OMT

MYOFASCIAL
CUPPING
Adding A New Dimension For You &
Your Patients
DISCLAIMER
• This presentation is solely for academic and professional
development purposes.

• The presenter does not own any of the research included in this
presentation and relevant references are given in the end.

• The pictures used here are only for illustrative purpose and do not
intend to promote any specific product or service.

• The pictures are either under creative commons public licence, or

these are referenced where used.
CONTENTS
• Introduction

• Background

• Known Benefits

• Technical Aspects

• Techniques of Cupping Application

• Mechanism of Action (Chemical, Neurological, Mechanical)

• Various Cupping Methods

• Contra-Indications and Precautions

• Methodologies

• Benefits and Applications

INTRODUCTION
• Myofascial Cupping Therapy is an alternative or traditional medicine
involving application of cups on to the skin.

• The application of the myofascial cups creates a local suction or vacuum

on the area where it is applied.

• The purpose of using Myofascial Cups is for easing the soft tissue restriction
by facilitating its release and mobilisation.

• Facilitates an improved blood and lymphatic circulation.

• The cups will have a similar effect that massage would have.

• Using the cups enables you to save your hands while giving the patient an
alternative treatment.
CUPPING THERAPY HISTORY
• Traditional therapy dating back to as old as 1500 BC.

• There is no concensus on its origin, but it has been present in ancient

Egyptian, Chinese, Greek, Indian and Korean civilisations.

• Chinese use of “Cupping” is the most widely known and is traditionally

called “Bu Huo Guan”

• The therapist would place the cup over the painful area or along an
acupuncture point (ashi).

• Typically cups are made from glass, bamboo, silicone or hard plastic.
BENEFITS….SOME MORE TEMPORARY THEN OTHERS.
• Improved blood circulation

• increasing lymphatic drainage

• Reduces pain by release of certain neurotransmitters (i.e. enkephalin)

• Enhances mobility by modulating the muscle stretch reflex

• Reduces sensitivity of certain areas of irritation and pain

• Targets trigger points to release without pain

• Facilitates mobilisation in tissue scars

• Alleviates the stiffness and viscoelasticity of tissues

• Enhances the length and capability of extension in soft tissues

THE CUPS
• Cup type

• Glass, Plastic, Silicone, Ceramic.

• Plastic and silicone are the most cost effective types.

• Cup shape

• The actual shape of the cup doesn’t change the treatment.

• The shape may show which part of the world you are from

• Japan or Europe – Bell Shaped or Round

• North America – Buffalo Horn Shape

• China – Rounded Shape.

THE CUPS
• Cup size….Depends what you are working and who you are working on.

• Smaller cups ranging from 0.60 – 1.50 inches in diameter are used for facial cupping therapy

• Small cups with a diameter of 1.18 inches are generally used on wrists

• Medium size cups of 1.54 inches diameter can be used on the biceps, calves and shoulders

• Larger cups with an average of 1.96 inches diameter are applied on thighs and back

• Cupping intensity

• Number of cups applied in a row

• Less is more (see the videos)

• Number of pumps

• Should be comfortable to the patient

• Duration of cupping application

• From 2mins – 60mins

CUPPING APPLICATION
• Number of cups
• Really is up to you.

• Use one or use many.

• Less is more most times and think of the treatment time you have and
what you are trying to achieve.

• To move or not to move?

• Patient can be stationary (i.e. relaxed, or stretched)
• Supine, Prone or Sidelying
• If patient has movement included in treatment, that could either be
active, passive or assisted.
MECHANISM OF ACTION - FLUID DYNAMICS

• You can expect certain chemical changes because of fluid motion.

• The changes in pressure could stimulate the lymph nodes and lymphatic
vessels

• Cupping creates and area of ischemia due to the suction

• Localised vasodilation occurs as a result, to address ischemia.

• An increased blood flow would help desensitise the area of local discomfort.

• This mechanism is exactly the same as certain massage based techniques

such as inhibition.
 MECHANISM OF ACTION - MECHANICAL EFFECTS

• May help with the tissues ability to glide over each other.

• Completely different sensation from the treatment as you are

mainly lifting and gliding the tissues (decompression) rather then

compressing through massage.

 MECHANISM OF ACTION – NEUROLOGICAL

• The irritable nerves can be desensitized by cupping

• Could potentially be used for treating various pain syndromes, (i.e. complex

regional pain syndrome / CRPS), hyperalgesia, etc.

• It is a good start before moving to the deeper or invasive techniques

• It can modulate pain by exploiting the pain control system of our own body

• It facilitates release of certain neurotransmitters (endogenous opioids) through a

controlled pain induction using cups.

• It can help with trigger points by desensitising the area.

 MECHANISM OF ACTION – NEUROLOGICAL

• It can improve mobility due to the modulation of the stretch-reflex

• To do that, cups are applied while stretching or with the patient moving
(passive or active), which stimulates the muscle spindles.

• Muscles being treated,

• Golgi tendon organ (GTO) is stimulated with the use of cupping

• A consistent stretch is, thus, applied to the tissue.

• Autogenic inhibition occurs, as a result.

• Muscle tone is inhibited and reduced temporarily.

