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Have you observed distinctive disc-shaped marks on the shoulder blades of your neighbors at the gym or in yoga class? Or perhaps you first spied the telltale round discolorations when watching Michael Phelps stroke to victory at the 2016 Olympic Games? Maybe you've witnessed the marks on an increasing contingent of athletes, both elite and novice, ever since? What are these marks, why do they vary in color, and why would someone seek out cupping?
Practiced in Chinese medicine for millennia, cupping creates gentle suction on the skin and superficial fascia, often leaving signature circular marks (1-3 inches in diameter) that gradually fade over one to 10 days. The decompression of cupping contrasts with most manual therapies (like massage) which use a compressive force. It is the suction that uniquely helps separate fascial layers that may be stuck due to injury or inflammation. This decompression improves circulation of blood and lymph, reduces pain and stiffness, breaks up fascial adhesions that restrict mobility, and optimizes tissue health, hydration and function.
Despite the unmistakable skin markings, cupping itself is generally not painful. When the cup is first placed on the skin you'll feel a gentle suction as air is removed from the cup. Mild cupping feels like a firm, pleasant stretching sensation, while more intense suction elicits a deeper pulling sensation. Many patients request it specifically because they know from experience the refreshing pain-relief and newfound tissue suppleness and mobility it ushers. I certainly relish the cupping treatments I receive!
Cupping techniques vary and are selected based on the patient's specific challenges. Some techniques leave nary a trace, such as channel cupping which involves gently pulling a lightly-suctioned cup over oiled skin along a meridian line. Other techniques involve a deeper static suction for longer duration, and often (though not always!) leave a temporary discoloration mark.
Experienced cupping recipients know that cupping marks vary a lot. Intriguingly, the mark itself – whether soft pink, deep red, purple, black, pale, grey, white, or even spotted with petechiae of various shades – is diagnostic. Cupping over healthy tissue elicits an even soft pink tone, regardless of the intensity or duration of the suction (within reason).
Annie Lindberg Cupping over challenged tissue can prompt an array of colors, each suggesting unique Chinese medicine diagnoses (such as heat, cold, or mild or severe qi and blood stagnation) each with distinct supplemental treatments. Over a handful of cupping sessions, the color evoked shifts toward soft pink. As the color improves so too does mobility, pain level, and tissue health.
Often folks are curious whether cupping marks are in fact bruises. Nope! Both involve skin color shifts but otherwise are distinct. Bruises form when blunt trauma causes blood capillaries to rupture. The result: subcutaneous bleeding, tissue damage, and often soreness. As the bruise heals it moves through a literal rainbow of colors from purple to red to yellow to green, as the hemoglobin under the skin is enzymatically broken down. Conversely, with cupping, tissue damage and pain are minimal to none as cupping does not generally rupture capillaries. Rather, cupping marks form when suction pulls fluid and blood cells through the endothelial cells that line the capillaries, toward the skin’s surface. As the fluid is reabsorbed by the lymph and blood vessels, the cupping mark fades in color without changing hue.
If you are curious to try cupping and yet would prefer no marks, just let your practitioner know, as he or she can often provide a gentle mark-free session so you can get a taste – still reaping benefits – and decide if you want to go deeper the next time.
Interestingly, though best known for helping with injury recovery, pain, and athletic performance (thanks to the cupping badges worn by prominent athletes like Michael Phelps, Kobe Bryant, LeBron James, Alex Rodriguez, and Tom Brady) cupping aids other ailments as well. When cupped along the relevant Chinese medicine meridians it can help with an array of concerns including chronic coughs, chest congestion, asthma, digestive issues, and various headaches and migraines.
If you're seeking optimal tissue health and mobility, improved blood and lymph flow, relief from stubborn pain or stiffness, or reprieve from other internal conditions, cupping may be a new friend! Of course there are several situations in which you would want to avoid cupping, or modify treatment location, intensity, or techniques, so be sure to seek out an experienced practitioner.
Annie Lindberg is a licensed acupuncturist, Chinese medicine practitioner, and Ayurvedic practitioner. She also holds a Masters of Environmental Studies. She owns and practices at The Point Acupuncture & Ayurveda, located in Madison Park and is a regular Madison Park Times health columnist.