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Raise your hand if you’re able to recall images of residual purple circles located on the upper back and shoulders of Michael Phelps during his debut at the 2016 summer olympics in Rio. If not, just “Google” the phrase “Phelps and cupping” and you’ll see the impact that was made on the internet 2.5 years ago. This is arguably when “cupping” first became apparent to most Americans.


However, “cupping” has actually been around much longer than when Olympians popularized it a few years ago. In fact, it has been used in ancient Chinese medicine for hundreds of centuries. The technique involves placing cups of various size on the skin. A little air pump is placed on a valve to create negative pressure, which results in the suction of skin to be pulled away from underlying muscle.


A common side effect of the technique is the famous purple circles that members of the US olympic teams sported in 2016. If the concept still seems foreign, realize that the purple circle side effect is the same reason that a person gets a “hickey.” Like a hickey, the bruising should go away within a couple of days.


What does “cupping” do?
Physiologically, cupping promotes an increase in blood flow to the affected area, which therefore increases the healing rate of sore or injured tissues.


But wait! Don’t we already have modalities that are thought to increase blood flow? Why can’t I just throw a hot pack on my back?

You could just kick back and try to relax with a hot pack, but there is another unique physiological response to cupping that promotes healing that traditional modalities do not offer. The medical term for cupping is Myofascial Decompression.” This is because the suction created by the cup creates separation between the muscle and fascial connective tissue layers. This process is thought to break up adhesions and scar tissue and thus decrease Myofascial dysfunction in a manner that other modalities cannot.

Another unique and beneficial property that cupping aka Myofascial Decompression allows for that a hot pack does not is that it can be combined with other therapies at the same time, essentially giving you “better bang for your buck.” Reduced muscle pain is usually experienced immediately while the cups are applied, allowing for increased participation in movement exercises while keeping the cups on. Moreover, when used correctly, cupping can even allow for neuromuscular feedback to the brain to promote healing. In other words, the brain is being re-programmed to relax one muscle (the cupped muscle) while concurrently activating the other muscles that need to be recruited. Don’t worry as much about this part, this is where your movement expert (your Physical Therapist and/or Physical Therapist Assistant) comes into the equation.


Okay, does it work?
Yes! Over the last several years, there has been a surplus of emerging clinical evidence that supports the use of cupping for various orthopedic conditions. There are several randomized control trials with outcomes such as less pain and improved range of motion, both short term and long term, when a group of individuals received Myofascial decompression as an adjunct to their treatment plan than if groups had not.

Are there any people for whom cupping should not be performed?
Also, yes. Precaution should be used if a person is taking blood thinners due to concern of bleeding and cupping should not be performed on a person with hemophilia (a specific blood clotting disease). Talk to your physician or doctor of physical therapy about concerns you may have and to find out if cupping is right for you.


Holly Kramer, PT, DPT
Physical Therapist
Isanti Physical Therapy

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