Ask a PT: Cupping

By: Steve Wowzynski, MPT, CMTPT/DN

Question: I keep seeing professional athletes on TV with these large circular welts on their bodies from something called cupping.  What is that, and could it help me?

Answer: Although cupping practices have been popularized in recent years (picture Michael Phelps), the practices are rather old. There are documented cases of cupping for therapeutic reasons in ancient Chinese and Egyptian cultures. 

What is cupping? It is a therapeutic intervention in which a vessel of some sort (cup) is used to create suction on the body and increase blood flow to an area by drawing the skin and muscles into the vessel. Materials vary between cultures and historical documents but have varied from vessels made of glass, wood, plastic, and now more recently, silicone.   The act of creating suction on the body was traditionally created by using a heat source in the cup, usually a flame, then letting the flame extinguish.  The cup is then transferred to the body. As the cup cools, the suction draws the skin and underlying muscle up into the cup interacting with the capillaries in the body to draw blood to the local area. As the practice of cupping has modernized, now a silicone cup with a lotion or cream can be manipulated on the body to create the suction force without the use of a flame. 

Within the practice of Physical Therapy, cupping can be used in conjunction with other forms of manual therapies, such as soft tissue mobilizations or myofascial release to improve blood flow to a restricted area in the body. Well-healed post operative scar adhesions are another area that could be addressed if, after surgical healing, the scars become restrictive to normal movements.  While this can be an anecdotally helpful technique, at MotionWorks Physical Therapy we provide a wide range of manual therapy services (myofascial release, scar mobilization, soft tissue mobilization, and dry needling) that accomplish the same results in the tissue without the risk of damaged skin and unsightly bruises.  The technique is also not covered by insurance, because it has not been proven to be effective in randomized, controlled research studies. 

There are some concerns with unskilled or at home cupping equipment leading to injury of the skin and muscles by holding the tissue under suction for too long. Bruising is the most common reaction following cupping procedures. That said, when performed improperly, cupping can lead to blistering, skin infections, necrotic or dead tissue which leads to permanently damaged skin and muscle, therefore, cupping should only be performed by a skilled professional.