I use them both in combination quite frequently. I like either instrument assisted soft tissue massage (IASTM) or cupping for some of the more broader areas or superficial sensory nerve distributions. I like it a lot in areas like the saphenous nerve or superior cluneal nerves where we have sensory nerves making their way through fascia. It's a nice addition to the needling.

I pick either IASTM vs. cupping based on their sensory feedback. Some people don't like the compression sensory feeling of IASTM so I will go with cupping to give them distraction. Opposite, if they don't like the cupping. It works well.

I tend to use the tools (cupping or IASTM) first and then follow with the needling mainly from a sanitary standpoint. If you needle first and then cup or scrape you have a higher likelihood of pulling blood and getting blood on your tools.

Thank you!