In the realm of massage tools, practitioners are constantly seeking innovation to optimize treatment outcomes and provide a holistic approach to client care. Among the massage tools that provide enhanced therapeutic outcomes are cups, scraping tools and tape.
Cupping therapy, scraping—also known as instrument-assisted soft tissue mobilization (IASTM)—and taping share some common uses in therapeutic treatment and may be beneficial as additional modalities offered in your practice. Integrating cupping, scraping and taping techniques into a massage therapy practice can offer several benefits for both the therapist and their clients.
All three of these modalities are non-invasive and require minimal training on top of your manual therapy education. Each uses specific tools and various techniques that aim to enhance your manual therapy treatments.
Powerful Massage Tools
Cupping, scraping, and taping have emerged as powerful tools that enhance therapeutic massage outcomes and provide added value to clients.
With their ability to stimulate mechanoreceptors, promote blood flow, encourage collagen deposition and decrease pain, these techniques go beyond traditional massage and manual therapy. They offer visible and measurable results, empowering clients to actively participate in their healing process and maintain the benefits of treatment long after the therapy session.
As massage therapists continue to explore innovative modalities, cupping, scraping and taping have become indispensable components of a treatment toolbox. By combining ancient and modern practices, practitioners can achieve remarkable outcomes and elevate the standard of care in the field of manual therapy.
Cupping and scraping techniques are based on older modalities, while taping is a more recent invention. Cupping, scraping and taping have emerged as valuable tools in the hands of skilled therapists and offer unique benefits that go beyond traditional massage.
This article explores the insights of experienced practitioners Paul Kohlmeier, Michelle Roos, Nikita Vizniak, DC, Brad Norris and Aubrey Gowing to shed light on the therapeutic potential and added value these techniques bring to the table.
Cupping: Contemporary Practice
Cupping, an age-old therapeutic modality, has gained significant attention in recent years. With roots in traditional medicines all over the globe, it involves placing cups on the skin and using suction to create the intervention.
As a modality that is practiced in a modern medical setting, we look to research to tell us how it may be used, and if it is beneficial. Paul Kohlmeier says that research indicates cupping increases range of motion and decreases client’s perception of pain and disability.
Additionally, it may induce cellular responses, encouraging tissue remodeling and decreasing inflammation in areas of the cups are placed. There are even some preliminary studies on using it as a manual lymph drainage treatment.
Aubrey Gowing states that the visual impact of cupping (and scraping), characterized by the striking changes in skin coloration, serves as both validation and motivation for clients. These visible changes are often accompanied by tangible benefits, such as improved range of motion and reduced adhesions.
Cupping can be a powerful complement to manual therapy, providing quick and measurable results that leave clients reporting feeling “lighter” in the area that was treated, and more empowered, especially if cups are given to them to do home care with.
Scraping: Unlocking the Fascial System
Historically, scraping has been practiced in many cultures. In Chinese medicine, it is called gua sha. In ancient Roman and Greek medical practices, an implement known as a strigil would be used to scrape the body after olive oil had been applied. These, and other cultures, have historically used scaping as a way to keep people healthy.
Scraping, known today as instrument-assisted soft tissue mobilization (IASTM), involves the use of specialized tools to treat various musculoskeletal conditions. Nikita Vizniak, DC, emphasizes that scraping stimulates mechanoreceptors in the skin, fascia, muscles and ligaments, triggering reflexes that enhance blood flow and reduce pain. It also encourages collagen deposition along lines of stress, promoting tissue health and optimizing movement recovery.
By strategically integrating scraping with movement and exercise strategies, therapists can restore kinetic chain function and mitigate pain. The application of scraping techniques not only reinforces the benefits of manual therapy but also empowers clients to continue self-care practices beyond the treatment session.
Taping: From Support to Rehabilitation
Taping has long been a staple in the world of sports and athletic performance, but its clinical applications have expanded significantly. Historically, it has been used to limit motion. This tape has been strong, with good adhesive and no stretch. With advances in materials, the types of tape have changed and has given rise to different taping methods.
