Maybe you have seen those “strange marks” on an athlete’s body – you know, the ones that are circular and look like bruises? Michael Phelps was one of the first athletes to popularize these peculiar-looking marks, and everyone started asking – what the heck are those things and how did he get them? What are they for? Let’s dive into cupping therapy today.

These marks that you may have seen before are called “cupping marks”, and they are far different from bruises, despite their similar appearance. They are the result of an increasingly popular therapeutic bodywork method called cupping. In this article, we will define what cupping is, how it works, what conditions it is used to treat, as well as some safety indications when considering the use of cups for body healing. We will also clear up the confusion on what those marks are and why they happen!

What is Cupping Therapy?

Cupping is a method of negative pressure therapeutic bodywork that utilizes silicone, plastic, or glass cups applied to the body, to relieve muscular tension and pain. Cups on the body create a pulling action, or “vacuum”, to the tissue it is applied to, which allows for fascia hydration, tissue congestion clearing, and improved circulation. Tissue congestion and pain can severely limit our range of motion and cause pain throughout our body, and cups are often used to relieve this discomfort for a wide variety of musculoskeletal conditions (5).

Learn more about other ways we like to recover, improve tissue circulation, and promote tissue optimization here at [P]rehab in this YouTube video!

Primitive cupping can be traced back as far as Ancient Egypt in 1550BC, when various suction devices such as horns or glass cups were attached to the body with the intention of “sucking out the toxins”. Over time, cupping methods evolved in traditional Chinese medicine with the use of silicone, glass, or pump gun cups, and today these modalities are becoming more widely utilized by physical therapists, massage therapists, and professional bodyworkers all over the world.

LEARN MORE ABOUT OUR THORACIC MOBILITY [P]REHAB PROGRAM

Looking for more ways to improve your tissue mobility? More importantly, are you dealing with any midback pain or discomfort, or are feeling stiff through your midback area? Our [P]Rehab Thoracic Mobility program is just what you are looking for! This 8-week program is designed to improve your midback health and posture! For more information, click HERE.

The therapeutic benefits of cupping therapy are many, and include (but are not limited to):

• Improved circulation
• Alleviate adhesions and scar tissue
• Help clear congestion and stagnation
• Lift, hydrate, and manipulate fascia
• Reduce inflammation
• Encourage the formation of healthy blood vessels
• Reduce overall pain
• Encourages lymph drainage
• Alleviates muscular tension and tightness
• Promotes muscle recovery

LISTEN: TREATING THE LYMPHATIC SYSTEM & LIVING WELL WITH LYMPHEDEMA WITH [P]REHAB?

Cupping Therapy Marks vs. Bruises – What’s the Difference?

During treatment, there may be cupping marks that appear on the skin. These are DIFFERENT than bruises, although can look the same. Cupping marks are the body’s natural response to debris being released from the muscle and tissues from the “vacuum”/negative pressure action of the cups (think like the action of your toilet plunger!) These marks indicate the release of old blood, medication, or foreign substances that the body marks as a waste products.

The marks may feel sensitive but should NOT be painful to the touch. They will simply fade away over a couple of days; they do not change color or shape as a bruise would. Bruises indicate tissue trauma, while cupping marks are simply a release of tissue waste that is coming to the surface of the skin. Cupping marks are never the goal for treatment, they are simply an ‘added bonus’, indicating the release of debris from your body!

Take a moment to appreciate the difference between the two pictures below with the top image highlighting the defined edges of cupping marks and the image on the bottom being a bruise that notably has changed shape and color as time lapses.

What to Expect Before and After A Cupping Treatment Session:

• You will be asked to expose the area being worked on, to your comfort level. Cups are applied directly to the skin.
• Oil and/or massage cream will be applied to your skin. Inform your therapist of any allergies!
• Cupping should NEVER hurt! Communicate with your therapist so they can adjust their pressure.
• You may feel many things after treatment: clients describe feeling either very tired or very energetic, varying levels of hunger, sleepiness, or irritability. These are all normal!
• You may feel very emotional after a cupping session. This is also normal, as sometimes the cups can release some tension or feelings we may be holding in our muscles.
• Resume all activities as normal, as long as you are feeling good. It is not recommended to lift heavy weights or do a workout after a cupping session.
• It is important to HYDRATE after receiving cupping treatment! Cupping pulls water from your tissues, and it needs to be replaced afterward.

LISTEN: WHEN MODALITIES PLAY A ROLE IN RECOVERY AND PERFORMANCE

What Conditions Can Cupping Therapy Treat?

