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What is Cupping?

Apr 28, 2022

The benefits of cupping therapy.

By now we all have all seen the cupping marks many of the swimmers, gymnasts and professional athletes are using to recover and get out of pain.  I’m sure you’re wondering why someone would do something to themselves that leaves those crazy marks.  You may be surprised to learn that the despite the interesting post treatment appearance it can actually feel quite nice.  When cupping therapy is done appropriately the bruises, while purple in color, are very superficial and don’t really exhibit the pain you might associate with a regular bruise.  Ultimately, if you understand the many benefits and mechanisms of cupping you can also perform cupping without leaving any marks at all. 


There are many benefits of cupping therapy that I believe have been responsible for its significant resurgence in recent years.  In this short article we want to talk about a few of those benefits so that you can better decide if cupping therapy is something you may want to try for yourself. The following benefits and discussion represent my opinion on cupping.  They are an expression of my thought process based on a combination of peer reviewed research and the development of my own clinical experience gleaned from mentors and from treating with cups for the last 9+ years.  






When you think about massage therapy, foam rolling, instrument assisted massage and other common treatments they are all compressive in nature.  They all push the muscle and tissue in towards the body.  Cupping is the opposite of that. It lifts the tissue away.  The negative pressure and distraction force from lifting away can be beneficial in a couple of different ways.   In the body when one direction hurts or feels threatening the other direction will often  feel better and relieving.  With cupping if foam rolling is absolutely miserable for you, switch directions and apply a negative force direction. It will still give you a host of benefits similar to other manual therapies. The next 3 benefits explore how that negative force actually works. 




Some of what you perceive as muscular or myofascial pain can be from decreased blood flow / oxygenation to an area.  When a muscle is tight, active, and turned on it uses oxygen to create energy.  If you can’t get enough oxygen to the tissue your body will switch energy systems that don’t require energy.  This is a great short term fix but this anaerobic energy system leaves hydrogen as a cellular byproduct and increases the acidity in the blood.  Your body doesn’t like acidic environments so it releases pain sensitizing chemicals that tell the brain something is wrong.  It is a well designed protective system… That is unless you can’t get the muscle to relax or get blood flow to the area to flush things out. 

With cupping therapy you can visibly see the blood flow changes to the skin and surrounding area as its happening.   It is likely that this quick rush of blood is part of why you feel so light and airy after a cupping therapy session. More to come on that feeling later. 




Part of being able to heal is the ability to clear out cellular waste products.  When you get injured, inflammation rushes to the area to repair the damage. Imagine a home repair project,  in the process of fixing things there is always a fair amount of  trash left over  that needs cleaned up.  The immune system functions the same way.  It repairs damaged cells but there is a host of waste that needs cleared out.  Your body clears the waste product out through veins and lymphatic vessels.  Think of your lymphatic vessels and veins as pipes that are used to flush out these waste products.  The cellular waste byproducts will get filtered and the excreted out of the body.  As you may imagine, problems might exist if something is restricting the flow of fluid through the pipes.  


This is 100% my theory but we know that in the presence of pain the sympathetic nervous system, or your fight or flight mode, kicks in.  This can cause changes in the tone of the skin and surrounding tissue.  The veins and lymphatic vessels live very close to the surface of the skin.  My theory is that as a part of that sympathetic response that causes tight muscles and skin we also end up with blocked drain pipes.  Now when the repair is done you have no way to get rid of the trash. 


 Cupping gives us a way to create a pulling force near the surface of the skin that may better help reduce the skin tension, open up the pipes, and clear out the waste products.  There will be more to come on this theory as I really believe it is untapped resource in getting out of pain 




If you have seen pictures of cupping you have also seen pictures of the bruises it can leave.  These bruises are a result  of capillary rupture.  Damaged capillaries from cupping tend to occur in areas of tightness.  These damaged or weakened vessels may rupture more easily than healthy and pliable tissue.  With repeated cupping, overtime,  the rupture and subsequent repair may lead to true tissue changes that may have long term benefits.  Like in our example above,  think of this like performing pipe repairs on your downspouts.  You have to make sure the pipes are running free so nothing gets backed up. 


This microrupture creates its own immune and inflammatory response for healing.  This may be a useful mechanism when dealing with chronic pain and you need to restart an immune response to an area. There is also some literature that has looked at nitric oxide release in the body from cupping.  Nitric Oxide may be responsible for some of that short term pain relief experience we mentioned earlier.


For more a more detailed and scientific read on the details of the mechanisms of cupping I highly recommend this article by Al-Bedah Et al. This is a free article published in pubmed where the authors really dig into the proposed neurophysiology behind the benefits of cupping therapy. 



If you would like to learn more about cupping and how to effectively and efficiently apply it to any area of the body consider our new NRT course where we teach you how to use cups, tools, and percussion massagers to treat painful areas throughout the body.



If you are near Cleveland, Beachwood, or Hudson Ohio schedule a cupping session with one of our PHYT providers. We would love the opportunity to work with you! Schedule HERE!



Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, Khalil AAH, Khalil MKM, Alqaed MS. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2018 Apr 30;9(2):90-97. doi: 10.1016/j.jtcme.2018.03.003. PMID: 30963043; PMCID: PMC6435947.

Written by Dr. Nicholas Sanders PT, DPT, CSCS, CIDN.  Dr. Sanders is the founder and owner of PHYT For Function where we provide a convenient and simple solution for people to continue to do the activities they love without muscle, joint, or nerve pain.  He is a national instructor for Integrative Dry Needling and Co-Creator of a Neuro-Inflammatory Manual Therapy course. 

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