You've probably seen them at the swimming pool: neat purple circles across someone's back. That's cupping. It's one of the oldest hands-on techniques still in use, and I sometimes use it alongside acupuncture in my clinic.
What is cupping?
Put simply, it's suction on the skin using a cup. The cups can be glass, ceramic, bamboo or plastic. To create the suction, I either warm the air inside the cup with a quick flame before it goes on, or use a small pump to draw the air out once it's in place.
Practitioners around the world use several kinds of cupping, including wet cupping, where the skin is pierced first. I don't do that. I only use dry cupping, so the skin is never broken, and I use it in two ways:
- Static cupping. The cups stay in one place. How long they stay on and how strong the suction is both vary from person to person. I'll usually start light and short, and build up over time if it suits you.
- Moving cupping. I put a little oil on your skin so the cup can glide, then move it slowly across the area, a bit like a massage. The oil also protects your skin from the edge of the cup.
The cup stays put. Suction lifts the skin gently upward; how strong and how long it holds decides how deep the mark goes.
A little oil lets the cup glide slowly across the muscle instead of staying in one spot, more like a deep, slow massage.
Where does it come from?
Cupping has roots in both China and the Middle East, goes back a very long way, and is still used all over the world. In Chinese medicine it belongs to the same family of traditional hands-on techniques as gua sha, and both were developed in China around 2,000 years ago.
What does it feel like?
As the cup goes on, your skin is drawn up into it. Static cups give a steady, firm pulling or squeezing feeling. Moving cups feel more like a slow, rolling pull, rather like a deep massage. Plenty of people find both very relaxing. If a cup ever feels too strong, tell me and I'll loosen it straight away.
Why the marks?
The suction pulls on the skin and the tissue just underneath, and some of the tiny blood vessels near the surface break. What you're left with is a round mark the shape of the cup, anywhere from light red to dark purple. The marks usually fade on their own within about 1 to 10 days.
Nothing to worry about. It usually just means the suction was gentle or brief over that spot.
Common after a first cup or a lighter session. Usually gone within a day or two.
Usually means stronger suction or a longer hold, often over a part of the muscle that feels tighter. Tends to clear within about a week.
The deepest mark, most often the first time an area's been cupped, or somewhere very tight. It's just deeper bruising under the skin, and can take up to 7–10 days to fade fully.
What the mark is, and isn't: a cupping mark is bruising: the suction pulls on tiny blood vessels under the skin until some of them break. It isn't toxins leaving your body, and the colour isn't a way of diagnosing what's wrong with you. How dark a mark comes up mostly depends on how strong the suction was, how long the cup stayed on, and your own skin and blood vessels, which is why the same cup can look quite different from one spot, or one person, to the next. There isn't good evidence linking mark colour to any particular health problem. Whatever the colour, it fades on its own like an ordinary bruise.
One practical tip: if a doctor or nurse examines you while you've got the marks, mention that you've had cupping so they don't mistake them for an injury.
Michael Phelps and Rio 2016
Cupping hit the headlines at the 2016 Olympics in Rio, when Michael Phelps swam with those circles on his back and shoulders. He'd shared his enthusiasm for it on Instagram, and other US athletes, like the gymnast Alexander Naddour, talked openly about using it too.
Not everyone was convinced. Dr Tony Bartone told ABC News in Australia that there was no proven evidence it had a role to play, and that argument between popularity and evidence has never really gone away.
Does it work?
The honest picture is that the research is still fairly thin. There's some encouraging early evidence that it may help with pain, though the studies so far aren't strong enough to say much beyond that with real confidence.
Because of that, I don't offer it as a targeted treatment for a specific condition — but plenty of people love having it as part of a session simply because it feels wonderful and deeply relaxing, and I'm always happy to include it for that alone.
Is it safe?
Done by a trained practitioner with clean equipment, serious problems are rare, but cupping isn't completely risk-free. Most of the problems reported, such as burns, scarring and skin infection, can be prevented with good practice. Some people feel a bit tired, light-headed or headachy afterwards, and it can make skin conditions like eczema or psoriasis worse.
I won't use cupping during pregnancy, or on anyone with a pacemaker, haemophilia or cancer. I also avoid any area with a wound, a fracture or a blood clot (DVT). Please tell me if you take blood thinners such as warfarin or aspirin, or if you have a bleeding disorder, a skin condition, heart problems or any other long-term illness.
And keep taking anything your GP has prescribed. Cupping isn't a replacement for medical care.
If you'd like to know what a session with me involves, have a look at what to expect on your first visit.