Cupping is enjoying its 15 minutes of fame. It’s fun to see the tell-tale marks on the back and shoulders of the most decorated Olympic athlete of all time, but I’m a little concerned that all this attention will entice poorly qualified practitioners to try to incorporate it into their practice. I have already heard athletic trainers and physical therapists refer to it as “myofascial decompression”. Give me a break, it’s cupping. The same thing happened first with gua sha and the “Graston Technique” and more recently with “dry needling” – dry needling is acupuncture, and it is legally beyond the scope of practice for physical therapists in this state….

But I digress, back to cupping…. Here’s the basics –

Cupping therapy is the method of using glass, plastic, bamboo, or suction cups to create a vacuum and draw skin and connective tissue away from the body. In Chinese medicine we call the marks left by cups “Sha”. We were taught in school that the darker the Sha, the more stagnant the blood. Trauma and chronic physical or emotional stress can create stagnation of blood in the superficial venous system. The suction created by the cups draws up skin, fascia, and muscle into the cup thereby freeing blood flow. Recent studies suggest that it can affect tissues up to four inches deep from the external skin.

Chinese medicine practitioners (along with other medical practitioners and many generations of grandmothers from around the globe) have been using this healing modality for thousands of years. It is true “folk medicine” that has withstood the test of time….

Given the recent attention it has received thanks to Michael Phelps and a growing list of Olympic athletes, it will also likely start popping up in spas, health clubs, and with physical therapists and athletic trainers. As with everything, make sure to always seek treatment from a qualified practitioner.

We learned cupping during our first year of school and I practiced on minimally one hundred people in the student clinic before receiving my acupuncture license. I have treated several hundred people (thousands of individual treatments) in the years since…. It isn’t a complicated procedure, but there is skill involved with the technique. More importantly, there is a list of cautions and contraindications, and it is my policy to not cup anyone in my practice without first doing an initial evaluation.

I use glass cups and practice “fire cupping” as I believe it to be the safest and most effective form of treatment. There are different types of cups – glass, plastic, and silicone are the most popular. Glass is the only form of cup that can be properly sterilized. The plastic and silicone cups also have more incidence of adverse reaction as it can easily create too much suction for the novice (or even experienced) practitioner. These materials are also difficult to slide and not conducive to techniques that are especially beneficial for muscular tension and myofascial release. Cupping should not be painful! It is a strong treatment and some may find it to be uncomfortable. Typically it is favored by those who enjoy deep tissue massage.

Acupuncturists use cupping for several different purposes. Here are the most common:

Cupping is one of the best deep-tissue therapies available.

The Chinese techniques of cupping, gua sha, and bleeding all release pressure from the superficial venous system thereby increasing circulation in the deep venous system. Anyone who has experienced cupping (along with gua sha and bleeding techniques) can attest that it decreases pain and inflammation, and increases range of motion (hello, Michael Phelps!)… But the increased circulation at the deep venous level is the reason that these modalities have such systemic effects.

Myo-fascial, trigger point, musculotendon, and musculoskeletal cupping are used when there are signs or symptoms of acute or chronic injury to any area of the body. The back and shoulders are the most common sites to see cupping marks, but cupping to the arms, legs, wrists, ankles, and occasionally the feet are also beneficial.

Cupping is a great first line of defense from invading viruses and bacteria.

According to Dr Daniel Keown, author of the article “Cupping: Ancient Medicine, Modern Explanation”, and the fantastic book The Spark in the Machine:

“Cupping does not work by ‘removing toxins’ but rather by drawing pathogens from deep levels to superficial. It gives the immune system (Wei Qi) another chance to ‘see’ the pathogen: Wei Qi is stronger at a more superficial level. Once recognised as foreign the immune system is able to mount a renewed challenge, in just the same way as a vaccination would cause an immune response. This is why cupping may cause a slight ‘fluey’ reaction after treatment: in essence the body is catching an (internal) Cold.

(Cupping’s effect on ‘stagnant Blood’ can be seen in a similar light as drawing out immunologically and morphogenetically active blood into the path of the immune system. The immune system is also responsible for policing cancerous changes of which stagnant Blood is an example.)”

Respiratory conditions are one of the most common things treated with cupping. Three thousand years ago, in the earliest Chinese documentation of cupping, it was recommended for the treatment of pulmonary tuberculosis.

For respiratory issues, I cup the upper back and often certain areas of the chest.

So be wary in the coming months if your physical therapist, athletic trainer, massage therapist, or the friend of a friend pulls out some plastic suction cups and suggests “myofascial decompression”…. Find out where they were trained, what the training entailed, and how much experience they have. And then walk away. Just make a cupping or acupuncture + cupping appointment with me or with another qualified acupuncturist!

As always, please don’t hesitate to ask questions. I love the simplicity and complexity of this medicine and I will continue to learn and share with you.

Be well – Jana

Jana Bricker
L.Ac., Dipl. Ac., Dipl. OM, MSOM, BS Nutrition
Apex Acupuncture and Wellness, Ltd.
514 N. Western Ave. | Suite B
Lake Forest, IL 60045