Cupping (part V)


Cupping is relatively easy, inexpensive, highly effective, and readily accessible. It can actually make a change in the cause of a problem while also treating symptoms. Certainly the thought of doing it yourself can be intimidating, especially when looking at the cupping kit with all the different size cups. But with a little training and encouragement most people can quickly learn to cup themselves. Many express amazement at how simple it really is. (Of course you can hurt yourself with anything, so be reasonable and get professional help when appropriate.) Let’s break it down into digestible elements.

1. Determine if cupping is appropriate and necessary.

Not every issue is going to benefit from cupping. First, look at the area in question. If there is any type of open lesion or sore then cupping should not be done directly over it (but it may be very appropriate nearby – just not directly over it). This includes fresh surgical scars or suture sites, as the vacuum pressure exerted in cupping may compromise closure and healing. This does not include rashes and closed lesions, as these may do very well with cupping. Then palpate the region. If the skin and hypodermis are tender to light/moderate pressure or pinching (see palpation section on Cupping part IV post), then cupping may help reduce this sensitivity.

2. Obtain a cupping kit.

There are many options available online. For the most part they share similar characteristics although quality may vary. I strongly suggest you make sure you are purchasing a kit with plastic cups (not glass, unless you know what you are doing) and also a tube that lets you hold the pump in one hand and the cup in the other. Without the tube you will be limited in body parts that you can reach on yourself.

This kit comes with a variety of cup sizes which suit various parts of the anatomy. The tube pictured in the middle photo also allows for self-treatment of hard-to-reach places such as the back. Most people are surprised to learn how inexpensive these kits are (as of this writing this kit is $36.99) through Walmart. I have used this kit for years and it has held up well. Photos by Colleen Whiteford, center photo from Walmart website.

3. Determine where to cup.

Determining the best location to cup is very individual. Consider the area of pain, the vicinity above and below, and/or where palpation reveals involvement. Appearance and palpation will also guide this.

4. Choose the appropriate cup size and shape.

Cup size is determined by anatomy. If you are working on an area that is broad and relatively flat, like the lower back, abdomen, or thigh, then the biggest cups are usually the best choice. Smaller sizes work better for bony places or the wrist/ankle regions. Most cupping kits typically come with a variety of cup sizes, and some even have curved bottoms as opposed to flat.

Flat and curved cups
The cupping kit I have at home has cups with curved edges as well as flat. These curved ones are nice for maintaining suction around bony areas such as the shoulder and knee. Photo by Colleen Whiteford.

5. Use the tube between the pump and cup.

This is not an absolute always rule, but usually it’s easier to manipulate the cup and reach awkward places on yourself with the tube. If you’re planning on cupping someone else then the tube may not be necessary. The tube allows you to reach most places on the back side of your body, although some places (like the mid-back) are pretty hard to reach even with the tube and assistance from someone can make the treatment a lot easier.

Teaching cupping
The tube allows for self-cupping in hard to reach places like the shoulder. Photo by Colleen Whiteford.

6. Have lotion available.

Lotion allows you to glide the cups over the skin, which can reduce the chance of bruising. I use nothing special – any lotion works fine. Others may prefer essential oils or something else. The suction action of the vacuum will not drive any of the substance used into the skin – it will actually pull out sweat and water from the skin, which accumulates in the cup along with some of the lotion.

7. Begin with light to moderate suction.

Dysfunctional tissue is sensitive and can be very painful. Begin with very light suction, glide the cups gently, and modify the amount of suction according to the response. If it’s too painful to tolerate even the most gentle suction and gliding or if a problem area will not resolve then consider using static cupping.

Multiple static cups on leg
Examples of static cupping on a tight and painful IT band region. On a slim and hairy leg such as this it can be difficult to get much tissue into the cup. Photo by Colleen Whiteford.

8. Consider a combination of static and dynamic cupping.

When an area is too painful to tolerate gliding or it is not improving then consider placing several cups in that area, pumping them with low to moderate suction, and leave them in place. The longer they sit there the more likely bruising is to occur. I typically do not leave them in place for more than 1-3 minutes but there are different approaches with this.

Self cupping static and dynamic
Cupping oneself can be a great way to expedite progress in therapy. Here this patient is using dynamic gliding on her right leg while the left leg has multiple static cups in place. Photo by Colleen Whiteford.

9. Determine appropriate length of treatment and frequency.

This can be quite variable. The length of time spent cupping in a session depends on several factors: the size of the area being addressed, the severity of the problem, and the tolerance of the person being cupped. Obviously a large area like the back will justify taking more time, while a smaller body part like the forearm may go much faster. There is no absolute right or wrong for length of time. The same may be said for the frequency or how often to cup. Depending on the problem it might be appropriate to cup every day for some issues, while others may need a break between sessions. The best advice is to listen to your body and heed the response it seems to be giving you.

10. Clean the cups and let them air dry.

Hand soap and warm water work fine to remove the lotion, water, sweat, and oil that the cups will collect.

11. Don’t hesitate to seek help!

While cupping is wonderful and relatively simple, you may get a better outcome by getting some professional guidance with it. I like teaching cupping to my patients that need it while I am treating them. I make sure they are competent, comfortable, safe, and effective to obtain the best results. As with anything it’s good to know your limits. And remember that bruising is optional!

Cupping in treatment
Cupping while in therapy teaches a patient how to approach cupping for their own care. Here I’m using static cupping on her painful hip while she uses the Hypervolt percussion tool on her abdomen. Photo by Colleen Whiteford.

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.

Wishing you health and joy!


Published by Colleen Murphy Whiteford

I am a physiotherapist, graduate of Saint Louis University Class of 1984. I married my best friend and business partner, Bill, who is also a physiotherapist, in 1988. We have worked together all these years - an example of God's grace! Together we started Appalachian Physical Therapy which continues to thrive. I am a big believer in the power of touch, the manual therapies, and treating holistically. There are many alternatives to medications, surgeries, and testing, but people are often uninformed. My perspective emphasizes the role of the connective tissues including the fascia. Lack of attention to this structure is the source of many physical ailments - our bodies are truly fearfully and wonderfully made (Psalm 139)! I am passionate about helping people of all ages and diagnoses maximize their health, and empowering them to understand their role in management and prevention of problems.

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