Cupping – hype or help?

Lets keep it simple.
What can a suction cup placed on your skin actually do?

I’m going to write this blog from a pure and simple experience angle and drop the science (there are plenty of papers published on cupping, but the evidence is mixed).

Cupping is an ancient form of adjunct medicine that goes back to healers thousands of years ago (literally). They used all kinds of creative things to serve as the suction cup, like animal horns or shells and believed strongly in the positive impact of cupping on health. Cupping progressed through the ages and through materials until we stabalised with 2 main options these days, glass and silicone but apart from that the practice is much the same. Use of cupping in modern medicine fluctuated and went in and out of fashion and my feeling is cupping now has a sort of split reputation. People either love it, or they think it’s a load of inflated quack.
My feeling is – the split has reason! Cupping has definite benefits and has a whole load of inflated claims. So what do I believe it does for the people I work with?

By placing the cup on the skin you create a negative pressure or vacuum over the skin which creates a tensile stress and causes the small skin blood vessels (dermal capillaries) to dilate. The high tensile stress will eventually cause the little blood vessels to break and leak blood into the surrounding tissue creating the characteristic red then purple bruising under the cup (ecchymosis). That is, if you leave the cup on long enough to do that!
The vacuum created by the cup
1) Stretches the superficial tissue (skin, fascia mostly but can include other tissues)
2) Decompresses superficial tissue pulling it up and away from the body
3) Pulls the fluid circulating in the tissue up with the tissue so can increase fluid flow
Which actually is pretty useful for certain things….

When is it useful to use cupping?

I’m pretty conservative based on my opinion on what cupping can achieve. But I am always testing, trying and re-evaluating so there will be updates.
My go-to applications for cupping are in areas where I see the benefit of decompression work rather than the usual manual compression of tissue in massage, or where I feel I need some help moving some fluid around in the superficial layers of skin, fascia, joints and possibly very superficial muscle. I do it where I’d prefer to lift than to press down on tissue to change it.

Examples where I use cupping on clients:
1) Iliotibial Band (ITB)
2) Lumbothoracic fascia LTF, (lower back)
3) Achilles Tendon and the ankle
4) Plantar Fascia (sole of the foot, especially in active people and runners)
5) Upper trapizius muscle (sometimes, depending on the density of the muscle and tissue)
6)Tempromandibular joint – TMJ, (jaw for jaw pain and dysfuctions like grinding teeth etc.)
7) Medial or lateral condyle of the elbow (tennis or golfers elbow)
8) Nuchal Ligament / cervical vertebrae area (back of the neck)

Bruising is the business of cups

Now comes the the real controvesy. Do you need to leave cups on so long they cause significant bruising to know they are being effective? Do you need to create dark, really dark severely bruised circles to reap the benefits of cupping?

I have to say, I really don’t believe that and I don’t find the evidence to support that practice. Coming from the medical side of things I can’t see a solid argument for creating nasty cupping marks that show extensive capillary damage has occured and claiming its the reason you will either move better or feel better. That brusing means you now have local trauma and will have to heal that tissue. So the more nasty cupping marks you make, the more extensive the tissue damage. Is it a good idea to have that over your enture back or legs?
To play Devil’s Advocate – there are times in manual therapies where you can justify creating a new trauma in the tissue to aid healing or regeneration, but its usually on a very local level and small scale. To create large scale tissue trauma seems some style of crazy uncecessary to me.
Personally, I don’t ever aim to leave severe cupping marks under every cup on every client. I aim to leave minimal marks for maximal benefit.

But that’s just my way.

My Cups
I have invested in a range of cups but they are all on the upper end to top end of strength. I use GRPS, EDGE-X and Energey-X cups from GameOn. They really can create a significant suction on the skin and need to be used with caution. I’m not messing around here, if I want to lift tissue, I want to lift tissue, not tickle the client and these cups are the business. Use with respect!