on cupping: what it is, what it’s for, and what is even happening in there

One service that I offer alongside traditional massage techniques is cupping. In my experience, I have found cupping to offer great relief from pain, specifically around the shoulders and lower back. While many folks have heard of this technique, there have not been many controlled scientific studies offering insight as to why it could be effective physiologically. In an effort to help my clients educate themselves, I’ve tried to seek out this information and compile the most relevant bits here.

Cupping is a practice that has been used in traditional medicine in many parts of the world. It involves creating suction on the skin using a cup shaped instrument, which could be made of a number of materials. Most often you see glass or plastic cups, but bamboo, ceramic, or silicone are also used in conjunction with different methods to produce suction. Traditionally, to create the negative pressure in the cup, a flame is applied to the interior to heat the air inside. Once placed on the skin, as the air cools, the pressure within the cup reduces, creating a vacuum effect. Today, some more modern sets are made of silicone or plastic, often with a hand operated vacuum. This allows for more specific control of the pressure within the cup. There are a few different methods of cupping, namely dry cupping, wet cupping, and “moving” cupping. For the purpose of this article, I will be focusing mostly on dry and moving cupping, as those are the techniques I use in my practice.

Much of what I hear when I ask folks about cupping is a sense of, uh, well, seems like it could work, right? And both the skepticism and intuitive notion are largely merited. While bodywork is never an exact science, the results produced by cupping have allowed it to be in relevant practice for hundreds if not thousands of years, and used to treat any assortment of maladies. What physiological effects cupping was creating within the body though was unknown. Today, more research is being done to understand this. In one study by Shabi Furhad, etc al. many theories for the efficacy of cupping are proposed, and in any one session more than one could be applied.

In my practice, I use cups to facilitate myofascial techniques. I find them to be especially effective in areas where the muscle and tendon structure is short, there are many layers of muscle, or there is much connective tissue in an area. This technique provides an effect on these structures that cannot be accomplished any other way. The suction actions moves tendons, muscle fibers, and connective tissue in a different direction than otherwise possible within the body. This can allow for a more dynamic stretching of elastic connective tissue, or separation of adhesions in connective tissue and fascia around muscle structures. I also often use moving cupping during massage, which is (much like it sounds) the application of cups onto the skin with suction, then gently moved to affect a larger area. This is only done when the skin is lubricated from massage lotions or oils, and the gliding motion combined with suction can create a very pleasant experience. This technique is also great for lymphatic function and lymph movement. I specifically like incorporating cupping for the treatment of pain in certain areas of the body. Relief from nerve impingement around the shoulder area and relief of sciatica are anecdotally where I have found the most relief when using cups on myself.

The most aesthetically striking result of cupping is of course the circles that remain when the treatment is over. I find this to be one of the most interesting parts of cupping, and it is certainly the most noticeable. When vacuum suction is applied to the skin, it pretty quickly takes on a darker, red to purplish color. This is due to the excess of blood in the area, specifically in the capillaries in the skin. Capillaries are the smallest blood vessel, generally only 5-10 micrometers in diameter; they are a crucial catalyst for the entire circulatory system. They are delicate, and their walls are only one cell thick, which allows for oxygen, nutrients, and waste to pass through. This fragility, however, is what accounts for the ecchymosis (bruising) which is left behind after a cupping treatment.

The suction on the skin breaks some of these capillaries, and the excess of blood in the skin creates a round bruise. In his study, Duane Lowe details what physiological process occurs after this happens, and why it could be beneficial. He focuses mainly on the body’s use of the enzyme heme oxygenase-1 (HO-1), a cytoprotective enzyme that responds to inflammatory stimuli in the body. In the case of cupping marks, it presents itself at the site of ecchymosis (bruising) though not until many hours later, and will remain present at slightly elevated levels for several days after the event. HO-1 is largely regarded as an anti-inflammatory enzyme, and its activation has been, “shown to have potent antioxidant, anti-inflammatory, anti-apoptotic, anti-proliferative, and immunomodulatory effects throughout the body either directly or via the biological activity of its products”. That is, while the cupping treatment is creating a small amount of tissue damage, this action serves to encourage chemical repair, and bring beneficial cellular action to the site of pain or discomfort. His paper goes on to detail more of the chemical processes involved.

