A therapist's view of Cupping.
In my search for information about cupping I have run across several
news sources. Wikipedia, The
American Cancer Society, The International Institute for
Islamic Medicine, and countless testimony from anecdotal sources
is available if you are willing to wade through advertisements for
cupping treatments and cupping sets. I was dismayed to see how little
information was actually available though. So this page is an attempt
to concentrate the knowledge I have and present it in a readable
format. If you have issues with the information on this page, feel it
is incomplete, incorrect, please contact me with constructive
criticism. (carrie[at]woodtigermassage[dot]com).
What is Cupping?
Cupping is the application of a vessel to
the skin of a client where a vacuum is induced in the vessel causing
the skin to rise in the vessel and seal it against the skin. This
decrease in pressure creates a vacuum which draws blood and lymph to
the area.
History of cupping
There are several semi-technical references to the
history of cupping online, though many of them seem somewhat
China-centric. All of these seem to agree that the earliest recorded
history of cupping is in the book A Handbook of Prescriptions for
Emergencies (Jou How Pei Jyi Fang), written by a Taoist alchemist Ge
Hong (281-341 A.D.) However, in a translation of Timaeus
(Plato ca. 360 B.C.) there is a reference to "medical-cupping glasses"
some 500 years earlier. The next reference consistently used is the
book Necessities Of a Frontier Official (Wai Tai Mich Yao) by Wang
Tayr (Tang Dynasty 618-907 A. D.). Contemporarily to the Tang book is
the Quran, written by Muhammad during the last 23 years of his life
(570-632 A.D.) which also contains references to cupping as a medical
practice. Cupping is used in several treatments by Ibn Sina (980-1036
A.D.) including tractioning broken bones. The most recent agreed upon
reference from Chinese history is Supplement to outline of Materia
Medica (Ban Tsau Gang Mu Chyr Yi) written by Zhao Xuemin (Qing Dynasty
1644-1912 A.D.) Although this is a relatively sophisticated text
(nearly an entire chapter was devoted to fire cupping) there are other
more primitive references to cupping in African settings (1701 The
Sudanese Travels of Theodoro Krump) at this time. More recently
cupping was used by barbers and doctors in western medical practice in
the 1800's. (A map of Allegheny County, Pennsylvania from 1862
contains advertisement for "Cupping, Leeching, Bleeding, and Tooth
drawing".)
At present, cupping has been relegated by western science to "Folk
Medicine", practices that have been discontinued,
CAM (Complementary/Alternative Medicine) practices or BDSM
play. In the realm of TCM and folk medicine, it is practiced in many
countries around the world, including Poland, Russia, Khazakstan,
Malta, Finland, Vietnam, Korea, Japan, China, and has achieved some
fame in the United
States. I believe it is in other places, but have no references
for them. (If you have references for other countries, please contact
me.)
Types of cupping
The two main divisions of cupping seem to be between "wet" cupping, a
synonym for blood letting with cups, and "dry" cupping, or cupping
over unbroken skin. I personally have no experience with "wet"
cupping, but here is a link to a more authoritative source
"Dry" cupping seems to be used for a variety of reasons, including
tractioning broken bones in early medicine, relieving cold and flu
symptoms, relaxation of an area, pain suppression and range of motion
in joints that have been injured. TCM uses it as an adjunct to
acupuncture/moxibustion and treatment, which is beyond the scope of
this article.
Cupping Theory
The two theories of cupping that I have been taught are this:
1) Western
The vacuum in the cup brings blood and lymph to the area, promoting
circulation and healing. In addition it will help break adhesions
between the skin and underlying connective tissues, allowing for freer
movement.
2) Eastern (Generic)
All pain and disease in the body is caused by stagnant chi. The
reverse pressure of the cup pulls blockages out of the chi meridians,
thus allowing for free flow of chi, and a return to healing and normal
chi flow. (If chi confuses you, well join the club. I recommend taking
a martial art for several years or coming from a non-western culture
for better understanding.)
Techniques of cupping
One of the original forms of cupping involved a horn and a small ball
of wax. The horn would be hollow and drilled with a small hole near
the end. At this point, the cupping can be done by placing the large
horn opening over the area to be cupped, and a practioner would place
the wax in his/her mouth. Then the practioner would suction through
the small hole to the desired pressure and with tongue manipulation,
seal the horn with the small ball of wax. I have never seen this form
of cupping, nor tried it. I have no idea if it works, or what effects
it might have other than the generalized effects of suction.
