The world was introduced to “cupping” as a practice in the 2016 Olympics, where the tell tale marks were easily visible on elite Olympic athletes that are using the practice to reduce pain and improve performance. While it may have been little known to the general public, cupping has been around as a form of alternative medicine for thousands of years, traditionally practiced by acupuncturists and eastern medical practitioners, and now practiced by a number of more modern therapists including physical therapists and massage therapists.
Cupping works by using a flame to heat the air inside a glass cup, causing the air to expand. The cup is then placed on the skin, where the air inside the cup rapidly cools and creates a vacuum with the skin, causing a pulling sensation that stretches the skin and underlying structures.
The Origins and Theory of Cupping
From an Eastern perspective, the theory behind cupping is similar to the theory behind acupuncture. It aids in the flow of chi, and helps to mechanically move energy throughout the body. While some cupping does create bruises, similar to a hickey, not all cupping leaves marks. The same cup placed on the right and left side, using the same pressure, might result in a mark on one side and nothing on the other. The eastern explanation for this phenomena is either an excess of energy or a deficiency of energy. If a bruise is created, then there was too much chi present, and it has now been drawn out to the surface where it can be cleansed by the lymphatic system. If no bruise results, there was a deficiency in energy and the cup helped to bring the energy and circulation where it was needed.
Present Day Cupping
These days, more and more practitioners and athletes are using cupping for benefits ascribed by western medicine, ignoring the energy component all together. In western medicine, cupping is often referred to as manual myofascial decompression. A massage therapist uses positive pressure with their hands to improve tissue elasticity, break up adhesion and scar tissue, and release myofascial restrictions. The same theory can be applied to cupping, but using negative pressure instead.
When cups are used by a massage therapist, they’re often placed on the skin after brief oiled warm up strokes with the hands, and then the cups are moved and manipulated over the surface of the skin, pausing where the tissues reaction to the negative pressure varies, as restrictions can be visibly seen by the therapist through the clear glass cups.
Cupping for Pain That’s Skin Deep
Subjectively, clients report that cupping can be quite uncomfortable during a treatment, but that after a session they’re feeling energized, with pain noticeably diminished and sometimes dramatic range of motion gains for restricted areas. Objectively, therapists report that when range of motion for the hamstrings or runners of the upper back “reach and pull” muscles of swimmers are tested before the session, clients with substantial restrictions can observe a 10 to 15 degree increase in the range of motion after a single treatment. Cupping is most effective for fascial conditions that are present right beneath the skin, including plantar fasciitis and illiotibial band syndrome.
Cupping for Illiotibial Band Syndrome
For illiotibial band syndrome, cups are placed throughout the lower extremity and the athlete is often asked to perform slow active movement to stretch the fascial structures beneath the skin and increase the effectiveness of the cups in place. As this is generally a fascial overuse injury, cupping can be very effective at accessing those structures and treating the injury within just a few sessions.
Cupping for Plantar Fasciitis
For plantar fasciitis, superficial restrictions in the connective tissue in the foot and calf result in dysfunction and inflammation in the plantar fascia. Those restrictions are often treated with massage, exercise and stretching, as well as braces and extended periods away from athletics. Cupping works to break up those restrictions and adhesion, allowing freedom of movement within the foot and lower leg, meaning that athletes generally see benefits after a single session. For plantar fasciitis, the cause can often be postural or related to poor footwear. While cupping can be very effective if the cause is overuse and damage to the fascial structures locally in the lower leg, it will only temporarily ease pain if the cause lies deeper in the posture.
Cupping is only now receiving attention by the western scientific community, and there are few peer reviewed studies as to its effectiveness. Thus far randomized controlled studies have shown cupping to be an effective treatment for carpal tunnel syndrome, chronic neck pain and low back pain. However, expect a number of studies to come forward in the next few years, as elite athletes are already anecdotally reporting substantial gains.