Every January, a new group of NFL hopefuls from around the country arrive in Florida to train for two months for the NFL combine and their pro days. These young men, most of them around 23 years old, will participate in grueling twice-daily workouts for six days a week.

I get the opportunity to help them recover from these workouts by combining massage and vacuum therapy, a recovery system that helps keeps them on the field and their dreams of playing in the NFL alive.

The NFL combine is an opportunity for football athletes to showcase their speed, strength, agility and all-around athletic prowess. With NFL team agents and scouts from around the country watching these athletes perform at the combine, it’s critical that they are at their best. The training sessions are vital and recovery is equally essential to allow them to continue putting their bodies through some grueling work. The group of football players I work with train at Athletic Edge in Lakewood Ranch, Fla., with Mike Gough. Through mutual pro athlete clients, Gough reached out to me in 2012 to help his athletes recover better.

From running backs to lineman, the athletes I work on range in size from 190 to 300 pounds and, in just two months, their bodies go through an amazing transformation. But with those frequent workouts, comes soreness and muscle fatigue, which is where I come in. By combining massage and vacuum therapy, I’m able to reduce those effects from their workouts and help keep injuries at bay, giving them the optimal recovery.

The vacuum therapy machine has various cup sizes, which range up to 6 inches, to enable me to go deeper and work more effectively on these athletes. Vacuum therapy is a unique type of manual therapy using the traditional Chinese cupping tool. In traditional cupping, small cups are used and placed on the body for long periods of time and some movement may be incorporated. In contrast, the modernized vacuum therapy modality uses an array of cup sizes and a machine to create the vacuum pressure that gives the therapist more control.

Manual cups used in traditional cupping therapies may also be used for vacuum therapy. Static cup placement can be used for short time intervals to release specific areas of tightness or a trigger point in the muscle, and other soft tissue mobilization techniques using the vacuum address multiple common conditions. The varied modes on the machine allow for static placement with a pumping action which is also so beneficial for recovery from workouts or injury.

By placing the cup opening on the surface of the skin and creating vacuum pressure with the machine, the tissue gently rises into the cup. This creates vasodilation almost instantly. With the machine’s variable dial, vacuum pressure can be created at a comfortable level for the athlete as I manipulate the soft tissue.

The larger cups enable me to cover more surface area, particularly with larger athletes, as well as to go deeper into the tissue and allow for a greater stretch of the fascia, connective tissue, and musculature. With athletes, there is often micro scarring created from tiny tears from the constant workouts and the vacuum therapy machine can make easy work of lifting and stretching this restricted tissue. This gives the athlete greater mobility and overall easier movement.The hip flexors are an area where restriction is often found and athletes often report back to me after a session about how their speed increased, along with their mobility.

Duran Lowe, a safety from Wake Forest College in North Carolina, said vacuum therapy treatments have made a world of difference for him. “I can honestly say that without vacuum therapy I wouldn’t have been able to perform at my peak for every workout, because my body would have been too tired and sore to push through the pain.”

Duran started getting treatments weeks later than the rest of the group, after hearing from other athletes he was training with how much they were helping. He was accustomed to various recovery techniques and would use the cold tubs after workouts, stretch, and utilize the foam roller. But he still remained sore. When he started receiving treatments with massage and vacuum therapy, he quickly realized its benefits. “Once I started getting the vacuum therapy, I could feel my body start to heal faster, my recovery process sped up.”

On a rare occasion, an athlete may have experienced traditional cupping therapy. Turner Petersen, from Rice University, quickly realized the difference between these modalities. “From my experience with cupping, smaller cups were the only sizes used and they typically are applied to a single area and would occasionally be moved along muscles/ligaments. The treatment doesn’t compare to vacuum therapy [with the machine]. For me, I was battling a lower hamstring issue this past summer while training. We were able to use different levels of suction and different sizes of cups to pinpoint the deep strain and week-by-week, relieve the pain I was feeling behind my knee.” Petersen had tried various massage therapy techniques with therapists, but to no avail. The next day when running, the pain was right back where it was. With the vacuum therapy added every session, we were able to locate the source of the issue at his distal hamstring attachment. With each weekly session, we were closer to alleviating the pain completely.

I have found that the therapy these young athletes have experienced varies greatly from college and universities, and it’s a unique opportunity to introduce them to vacuum therapy combined with massage, especially as they seek out ways to sustain such vigorous workouts and pursue their NFL careers. Sometimes they make it as an NFL athlete, sometimes they don’t. I’ve seen these athletes be selected as fifth round draft picks and play in the Super Bowl their first season earning a ring.