Another early form was to cut bamboo in such a way that one end was
sealed by the natural growth of the grass. You can see an example here. From there, the cups could be boiled in
a pot, then the opening wrapped with a cool towel for a few seconds to
make the edge bearable. Then the cups were placed upended on the area
to be cupped. The advantage of this is that the cups could be boiled
in a specified set of herbs that were a remedy to the condition. The
disadvantage is that the cup must be held on the skin for a while to
cool, and a new set of cups must be manufactured for each person and
for each ailment. Or you can soak a small piece of paper in alcohol,
light it on fire and then clap the cup to the area where you wish to
cup. The best example of this I have seen is in the movie Iron Monkey
also known as Siu nin Wong Fei Hung ji Tit Ma Lau. The advantage
of this is that the cup itself can be reused from patient to patient,
allowing more time for crafting of the cup (i.e. better quality), and
that it is quick. The disadvantage of this is that the paper, soaked
and burning is *supposed* to adhere to the bottom of the cup. That
does not always happend. Often the burning paper will dislodge and
fall inside the cup onto the skin of the client.
Cupping with glass has a few techniques as well. One of these is to
place a drop or two of alcohol in the glass, swirl it around to coat
the interior of the cup, then light it on fire and place over the area
to be cupped. The theory is that the alcohol will burn off, creating
the heat to expand the gas in the cup and then burn the alcohol
off. In practice it is difficult to get the quantity of alcohol
correct for each size cup and suction. If you get too little, the cup
doesn't stay on. if you get too much, you drip burning alcohol on the
client. In theory you could use this with bamboo cups, but the alcohol
would likely absorb into the cup and be even more difficult to work
with.
This brings us to "Lightening Flame" technique with which I am most
familiar. I also believe that this is the safest technique involving
fire. A cotton ball is soaked in alcohol and clamped in a hemostat. The cups is
placed on it's side and the lit cotton ball is held in the cup for a
few seconds before removal of the flame and placing of the cup on the
skin. It is possible to burn the skin with this technique, but with
practice it is much easier not to (my opinion.)
Why do people get cupped?
The reasons that people will have a cupping treatment are varied. Most
people who are familiar with cupping as a folk treatment use it as a
treatment for relieving symptoms of the common cold or flue. In such
cases the cups are placed in rows down the back next to the spine for
10-20 minutes. Other people come across cupping as an adjunct to TCM
in which case they are looking to solve a specific medical
condition. Qualified practitioners will often place cups on acupuncture
points in pattern specific to the issue. With the media "discovering"
cupping via some Hollywood stars, there are people who try cupping for
the novelty. Occasionally I will see women seeking to lessen the
"dimpling" effect of cellulite with "walking" cups. Cupping is also
used for relaxation and stress relief. But most people (in my
experience) are looking for pain suppression. Back pain, neck pain,
frozen shoulder, old football/Rugby injuries, repetitive stress
injuries are all reasons I have had people on my table for cupping.
In most cases folk medicine cupping is done at home by family
members. TCM treatment is done in a clinic setting by (hopefully)
qualified practitioners. Cellulite reduction is often offered in spas,
and relaxation pain suppression is offered by a variety of practitioners
from the local wican guild to licensed massage therapists.
Because it is part of cupping I feel I must mention it, but frankly I
do not know anything about, nor do I want to know anything about
cupping as part of the BDSM community. If you want to know more about
this I recommend searching on google.
Evidence for/against cupping
At this current time I have been unable to find any rigorous
scientific evidence for or against cupping. The American Cancer
society said that they do not have access to any studies
currently. There are many, many testimonials (anecdotal evidence) for
cupping, and some that are ambivalent. I have run across few that are
against, with a notable exception being Quackwatch,
a vehemently anti-non-western-medicine site. I have provided a link,
but be aware that this site is so conservative that occasionally I
find incorrect "scientific" evidence on it to support their views. It
often uses technical language to confuse and impress people in my
opinion, though they do provide a good guide (albeit heavily biased)
to alternative medicine should you wish to investigate.
Why do I use cupping in my practice?
The theories of cupping are, in my opinion, supportive of using cupping
in a massage practice, especially since one of my goals is help people
heal themselves. Improved circulation, chi flow and easing of
adhesions are all good steps toward that goal. But that is not why I
use cupping in my practice.
