Effect of the Graston Technique and Cupping Therapy on Pain and Functions in Individuals With Medial Tibial Stress Syndrome: A Randomized Clinical Trial

Abstract

Background The discomfort in the mid-shaft and distal end of the tibia caused by shin splints or tibial periostitis also known as medial tibial stress syndrome (MTSS) is frequently induced by participating in sports or other strenuous activities. The two treatment methods used in this study are the Graston technique and cupping therapy; we have compared cupping with the Graston technique. Method It was an interventional study at Ravi Nair Physiotherapy College and Acharya Vinoba Bhave Rural Hospital. A total of 46 participants with MTSS were included in the study. The participants were randomly divided into two groups and treated for three weeks with four weekly sessions. Result Statistical analysis was done after the completion of sampling. Paired and unpaired t-tests were used. A p-value of <0.05 was considered significant. The result was obtained after comparing the pre and post values of the visual analog scale (VAS), treadmill test, step-up and step-down tests, manual muscle testing (MMT), and range of motion (ROM) of the ankle joint. After three weeks of treatment, pain with a p-value of 0.01 S showed a significant effect, and improved functions were reduced in the cupping and Graston technique groups. When compared, cupping therapy showed better results than the Graston technique. Conclusion We saw that the cupping therapy might be better than the Graston technique in reducing pain and improving functions.

Keywords: cupping therapy; graston technique; medial tibial stress syndrome; pain; runners.

Figure 1. Comparisons of VAS in Groups A and B in the pre and post test. The average VAS score for Group A prior to rest was 4.48, and after rest, it dropped to 2.09. During the pre-activity phase, the mean VAS score was 4.74, and after the activity, it decreased to 2.00. As for Group B, the mean VAS score before rest stood at 2.59, and after rest, it decreased to 0.68. During the pre-activity phase, the mean VAS score was 4.39, and after the activity, it was 1.26

VAS: visual analog scale

Figure 2. Comparisons of treadmill time in Groups A and B in the pre and post test. During the pre test, the average treadmill time for Group A was 5.09, and during the post test, it increased to 8.91. As for Group B, the mean pre-test treadmill time was 5.46, and it rose to 9.91 in the post test

Figure 3. Comparisons of treadmill speed in Groups A and B in the pre and post test. The mean value of Group A in the pre test was 4.24, and in the post test, it was 4.66 with a 2% inclination. In Group B, the mean value of the pre test was 4.55, and the post-test value was 5.16 with a 2% inclination

Figure 4. Comparisons of step-up and step-down tests in Groups A and B in the pre and post test. In the pre test, the mean value for Group A during the step-up test was 2.01, which subsequently increased to 3.70 in the post test. Similarly, during the step-down test, Group A recorded a mean value of 2.01 in the pre test and 3.70 in the post test. In contrast, Group B exhibited a mean value of 2.64 in the step-up pre test, which remarkably rose to 4.79 in the post test. Likewise, in the step-down pre test, Group B displayed a mean value of 2.64, which again increased to 4.79 in the post test