Because of a recent back injury, I decided to try what Michael Phelps made popular at this year’s Olympic Games: cupping therapy. I popped in for a session with Lisa Sherman, a local acupuncturist who offers this therapeutic approach.
Traditionally, cupping involves heated glass cups that are applied to the body to create suction. Sherman, however, uses no heat and instead applies pressure via silicone cups, when released, pull the oxygen out, she says. “It exerts negative pressure as it pulls the tissue up,” says Sherman, who studied molecular biology at Kings College in London and acupuncture at the University of Westminster. Cupping is similar to massage in that both squeeze and pull muscles to bring relief — one with the hands and the other with cups, she explains.
For me, the effect was a week with reduced back pain and some purple dots on my skin.
Historically, cupping may go back to 3000 B.C., but it was first recorded on Egyptian papyrus in 1550 B.C. The therapy was a part of Egyptian, Arabic and classical Greek medicine. In this country, it became commonly used in Appalachian folk medicine.
Many acupuncturists use fire cupping, using a glass cup that resembles a Mason jar, Sherman says. A flame produced on a cotton roll and held inside the jar consumes oxygen; then the flame is removed and the cup is flipped onto the skin so that suction and vacuum are created. That’s also the traditional Chinese method of cupping, but modern advances have offered safer methods to prevent burns. Sherman, for example, uses oil on the skin and a silicone cup that she slides across the body. The cup sucks the muscular tissue into it, thus removing oxygen. Pressing down on silicone cups or using a cupping gun draw out the air and pull the skin into the cup.
“Static, or stationary cups, and gliding, the action of moving the cups along the skin, are the two main techniques,” Sherman notes. “You can see the tissue go pink when blood is drawn into it,” she says. “With a small amount of suction you get pinkness, and you might see red dots start to appear and then purple dots. … You are increasing blood supply to the tissue, which brings in things that are good, like oxygen and nutrients, and takes away things that are bad, like lactic acid and byproducts of metabolism.”
Sherman wrote her dissertation on the topic, so she understands the molecular process involved.
If a client has an injury or muscle atrophy, the tissue gets stagnant, she explains, and there are microadhesions in the tissue that eventually cause the tissue to become “shrink-wrapped.” Muscles that would normally contract and release nicely end up becoming stuck together. Over time, muscles that have been injured cause inflammation and then fibrosis (where fibers knit muscle together), causing them not to release, Sherman says.
Cupping pulls blood into the tissue, stretching the muscle and helping reduce adhesion as well as inflammation. The pressure and vacuum break the capillaries in the tissue, which is what Phelps brought to the public eye by showing the big purple spots on his body after treatment.
The process “causes microtrauma to the tissue; when the body comes in to fix the microtrauma, it goes in … and mops it up,” says Sherman. “Tiny trauma to the tissue is like waving a flag to the immune system to come fix it. Chronic inflammation happens when the trauma doesn’t switch off, but transient inflammation like cupping is part of the healing process.”
There is some evidence of the salutary effects of cupping, but it is limited, Sherman says. A 2016 study, in which cupping was applied to 60 people with neck and shoulder pain, showed decreased pain by 6 points on a 10-point scale.
Anita Shannon, owner of MediCupping and VacuTherapies in Asheville, was a massage therapist for 32 years before she got hooked on cupping. Shannon was inspired by the effects of cupping and created her own prototype for a cupping device, the MC-600 MediCupping Machine, which performs what she calls VacuTherapy or Medi-Cupping. “We work with surgeons who do pre- and post-surgery, and we work with a lot of patients who have had a mastectomy,” she says. “We go in with the [MediCupping] vacuum and work with scar tissue to increase range of motion. We’ve seen some doctors’ eyeballs pop out, they were so surprised [by the results].”
The machine, a pulsating vacuum that sucks the skin into a cup and then releases it, has several intensity settings and different-sized cups. It makes a gentle hum.
Shannon trains licensed professionals — including massage therapists, nurses, physical therapists, occupational therapists and chiropractors — to do cupping. Her program, called Ace Massage Cupping, is offered in Asheville and around the country. Next year, Shannon says, she will turn her training center into a full-time clinic for vacuum manual therapy (aka MediCupping) that will focus mostly on mastectomy clients but also scoliosis clients. “We work on fascia [injury] that happened during trauma, which locks itself into a twist and keeps pulling the spine out of alignment,” says Shannon. She offers trainings at her Asheville clinic several times a year.
“It’s definitely a huge twist on an old tool, a kind of an updating,” Shannon says about modernizing the Chinese process, which included a flame, alcohol and glass cup, all of which could injure clients or pracitioners.
Cammie Townes Taylor became passionate about working with her hands as a massage therapist but opened her eyes to her own body mechanics while doing massage. She decided to investigate an alternative way of working on clients that was less taxing to her body. Taylor took Shannon’s course last summer. “The first step is to take a step back and remember my body, and how it feels is as important as the client’s. That is why I was drawn to cupping,” says Taylor, who integrates cupping into her massage therapy. She notes that cupping can be a beneficial tool that helps practitioners sustain their own practice.
According to the American Massage Therapy Association, the average career span for a massage therapist is seven years, and for some it is a much quicker burnout. “Cupping came into play because it’s helpful with the nitty-gritty stuff that saves my hands,” says Taylor, who uses several sizes of cups as well as magnetic cups.
“I don’t want to lose the tranquility and deep focus pressure of a massage, but I see cupping as another tool on my tool belt for when it is appropriate to integrate into work,” says Taylor, who has an office at the Point Collective in West Asheville. She likens cupping to using a metal detector: As she glides it along, the cup may come to a halt where “the fascia is gummed up and there are adhesions, and I will let the cup rest there and be stationary,” she says.
“I try to follow lymphatic passageways, break up adhesions and move pooled lymph back to lymph nodes to help flush old blood out and bring in new oxygen rich-blood,” Taylor explains.
Donna Ginther started having massage with Taylor the relieve the symptoms of hereditary lymphedema, which causes swelling of the legs. The therapist suggested cupping because it would help with the fluid buildup in Ginther’s legs. “The first session we did was phenomenal,” Ginther says. “She was moving the fluid, which sometimes is so solidified. She would cup and then massage, and I could literally feel her move the muscle and fluid, and it kept the fluid off my legs for almost two weeks.”
Taylor was able to move the fluid more effectively with the cups than her hands, Ginther says. “Normally, when [Taylor] does stretching of the muscle with massage, I will have some relief from leg pain, and for two to three weeks I can walk without a cane.” But with the addition of cupping to her massage therapy, she went almost six weeks without a cane, she notes.
“I think you use every tool you can,” Ginther says, “and I think cupping has a place in that.”