Cupping therapy can play a valuable role in knee replacement recovery by addressing fascia tightness, reducing swelling, and improving skin elasticity. Before surgery, cupping helps loosen fascia and prepare the skin to reduce complications during the procedure. After surgery, it aids lymphatic drainage and minimizes scar tissue formation, promoting better mobility and healing. Careful technique is key to avoiding congestion and supporting a smoother recovery process.
Key Takeaways
- Pre-surgical cupping focuses on fascia release and improving skin elasticity to reduce complications during knee replacement surgery.
- Post-surgical cupping prioritizes lymphatic drainage to reduce swelling and promote healing without irritating the surgical site.
- Non-congestive cupping techniques (avoiding heavy marks) are essential to prevent excess fluid buildup and tissue compression.
- Skin turgor and collagen health are critical for proper recovery and minimizing risks like infection or scarring.
- Consistent, gentle cupping therapy before and after surgery can enhance mobility, reduce pain, and support long-term recovery.
A great advantage with cupping is the lift of tissue, which releases fascial adhesions and via the fascia connections, muscle tension is released—all of which is helpful for hip replacement recovery
Total knee replacements or knee surgeries are unique compared to other joint replacements or surgeries. The knee is a hinge joint with small degrees of medial and lateral rotation. The shear forces a knee undergoes in relation to one’s body weight is remarkable.
Walking across level ground applies the equivalent of one-and-a-half times your body weight. Which means a 200-pound man will put 300-pounds of pressure on his knees with each step. Traveling up and down stairs, on inclines or declines, two to three times your body weight of pressure is applied; squatting down to tie your shoes or sitting on your heels, applies four to five times your body weight. Understandably, knees need much care before and after surgery. Cupping can be instrumental in the process of knee surgeries and recovery.
The structure of the knee is naturally compressive to withstand the pressure from every day use. Addition of an injury or degeneration with inflammation and scar tissue will increase the compression and subsequent tension. This results in swelling, pain, tightened muscles, and skin surrounding the knee joint, and limited range of motion.
Cupping Moves Fluid
Cupping with techniques with little to no marks that do not congest the tissues is so valuable. Not that cupping marks are all bad, but they are a form of congestion; and in a compressive place like the knee, this will create problems. Lymphatic drainage is not the only advantage from cupping. Release of muscle, skin, and fascia tension surrounding the knee is an added beneficial.
As surgery for a knee replacement approaches, most people experience swelling, become more sedentary, and are unable to perform stretching due to the knee pain. An important key element most overlooked prior to knee surgery, is the tightness of the fascia, skin elasticity and the skin’s turgor around the knee. The skin can become adhered to the underlying tissue due to the complications which arise from problems related to knee pain. Serious complications which are possible following knee replacement surgeries are: damage to the skin from the retraction and subsequent infection of the soft tissue surrounding the knee.
Surgeons stretch the skin to its limit during a knee replacement. If the skin’s collagen reserves are insufficient for recovery, skin breakdown may occur.
This can lead to additional complications. Cupping before surgery can help to minimize the risk for these possible complications by reducing the fascia adhesions of the skin, hydrating the tissue, and reducing excess lymphatic fluid buildup.
Our skin and its many layers contain two kinds of proteins: collagen and elastin. These proteins are responsible for the skin’s elasticity. The elasticity affects skin’s turgor, which is the skin’s ability to rebound after being stretched. Any breakdown of the elasticity due to injury, edema, dehydration, or fascia adhesions, will limit healing and may increase risk for infection after surgery.
For this reason, I dedicate plenty of time toward liberation and hydration of the skin without congesting it from excessive fluid buildup that cupping naturally brings.
Cupping for Knee Replacement Recovery
Unlike lymphatic drainage focus with pre- surgery preparation for hip replacements, I find it is best to work mostly on fascia release before knee surgeries; being mindful not to congest the tissue by leaving marks on the skin or to flood the underlying tissue with unnecessary extra fluid. By controlling negative pressure, the work is not painful and leaves little to no marks.
This type of fascia work is used to loosen the skin, quads, hamstrings, adductors, IT band, and the calf as much as possible. The goal is not to stretch the skin but get the maximum amount of fascia release possible in effort to minimize damage from retraction of the skin during surgery.
This process takes time. If we try to force the fascia release or stretch of the skin, a subsequent natural inflammation process can hinder recovery or we can create a skin tear. It is important to follow the fascia work with lymph drainage, so as not to congest the underlying tissue.
I aim to provide treatment before surgery, approximately two times per week over the course of four weeks. The first couple of sessions may achieve very little release, typically working only 15 to 20 minutes on the target leg. A significant amount of warm up is necessary to get the layers of fascia to soften. This is when cupping is invaluable.
Cupping lifts the tissue and stimulates simultaneous warming and gentle softening of the fascia. This lift enables the benefit of cupping from superficial to deep layers of tissue without the increase of negative pressure or pain. I like to work the upper leg (both fascia release and lymph drainage) during the first session of the week and the lower leg during the second session.
I repeat this process each week leading up to the surgery date; always looking to the elasticity and turgor of the skin as to determine if I have done all I can to help my client with their pre-surgery work.
After the big day, knee replacements are unlike hip replacements. Most people require additional time in the hospital and are unable to ambulate on post op day one, which makes post-surgery treatment more difficult but still very important.
As previously stressed, lymphatic work is essential following knee replacement due to the post-surgery edema and its negative effect on range of motion and pain. Because of the location and mobility barriers, access to my clients (and vice versa) is limited. Frequency and duration of initial cupping sessions are also limited. Most of the therapeutic work following the knee replacement is delayed until the client has returned to everyday activities.
I initiate post-surgery treatment with the clearing of lymph in the upper thigh and hip. I am careful not work anywhere around the surgery site, only superior to it. I also focus my cupping techniques at this point, to suction and release on the mid-thigh, paying close attention to the turgor of the skin.
Suction and release techniques is a momentary, one to two seconds, of suction followed by a release of the suction. With dedicated work to clear the hip, the lymph naturally clears from the knee, which allows the client greater movement during their physical therapy. I defer any post-surgical stretching of the skin until the stitches have been removed, any scabs have resolved, and the skin is deemed intact.
Once the skin around the surgical site is determined appropriate for treatment, I begin working around the knee. Again, I pay special attention to the elasticity and turgor of the skin. With utilization of cupping techniques specific for treatment of scars, I perform light work around the scar over the knee. The goal is to limit adhesions during the healing process. If the scar becomes bound with the fascia, range of motion will be limited and recovery duration unnecessarily extended. Clients are likely to limit their activities if their knee is difficult to bend due to fascia adhesions.
Cupping Before and After Surgery
In contrast to therapeutic work before knee surgery, post- surgical warm up is followed by lymphatic drainage and then gentle fascia release as pre-surgery is fascia release followed by lymphatic drainage. Also, I typically work only once a week with them instead of twice a week.
As an advocate for massage therapy in hospitals, I believe adding non-congestive cupping therapy in acute care settings for people who have undergone joint replacement surgery would result in decreased pain and improved recovery, as well as overall patient health. Thus far, I have only had opportunity to provide this invaluable service outside the hospital setting.
Having achieved amazing results despite the delay in non-congestive cupping therapeutic massage intervention, imagine what could be accomplished if given the opportunity to work with these people sooner!
About the Author
Garrett Brown, CMCE, LMBT (13665), has been a massage therapist for 10 years, teaching continuing education for ACE MediCupping for seven years. As a classically trained welder and machinist with an engineering background, he brings a unique perspective to the massage field. Finding massage by accident via a gift card from a friend, Garrett found his calling, massage therapy.