Cupping is used to treat a vast array of conditions, everything from treatment of tendonitis, lymphedema, cellulite and facial treatments, and generalized pain and muscular stiffness. In one study, cupping was shown to reduce pain intensity scores and demonstrate improvement in functional outcome tools (as compared to traditional treatments such as medications and “usual care”) for patients with low back pain (1, 2). Another study demonstrated improvements in patients with chronic neck pain (3), and further studies demonstrate the effectiveness of cupping to improve diabetes mellitus (4).

LEARN MORE ABOUT OUR THORACIC MOBILITY [P]REHAB PROGRAM

Looking for more ways to improve your mobility? Our [P]Rehab Thoracic Mobility program along with our other mobility programs could be just what you are looking for when It comes to recovery and performing at your best. For more information about our mobility programs click HERE.

While there are many conditions that cupping is beneficial for, it is always wise to be cleared by your healthcare provider before undergoing cupping therapy. There are certain situations in which cupping CANNOT be applied, and it is wise to ensure you do not have any of these conditions before receiving therapy.

Cupping Therapy In Action!

There are various types of cupping applications, depending on what your goals for treatment are. Your therapist will talk to you about the different applications and decide what is going to work best for your treatment. Here are a few types of cupping applications:

Static Cups

Static cups are placed directly on the skin and are not moved. Generally, they are left in place for only a few minutes, and will likely cause a cupping mark.

Moving Cups

Cups can be moved or “slid” in all different directions on the skin, with varying degrees of pressure applied based on the tolerance of the person to which they are being applied.

Lift/Release:

A technique used for decompression at a specific area.

Gliding/Sliding Cupping Therapy:

Used to decompress a tissue along it’s full length.

Flash Cupping:

A technique used to bring rapid bloodflow and circulation to an area.

Cupping with Movement:

Cupping can also be coupled with different movements as the cups stay on statically while the individual goes through a range of motion with the cups on. This can serve as a way to increase localized circulation due to the muscle activation.

Sample Thoracic Mobility Program Exercise

This Quadruped Thread the Needle exercise is a great exercise to perform with cups on the midback area, low back, shoulders, or all of the above depending on which specific individual needs! It can be found in our [P]rehab Exercsie Library as well as in our Thoracic Mobility program!

Closing Thoughts on Cupping Therapy

Cupping is an excellent therapeutic tool to add to your treatment session to help relieve chronic pain and discomfort from various conditions. Ensure that you have a skilled provider, and are thoroughly educated as well as medically cleared before receiving treatment. And, don’t worry about the cupping marks! That is just all that “junk” leaving your tissues and helping you heal!

References

1. Wang YT, Qi Y, Tang FY, Li FM, Li QH, Xu CP, et al. The effect of cupping therapy for low back pain: A meta-analysis based on existing randomized controlled trials. J Back Musculoskelet Rehabil. 2017;30(6):1187-1195. doi:10.3233/BMR-169736.
2. 35.Moura CC, Chaves ÉCL, Cardoso ACLR, Nogueira DA, Corrêa HP, Chianca TCM. Cupping therapy and chronic back pain: systematic review and meta-analysis. Rev Lat Am Enfermagem. 2018;26:e3094. doi: 10.1590/1518-8345.2888.3094.
3. A.F. Ahmed, M.M.R. Hssanien. Effect of cupping therapy in treating chronic headache and chronic back pain at Al heijamah clinic HMC. World Fam Med J, 99 (289) (2010 Apr), pp. 1-7
4. S.R. Vakilinia, D. Bayat, M. Asghari Hijama [wet cupping or dry cupping] for diabetes treatment Iran J Med Sci, 41 (3 Suppl) (2016 May), p. S37
5. Gilmartin, S., & Scroppo, F. (2017). The guide to modern cupping therapy: Your step-by-step source for vacuum therapy. Toronto, Ontario, Canada: Robert Rose Inc..

About The Author

Taryn Beaumont, PT, DPT, CLT, CF-L1, CNC

[P]rehab Writer & Content Creator

Taryn was born and raised in Maine and still resides there with her boyfriend and son. Taryn received her Doctorate in Physical Therapy from Husson University in 2010, and also carries a Bachelor in Kinesiology and Human Movement Science. She is a Certified Lymphedema Therapist, a Certified Crossfit Level 1 Trainer, and a NASM Certified Nutrition Coach. Taryn has 10+ years of experience in many different realms of PT, from the young athlete to the geriatric patient. Taryn considers herself a ‘lifelong learner’. She has special interests in oncology care and breast health, dry needling, and Crossfit training. In her free time, Taryn enjoys fitness, spending time with her family, continuing education, writing, and reading, and is very excited to be a part of The [P]rehab team to educate and empower others to take control of their health and wellness.

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.