Cupping

This post is part of a series on cupping. To facilitate a better understanding of cupping, I would suggest you first review an introduction to the connective tissues and their layered formation by reading Fascia Facts.

I love cupping!  My only regret with using it is that I did not begin sooner.  I stumbled upon it in 2016 or so.  I, along with the rest of the viewing world, saw Michael Phelps, the Olympic swimmer with circular bruises all over his shoulders (and other places).  Prior to this I had heard of cupping but had no exposure to it.  Fast forward to now, 2021 as I write this:  I use cupping on practically every person I treat!  It’s not the answer to every problem, and it’s not the only intervention I utilize.  But when it is the right technique to use and it is applied in the right location with proper dosing it can impart incredible influence on the body.  I remember using it once on a young woman who had pain in her anterior (front of the body) lower rib region following a surgery in the area years prior.  Nothing seemed to help her pain, and she was truly suffering.  I cupped her throughout the area and not only did it alleviate her pain, but also her constipation which had been present since childhood.  Magic?  Sort of, but not if you understand the anatomy and physiology of our amazing bodies. 

What is Cupping?

Cupping basically involves the use of suction or a vacuum force applied to the surface of the skin.  I guess you could use the hose of a vacuum cleaner, I never thought about it until now.  Kind of hard to control the intensity of the suction at least with my central vac, so let’s not.  More commonly cups are used, although some cultures used animal horns, pottery, or metal containers and still may (see the history section).  The vacuum effect was often created by the practitioner placing the pointed end of the horn in their mouth and sucking.  Fortunately we now have some alternatives on the market!  Modern day cups are typically glass, hard plastic, or soft silicone depending on the technique used as well as the preference of the practitioner and patient.  A vacuum or negative pressure is created in the cup, causing it to suction the skin and tissue below where applied.  I explain to patients that it decompresses the hypodermis, which I’ll elaborate more in the physiology section.  When using the soft silicone cups the vacuum is created by simply pressing the cup onto the skin, making them very simple to apply especially for self or home treatment.  This simplicity comes at the cost of versatility, specifically in terms of the amount of suction available (all or none).  The hard plastic cups often have a valve at the top and come with a pump that creates the negative pressure (this is the type I use in practice).   Glass cups are preferred by some, especially when heat is being used to create the vacuum effect. 

Some sources recognize as many as 10 different types of cupping methods, which could vary according to how you classify them:  weak/light cupping, medium cupping, strong cupping, moving cupping, needle cupping, moxa/hot needle cupping, empty/flash cupping, full/bleeding cupping (see image below), herbal cupping, and water cupping.  It’s not my intent or desire to address all of these, and some are self-explanatory.  To my way of thinking moving or dynamic cupping could have more than one interpretation.  First, the practitioner is gliding the cup on the patient as I’m doing on the leg in the earlier picture.  This requires some type of lubricant, and may even necessitate repeat application of the lubricating agent depending on the dryness of the skin and the length of the session.  I tend to use generic lotion, but others may use essential oils or something else.  This is my favorite method for several reasons:  it minimizes bruising as compared to static cupping; it can cover a broad area of dysfunctional tissue; the gliding of the cups mimics massage in a way, but with a decompression element as opposed to a compressive force such as our hands impart; it helps to highlight areas of greatest dysfunction in the tissue, as they will typically be more sore. 

A second interpretation of moving/dynamic cupping could be to having the patient actively move the body part that has the cups on it.  So if the thigh was being cupped, the patient would bend and straighten the knee, or walk around with the cups on.  The challenge with this is keeping the cups on, as movement tends to dislodge them especially if there is lubricant on the skin.  Glass cups certainly would not be a good idea in this case!  For me the decision to use light, medium, or strong cupping depends on the person and the issue being addressed.  Dysfunctional tissue can be very sensitive, so I tend to respect the patient’s pain report and vary the intensity of suction according to their tolerance and response.   Sometimes I’ll also use a combination of static and dynamic cupping simultaneously.  If there is a particularly stubborn and painful area within a larger area that I am treating, then I may place a cup over the worst spot and leave it still for maybe 1- 5 minutes while I do dynamic cupping around it.  I have also placed cups over stubborn and painful fascial densifications that are resisting resolution with manual shearing (for more information on this see my section on Fascial Manipulation).  Sources vary as to how long to leave cups in place, and I have read anywhere from 10-30 minutes. 

Watch for more information on cupping in future posts!

Wishing you health and joy,

Colleen