I use cupping because as a side effect of whatever it may or may not
do, it produces profound relaxation in the area around the cup. I have
had clients where I could have worn my elbows out on them with no
results. I put a cup on and the transformation from spasming muscles
to relaxation was incredible. I put cups on injured joints because the
relaxation that comes with the cupping allows people to re-explore the
limits of the joint. I do it, because I see it work. And that is a
testimonial. It is not a rigorous scientific study with a placebo
group, so do not represent my opinion that way. I am waiting for a
study (or the money and expertise to do it myself), but until then I
find it worthwhile enough to continue to practice the technique.
How does it feel to be cupped?
Cupping is a process that looks pretty scary from the outside and
once you have had it done a few times becomes routine and in some
cases, boring. The first thing is to clear up the pain issue. Cups are
put on with suction. It stands to reason that if the practitioner puts
cups on with very weak suction you will feel hardly anything at all,
except that pressure of the cup on your skin. With medium suction you
can feel a "drawing" or "pinching" of the skin. At more extreme
suction you will feel "painful pinching". A skilled cupper will put
cups on with medium pressure.
Depending on what kind of cupping technique you are having done, there
are other concerns. Any type of cupping involving fire produces some
anxiety in the general populace. The concept of having an open flame
near your skin generally is not what most people consider
"relaxing". It is important to note that most practitioners have
practiced their technique on themselves first, so they have learned
first hand what getting too close means. A good cupper will have
practiced a lot on them self before even thinking about trying it on
another person. Thus what people usually feel when being "fire" cupped
is pretty much the opposite of what they expect. Fire cupping
generally uses glass cups because of durability and consistency and
glass cups at room temperature feel cold to your skin. This is
important because the temperature of the glass is what causes the
heated air inside to contract once the cup has sealed against the skin.
So despite the fact that it is called "fire" cupping, it is usually
the pressure of cold glass that you feel on your skin. After a few
seconds of contact the glass will warm a bit, but expect it to be a
bit cool.
One of the other issues that almost always is discussed is the marks
that cupping tends to leave. It can truly look like you had a fight
with an octopus for several days. Or you can have redish rings from
the edge of the cup that last a few hours. Or, if the cups are on too
tightly, you can have bruising show up. The marks that normally come
up under cups (redish brown to black in color) look like Hickeys. Some
western medical practitioners have defined the mark to be a bruise like
a hickey. However in my experience and from my teachers it is not. A
medium pressure cup may produce color that does not yellow or fade
like a true bruise, and not hurt like a bruise. Chinese practitioners
call this mark "Shaw". In my experience it does not affect the
effectiveness of the treatment whether or not color comes up. There
are people who swear that "shaw" is an indicator of past or current
issues, but I have cupped over areas that benefited from it and no
color came up at all. In rare occasions I have seen small blisters
come up under the cup. Depending on the illness of the client, they
have been either filled with clear, or a strange bright orange
fluid. These blisters can either be left alone, (your body will take
care of them) or popped and treated with an anti-biotic cream and
covered with a bandage until they heal over (a couple of days). I do
need to stress though that I have RARELY seen them. A
D.O. hypothesized to me that the "shaw" was red blood cells that had
migrated from capillary beds into the surrounding tissue without
breaking the actually capillary bed (thus not meeting several
requirements for a "bruise".) In any case, it is wise if you
are going to be donning a swimsuit or evening gown that reveals parts
of your body and you do not wish to be explaining what you have done
that you do not engage in cupping at that time.
When should I NOT have cupping?
It is important to note that cupping is a relatively non-invasive
technique. As such you generally don't have much to worry about with
it. But there are times when it is best NOT to have it. There are
some rules you should follow. DO NOT GET CUPPED IF YOU HAVE ANY OF
THESE CONDITIONS:
1) High fever and/or convulsions
2) Moderate to severe cardiomyopathy
3) Hemophilia
4) Generalized edema (swelling)
5) Areas with skin ulcers or an unhealed wound
6) Extreme debility with loss of skin elasticity
7) Women during pregnancy
8) Very young children or weak elderly people
Cups should also not be used over thin muscles, uneven bony structures
or over extremely hairy areas. Have some common sense. Cupping is not
a silver bullet.
Index of References
Wikipedia
The American Cancer Society
The International Institute for Islamic Medicine
Institute for Traditional Medicine
CBS News
Shiatsu Place
Krystian's Blog
The Mr. Science Show
Classics in the History of Psychology
Virtual Finland
Pittsburg Post-Gazette
PBS
Squidoo
Christine Lee Zilka Blog
Azerbbaijan International
Estonian Folklore
Kean University
Muslim Heritage
Ummah
And in addition I used the information given to me in class at Big Sky
Somatic Institute. If you would like a link to any of the above
sources, please email me.
Return to Wood Tiger Massage.
