Being a massage therapist requires that we develop good communication skills to simply and easily convey key concepts about our practice to our clients and to referring medical professionals. Clients and others frequently have questions about massage cupping.

Being a massage therapist requires that we develop good communication skills to simply and easily convey key concepts about our practice to our clients and to referring medical professionals.

Clients and others frequently have questions about cupping. Here, I’ve highlighted some of the most common questions I hear at my clinic and which I imagine any therapist involved in cupping hears as well.

Now you’ll be armed with answers.

“What is Massage Cupping?”

The term cupping often brings these traditional images to mind, even when modified to names like massage cupping, modern cupping and contemporary cupping.

In the work we teach to spa and medical professionals and use in our clinics, we are doing pure manual therapy using vacuum cups.

The term vacuum manual therapy accurately describes these techniques and can help avoid misconceptions people may have about cupping therapies.

Traditional cupping is widely used in Chinese and Ayurvedic Medicines with superb results, and the use is based on medical systems that require years of study and experience to master.

Massage therapists use the same tool, massage cupping, in a very different way to influence soft tissue, adding an amazing component of decompression of the tissue to the treatment.

“What is the Massage Cupping Technique Used For?”

Vacuum manual therapy is mainly used to:

  • Separate adhesions in tissue payers and create space in the fascia;
  • Liberate trapped inflammation;
  • Liquefy and stimulate lymph drainage;
  • Sedate and regulate the nervous system;
  • Relieve pain;
  • Soften and minimize scar tissue; and
  • Release rigid tissue and compensatory patterns.

These basics can apply to such conditions as diabetes, arthritis, dense breast tissue, scoliosis. They can also be applied to athletic performance enhancement.

Each client is assessed and a custom protocol developed, including adjunct health care professionals. It is critical for successful results that a cross-referring team is working together.

“What Are Those Circular Bruises?”

There have been many cup-mark sightings in the last decade—from those on prominent athletes in the Olympics to stars on the red carpet, all sporting the circular discolorations that often occur when a cup is left in place.

While aggressive suction or stationary placement of a cup can actually bruise and damage the tissue, the marks most often are created by the vacuum pulling old debris up to the underside of the skin.

Most clients can identify the debris-causing incident in their past: falls down stairs, falls from horses or other injuries. Others have created the debris from chronic movement patterns such as hammering, lifting weights or loading freight.

In vacuum manual therapy, the vacuum cups are kept dynamic and liberate the debris from the tissue without pulling it all up to the underside of the skin. This avoids a hyper-congested state that the lymph system has to work harder to eliminate, along with avoiding damage to superficial lymphatic terminations.

Some people will get discolorations much more easily than others, and this will reflect their life history, genetics, general health and habits.

Care must be taken when working with clients who have any vascular weakness, for example, to avoid damage. Those who have been exposed to gases and radiation also require a light and brief exposure to vacuum therapies to eliminate these toxins from their body slowly.

While circular marks are certainly not the goal of using vacuum cups, it is beneficial to eliminate the debris from the tissues. This congestion can restrict movement in a joint by binding tissue together, and also block fluid flow to and drainage from the tissues.

“How Will I Benefit From Cupping?”

Each client is a wonderful mystery to unravel, and cookie-cutter protocols just do not get the same massage cupping benefits for everyone.

The best exposure is a little demonstration of the techniques, and that is easy to do during their session if you have discussed it prior to going into the treatment room.

When we can identify what events and actions got their body to the place is, they can begin to understand that the impact of life events stays with them much longer than they thought.

I love to share anecdotes from clients, such as:

I had a client last year with severe scoliosis who had been treated surgically from childhood with Harrington rods, metal plates and screws used to keep her spine from curving more as she grew.

I only got one session with her, but through observation and questioning we discovered a very good possibility that a fall down cement stairs on her head at around age 3 could be the origin of this issue.

She was able to lay flat on the table after the session, so this is a great indicator of the potential to reverse that old damage and let the surgically implanted devices support some very new positioning.

I explain that recovery is a process and not an event. It took this client’s body years of compensation to keep her upright and active in this world. While we should see measurable progress, it has to be done at a pace that enables the body to assimilate changes.

“How Will My Patients Benefit?”

This is when it is beneficial to have some before-and-after pictures. Physicians and their staff very often have little time, and pictures of drastically reduced scars and swelling will make an impact.

Measurements of changes in ROM or other issues you have worked on with clients create data that gives a solid picture of potential patient progress.

It is important that the physician understands that this complements their work. Ask the physician or staff member if they have any issues that you could demonstrate this work on and set up an appointment for a complimentary session.

Keep the discussion geared to their specialty, and explain that for all surgical applications it is recommended to prepare the patient for a few weeks prior to the procedure to clear lymph and increase blood flow to promote quick recovery of tissues, as well as post-surgical treatments for any scars or restrictions, and to move surgical blood and lymph out of the area.

It is especially important to do more than a few weeks of preparation when working with bariatric surgery patients. Assisting their body to eliminate excess lymph prior to surgery helps decrease strain on the heart.

When you do your follow-up call after the complimentary session, it is a good time to ask if they would pick four to six of their most challenging patients to send for treatment so those results can be documented. It can be beneficial to offer a special discount to these patients.

A physician might ask about research on cupping. Some recent studies that include benefits of cupping include:

“Effects of Traditional Cupping Therapy in Patients With Carpal Tunnel Syndrome: A Randomized Controlled Trial” (The Journal of Pain, 2009);

“Pulsatile dry cupping in patients with osteoarthritis of the knee–a randomized controlled exploratory trial” (BMC Complementary and Alternative Medicine, 2012); and

“The effect of cupping therapy for low back pain: A meta-analysis based on existing randomized controlled trials” (Journal of Back and Musculoskeletal Rehabilitation, 2017).

Training and Experience Are Key

The key to explaining vacuum manual therapy is to have thorough training and some experience with the techniques. (And massage therapists who offer cupping should possess a liability insurance policy that covers them in case of client accident or injury.)

One great way to attract clients who have the issues you want to work with is to give a demonstration and talk at support groups for the applicable condition, and another wonderful way to get lots of pictures and data is to offer a free clinic day one-to-six times each year.

About the Author

Anita Shannon, LMT, has been licensed in massage therapy and cosmetology since 1983. An educator since 1990, she appears at national chiropractic, massage, and spa conventions and currently presents workshops on ACE Massage Cupping and MediCupping at international locations since developing these brands of bodywork in 2002. She has created five educational videos on vacuum therapies. She was inducted into the Massage Therapy Hall of Fame in 2011. Shannon is a regular contributor to MASSAGE Magazine, and her articles include “The Most Overlooked Tool for Effective Rehab” and “Lymphatic Liquefaction Using Vacuum Cups” (March, in print).

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