While cupping therapy presents very few risks, because of the specific way in which it effects the cardiovascular system, those with issues regarding healing, blood clots, elevated cholesterol, or taking blood thinners are discouraged from using this technique. Pregnant folks, those with thin skin, geriatric, and pediatric clients are also discouraged from using this treatment. This, as with most all bodywork, is bespoke science, and through education and trial I aim to find the most effective methods to achieve the outcome desired. What helps one body might not help another body in the same way, but it is always my intention to provide the most relief using whatever tools I have available. I really enjoy when I am able to meet with clients on a regular basis to find out what methods and techniques are most effective for them specifically, and work to achieve the kind of experience the want to have.

This particular techniques is a great option to try if you suffer from some types of regular pain. Because of the way we structure our sessions, there is no additional cost to incorporate cupping therapy into your massage; however, we encourage massages of 75 minutes or more, as anything less is a bit too rushed. If you have further questions, I encourage you to reach out to start a discussion, and continue your research with other sources. We are always learning!

why on earth are you writing a blog? and other business transparencies

when I opened my practice in may of this year, I was equal parts excited and terrified to embark on the prospect of actually working for myself. it seems like some ambition and promise that’s constantly being waved to motivate the worker - to be the owner of your labor completely is the only means to be satisfied with your work. of course, there is truth to this- it is certainly liberating and empowering to be freed from the routine of being on someone else’s schedule, being paid what someone else has determined your time is worth, maybe even being asked to do things that don’t line up with your own code of ethics. I am so grateful to now have some greater control over this aspect of my life.

with these liberations, however, come the added pressure of insecurity and liability. there is no employer to pay me for my work, regardless of the success of the business. no guarantee of income, no safety net of a set schedule. additionally, there is no one to shift accountability to should I encounter a complaint about my practice. I set the terms of my business myself, and I am the one who must answer to any and all questions about the ethics of that business. that is something I am eager to do.

wellness - this word has become a commodity, an ambiguous vibe that has been attached to everything from taking a bath to taking a vacation. it is marketed as self-care, self-love, health, beauty, long life, desirability, even in some cases a path to wealth and material gain. to be well can be interpreted endlessly, but in any instance it cannot simply be bought. this is an abhorrent notion to the endless march of consumerism insisting on selling it to you. massage so frequently falls into this wellness category. it’s not inaccurate necessarily; massage can truly contribute to an overall higher quality of life. but it is often sold as a quick fix, or promises something that simply cannot be attained by a simple, single transaction. I believe massage is a tool, and with an arsenal of other tools and resources, it can help one build a satisfying, comfortable and joyful life - something we all deserve.

to start this business, I had to think deeply on the ethics of a practice where I sell better health for personal gain (granted, the personal gain is just paying my bills, but it’s personal gain all the same). I do feel deeply and certainly about the benefits of massage therapy and what it can do to improve the holistic experience of one’s life. I wanted to make sure that I was intentional about what I am offering and how I am offering it. with this in mind, I wanted to write my first blog entry on just that - being transparent about my intentions and business practices in an industry that can often rely on smoke and mirrors. I wholly believe that communication and clarity are vital to building trust, and invaluable to allowing me to provide the kind of care I wish to offer.

honesty and integrity are values that I hold dear to me in my personal life, and I intend to operate my business in the same regard. to this end, i’ll let you in on my true motivation for blogging - it helps bring people to your website if there are more words present. you know when you try to find a recipe, and there is a whole story about chickens before you get to how to make a pot pie? usually these stories are AI generated floof with the recipe’s key words present as many times as possible. I won’t explain everything about search engine optimization, but that was the impetus for a blog. I was resistant at first, loathing the idea of using contrived prose to manipulate readers. in a way, I suppose i’m taking an alternate route to the same destination. but after some thought, I realized how useful a tool it could be to explain my practice and myself. I can use this venue to answer questions I hear frequently, share resources for good living, or just to wax poetic about all matter of topics, “wellness” and otherwise, that could be relevant to my clients (or anyone else who find it interesting).

there is so much to be discussed relative to massage: the machines that are our bodies and minds, nervous systems, fascia, eastern medicine. vagus nerves, trauma responses, vulnerability, touch therapy. cupping, reiki, grief, death. nothing is off the table, and I am eager and open to hear from my clients and community. we’re all just out here trying to feel good, and I hope that ultimately I can help be a part of making that available to you. in the meantime, feel free to contact me and let me know what’s on your mind regarding massage therapy and what it could do for you. there are endless paths to the elusive goal of “wellness”, and discourse along the way is always encouraged.

good luck out there, and maybe i’ll see you soon.