LYMPHATIC DRAINAGE
• You need to create a pressure difference in order to drain the lymph into the lymph
duct, which is then drawn into venous system.

• The limb (undergoing treatment) can be elevated if possible but not essential.

• After applying cups, pump 10 times over the collection of lymph nodes (axilliary,
inguinal, or popliteal, etc.)

• For stimulating the lymphatic vessels closer to skin, slide by applying a gentle pressure
over the regions of limbs.

• To stimulate the muscle pumping, perfrom isometric movement 5x5 seconds will be a
good start. Always work within the patients capability.
TRIGGER POINTS

• The fibres need to be stretched locally and distally. Treat the whole body.

• First, locate the trigger point.

• For the trigger point, make an assessment of pain pressure threshold (PPT) –
on a scale of 1 to 10, with 10 being the maximum pressure.

• Cup size would depend on how large the area is being treated and the
patient size.

• Re-assess the pain score at the end, and re-treat if needed.

SCARS
• For relatively healed scars, you can cup over the scar directly with only a light lubrication.

• For fresh scars, you can cup to the nearby tissue and lubricant should be enough to avoid
irritation or dehiscence of the scar.

• For increasing the length of tissue,

• You need to increase the local deformation of the tissue

• You can apply cups along the tension line, so that the tissue is stretching with a bearable suction
over it.

• The cupping needs to last at least 2 minutes over the area.

• For a long lasting effect, multiple repetitions are needed, so you can teach your patient to
perform this technique at home.
CONTRA-INDICATIONS AND PRECAUTIONS
• Although cupping is an effective and safe technique, it does have some contra-indications
and precautions to follow:

• DO NOT apply for patients with a clotting disorders or anticoagulants.

• DO NOT apply with patients of various arterial or venous diseases.

• DO NOT apply to pregnant patients, especially in first trimester. For later than that, a doctor’s
approval would still be needed.

• DO NOT apply cupping over rashes, inflammed skin, active infections, open wounds (or the slow-
healing ones), hernia or its repair site.

• DO NOT apply over nose, eyes, ears, or reproductive organs.

• If patient is sensititve to bruising, you should be careful with cupping.

• It is always better to consult the primary care physician whenever you are hesitant to do cupping.
AFTER TREATMENT EFFECTS
• The patient will see cupping marks but they do not represent unhealthy tissue or stagnant blood.

• These marks may last upto a week, as it is due to rupture of small capillaries.

• There is a risk for the rupture of blood vessels close to skin. That would leave a dark bruise that may
last up to 3 weeks.

• The redness is temporary, and occurs due to vasodilation.

• The soreness can last up to two days, although it may go away within few hours.

• PLEASE NOTE: More bruising does not mean a better treatment. Ideally we want to create the least
amount possible.

• Generally the bruising (if present) does not hurt the patient at all.
REFERENCES
• Aboushanab, T. S., & AlSanad, S. (2018). Cupping therapy: an overview from a modern medicine perspective. Journal of acupuncture and meridian studies, 11(3), 83-87.

• Al-Bedah, A. M., Elsubai, I. S., Qureshi, N. A., Aboushanab, T. S., Ali, G. I., El-Olemy, A. T., ... & Alqaed, M. S. (2019). The medical perspective of cupping therapy: Effects and mechanisms of
action. Journal of traditional and complementary medicine, 9(2), 90-97.

• Cavlak, M., Özkök, A., Sarı, S., Dursun, A., Akar, T., Karapirli, M., & Demirel, B. (2015). Iatrogenic artefacts attributable to traditional cupping therapy in a shotgun fatality. Journal of forensic and
legal medicine, 35, 26-28.

• Christopoulou-Aletra, H., & Papavramidou, N. (2008). Cupping: an alternative surgical procedure used by Hippocratic physicians. The Journal of Alternative and Complementary
Medicine, 14(8), 899-902.

• Jan, Y. K., Hou, X., He, X., Guo, C., Jain, S., & Bleakney, A. (2021). Using elastographic ultrasound to assess the effect of cupping size of cupping therapy on stiffness of triceps
muscle. American Journal of Physical Medicine & Rehabilitation, 100(7), 694-699.

• Lowe, D. T. (2017). Cupping therapy: An analysis of the effects of suction on skin and the possible influence on human health. Complementary therapies in clinical practice, 29, 162-168.

• Mehta, P., & Dhapte, V. (2015). Cupping therapy: A prudent remedy for a plethora of medical ailments. Journal of traditional and complementary medicine, 5(3), 127-134.

• Musumeci, G. (2016). Could cupping therapy be used to improve sports performance?. Journal of Functional Morphology and Kinesiology, 1(4), 373-377.

• Tham, L. M., Lee, H. P., & Lu, C. (2006). Cupping: from a biomechanical perspective. Journal of biomechanics, 39(12), 2183-2193.

• Warren, A. J., LaCross, Z., Volberding, J. L., & O’Brien, M. S. (2020). Acute outcomes of myofascial decompression (cupping therapy) compared to self-myofascial release on hamstring
pathology after a single treatment. International Journal of Sports Physical Therapy, 15(4), 579.

• Zeng, K., & Wang, J. W. (2016). Clinical application and research progress of cupping therapy. Journal of Acupuncture and Tuina Science, 14(4), 300-304.