Cupping therapy gained widespread attention during the 2016 Olympics when swimmer Michael Phelps appeared with large purple circles on his shoulders. Since then, its popularity has grown in various healthcare settings, including physical therapy. But what exactly is cupping doing, and how can it benefit certain conditions?
Cupping therapy has been used for thousands of years, with records tracing its medical application back to 1550 B.C. in ancient Egyptian texts such as Ebers Papyrus, one of the oldest medical manuscripts (Qureshi et al., 2017). Early practitioners used hollowed-out animal horns before transitioning to bamboo, glass, and now often using plastic or silicone cups.
Traditionally, cupping was believed to remove toxins from the body. There are two main types:
Though cupping declined in popularity in the U.S., it has made a strong comeback in the last decade due to increased exposure in sports and alternative medicine.
Cupping works by creating suction that pulls layers of tissue upward. The level of pressure applied can influence different bodily systems:
Some people claim that cupping “breaks up” fascia to improve flexibility, but research suggests this is unlikely unless using a scalpel. Instead, cupping helps mobilize fascia by increasing circulation and promoting the flow of hyaluronic acid, a lubricant between tissue layers (Pratt, 2021). This can reduce muscle tightness and enhance movement.
The images below show an MRI image of the shoulder without and then with a cup applied. You can see the black line, which is fascia, being pulled on and moved along with lots of other muscle tissue.
Research on cupping therapy is relatively sparse as shown in this evidence map below (Choi et al. 2021). This shows the effectiveness of cupping on each diagnosis, how many papers have been written on each diagnosis. The size of each bubble is meant to represent the relative number of patients in each diagnosis category for these studies and the coloring marks how confident we can be in the results based on the study design.
We can see that there is a strong need for further good quality research in multiple areas relating to cupping and how it benefits multiple conditions. In most physical therapy practices, cupping is used to help improve muscle tightness, increase scar mobility, and to decrease pain from nerve irritation.
Cupping is often used to reduce muscle tightness. When applied to a tight muscle, a cup creates a vacuum that helps stretch the muscle fibers and pull on surrounding fascia. This action can relieve tension and increase flexibility. For added benefits, it is often recommended to move or stretch the body while the cups are in place. This enhances the “slide and glide” effect of the tissues, further improving mobility. For example, if you’re experiencing lower back tightness, placing cups on either side of your spine and then stretching into a child’s pose can help reduce tightness and improve flexibility.
When an incision is created during surgery or a wound is created the tissues around the area will eventually scar down and heal. Sometimes, these tissues heal more stiffly than we would which can limit range of motion. You can see an extreme example below where the tissue “puckers” rather than being uniformly pulled up by the vacuum in the cup.
Using a cup over this area may help to improve mobility of the scar tissue and therefore improve range of motion.
Cupping can also help relieve nerve pain caused by compression at specific sites. For example, in carpal tunnel syndrome, where the median nerve is compressed at the wrist, cupping can create a pulling effect that helps to alleviate pressure on the nerve. By pulling the tissue away from the nerve, cupping may help reduce discomfort and improve circulation to the area
Cupping therapy is an ancient treatment that continues to evolve and find new applications in modern healthcare. Whether used to alleviate muscle tightness, improve flexibility, or relieve nerve pain, cupping offers a non-invasive option to complement other therapeutic techniques. While more research is needed to fully understand its mechanisms, cupping has proven beneficial for many people, especially when integrated with physical therapy and exercise. If you are interested in learning more about cupping or trying it for yourself, contact Maven today to schedule an appointment.
Qureshi, N. A., Ali, G. I., Abushanab, T. S., El-Olemy, A. T., Alqaed, M. S., El-Subai, I. S., & Al-Bedah, A. M. N. (2017). History of cupping (Hijama): A narrative review of literature. Journal of Integrative Medicine, 15(3), 172–181. https://doi.org/10.1016/j.joim.2017.03.003
Choi, T. Y., Ang, L., Ku, B., Jun, J. H., & Lee, M. S. (2021). Evidence map of cupping therapy. Journal of Clinical Medicine, 10(8), 1750. https://doi.org/10.3390/jcm10081750
Pratt, R. L. (2021). Hyaluronan and the fascial frontier. International Journal of Molecular Sciences, 22(13), 6845. https://doi.org/10.3390/ijms22136845
Zügel, M., Maganaris, C. N., Wilke, J., Jurkat-Rott, K., Klingler, W., Wearing, S. C., Findley, T., Barbe, M. F., Steinacker, J. M., Vleeming, A., Bloch, W., Schleip, R., & Hodges, P. W. (2018). Fascial tissue research in sports medicine: From molecules to tissue adaptation, injury and diagnostics: Consensus statement. British Journal of Sports Medicine, 52(23), 1497. https://doi.org/10.1136/bjsports-2018-099308
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