If you are interested in more info about cupping you can easily do some google searches. If you live in the greater Los Angeles area and are interested in cupping or acupuncture (great for so many back issues) you can reach Carlo St. Juste LAc at his practice on-line www.csjacupunture.com in Azusa. Follow him @csjacupunture on Twitter.