• Sarah Shaw, PT, DPT

Cruisin' for a Bruisin'? Try Cupping: Not as Sucky as it Looks.

Made famous by the gold medal swimmer, Michael Phelps, cupping is an ancient treatment that comes from traditional Chinese medicine used to treat all kinds of ailments from migraines to high blood pressure and even fertility. Many physical therapists and massage therapists, however, have found it as a very useful tool to address pain. In Eastern medicine, cups have been used to address energies in the body that travel along meridians, which are pathways in which the energy flows. These are not anatomical structures and there are no conclusive studies to prove their existence, however, patients undeniably have benefited from the healing effects of Eastern medicine techniques including acupuncture and cupping. We've taken the Eastern medicine philosophy of energies (known as "qi") and meridians (energy pathways in the body) and integrated them into our Western medicine practices by using the cups on anatomical structures to make physiological changes for healing.


How it works: While massage uses positive pressure to reduce muscle tone and relieve trigger points, the suction from these cups uses negative pressure to gain a similar effect, reduce tension, and offer improved mobility to the tissues underneath.

Alongside therapeutic activities, cupping can be used as a helpful adjunct to physical therapy when the goal is to improve mobility, reduce fascial restrictions, or reduce scar tissue.


Fascia is a connective tissue that exists between layers of fat, skin, muscles, and organs in our body, holding everything in place but also allowing everything to slide and move around as needed—almost like a hairnet—containing everything but allowing movement underneath. Sometimes with injury, repetitive strain or movement, or poor posture, the fascia will adapt—and not always in a good way. Sometimes the fascia can get bunched up or caught in scar tissue or grow too tight—we call this fascial restriction or tension. The idea behind cupping is that it can create a suction on the skin that can lift the skin and tissue layers underneath, moving and releasing any restrictions in the fascia, superficial muscles, or in any scar tissue that exists.


Scar tissue is also a connective tissue that can sometimes get a little out of hand. Based on the depth, type of laceration, and genetics, scars can really differ! Scar tissue is great at its job—connecting the dots. However, scar tissue is not the same as the tissue that was there before and can sometimes go a little overboard, adhering to structures deeper than the surface. Cupping can help to soften scars, lifting them away from other structures underneath, improving texture, and scar mobility.


In my own practice as a pelvic floor physical therapist, I love using the cups for C-section scars or other abdominal scars to help improve pelvic floor disorders. I've also noticed decreased symptoms for my patients with endometriosis, and fibromyalgia—both chronic pain disorders that usually present with pelvic pain and back pain. Cupping can be helpful for other orthopedic conditions as well including back, neck, shoulder, or upper and lower extremity pain.


Would you benefit from cupping? Ask your physical therapist! It isn't for everyone. Here are some precautions to consider before giving it a try:


  • Cupping is not recommended over open wounds, active infections, inflamed tissues, fractures, severe ligament sprains, or tendon ruptures. It is also not recommended for active cancer patients, those with hemophilia or similar blood disorders, organ failure, or deep vein thrombosis. It is important to use extreme caution or avoid cupping for pediatric or geriatric patients.


What to expect: Cupping for the first time? Definitely expect some temporary skin discoloration in the areas being cupped. It usually looks like circular bruises (google "Michael Phelps cupping"). Sometimes a little local soreness is felt afterward. Make sure to drink extra water the day you receive cupping to address any adverse responses. Your therapist will explain ahead of time what technique is being used, how it may help, as well as any possible adverse expectations.


Sarah Shaw, PT, DPT, is a physical therapist specializing in pelvic floor rehabilitation at Rehab United's Bonita and Kearny Mesa locations. She received her Doctorate in Physical Therapy in 2019 from San Diego State University and has since been continuing her education in pelvic pain, women's and men's pelvic health, and Applied Functional Science. While the pelvic floor is her specialty, Sarah also treats other orthopedic-related injuries, ensuring a more well-rounded and holistic approach to pelvic health.

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