Brad Norris highlights the role of kinesiology tape as a therapeutic tool that can enhance motor control when combined with manual therapy and corrective exercises, without limiting range of motion. It works by mechanically decompressing the skin and fascia, facilitating neuro-fascial “slide and glide” mechanics and optimizing communication with the central nervous system.
Aubrey Gowing emphasizes that taping provides clients with a tangible take-home tool that prolongs the benefits of treatment. It can improve range of motion, ease movement and alleviate pain.
Taping serves as an effective adjunct to reinforce the effects of therapy between sessions, providing ongoing support and facilitating adherence to rehabilitation exercises. Furthermore, therapists benefit from tape’s ability to assist in retraining the nervous system and reducing concerns about non-compliant clients.
Precautions & Contraindications
While these modalities are considered safe, there are some precautions and contraindications to be aware of:
• Cupping, scraping and taping should not be applied over skin with open wounds, recent burns, infections or ulcers.
• Cupping and scraping should not be done over areas with inflammation, swelling or edema.
• Clients with bleeding conditions or those using blood-thinners should avoid cupping and scraping treatments, as they can cause bruising or bleeding.
• Some clients might be allergic to the adhesive used in the tape, it is wise to choose a small area to perform a patch test before applying tape to a larger area. It is also a good idea to use tapes with non-latex adhesives as latex is a common skin irritant.
Integration into Your Practice
Michelle Roos explains that all these modalities are easy to add into a manual therapy practice. All come with varied indications and contraindications, so a therapist should take a course in each of the modalities.
The certificate that is given for participation in the course should be enough to satisfy any liability insurance conditions. Of course, check your state or local massage therapy regulations to make sure there are no restrictions on practicing any of them. Most of these modalities are taken in continuing education format, normally one or two days in length.
It is also very important to take a course based on evidence and current medical thinking. As health care practitioners, there is an ethical obligation to apply treatments that have some science behind them, to tell clients things that are true and to tell it in a way that does not break their idea of how their body works.
Similarities Among Modalities
These modalities have many similarities. Cupping, scraping and taping can create a change in local blood flow, which may or may not be part of their outcomes. This increase in blood flow has been put forward as a possible mechanism for these modalities’ therapeutic action; however, not enough science exists to make a strong case for this as the method of action.
These modalities may alleviate pain or discomfort by targeting the nervous system in general. In addition, they can influence the body’s healing processes, as well as promote tissue organization and remodeling, and resolution of the inflammatory cycle.
Cupping, scraping and taping are often used to reduce pain and improve range of motion. Depending on how it is applied, the suction created by the cups and the sensation created by the scraping or taping can have a soothing effect on the nervous system and promote relaxation. This in turn may decrease muscular contraction, thus increasing range of motion and decrease pain overall.
Scraping techniques use special tools to apply controlled pressure and friction, helping to remodel tissues where there has been previous injury. Cupping can do the same with suction or shearing forces from the cups being moved or the tissue beneath the cup being moved.
Both modalities may help to apply force on newly repaired tissue in order to allow for remodeling of the tissue along lines of force over that tissue. They may do this directly by their application or as a side effect from increased range of motion and decreased perception of pain, allowing the client to move more during their daily life, after the treatments.
Certain taping techniques, as well as certain cupping techniques, may help reduce swelling by improving lymphatic drainage. These are usually specialized techniques within these modalities. These are commonly used and certainly seem to have some anecdotal evidence, although there is a lack of research to back these treatments.
Depending on the type of tape and techniques used, your results may vary. Restrictive taping may help provide additional support and enhance stability of joints and muscles during physical activities, therefore reducing the risk of injury or re-injury. Kinesiology taping techniques can also be used to assist in better kinesthetic awareness leading to better movement patterns. Either may assist in rehabilitation and better athletic performance outcomes for our clients, depending on the state of the injury.
All of these additional modalities can complement the effects of massage therapy by adding to or extending the therapeutic benefits of treatment.
Research-Based Practice
It is important to stay current with new research as it becomes available as the scientific evidence supporting these techniques is still evolving.
Here is an overview of research into cupping, scraping and taping:
Cupping:
• In a meta-analysis of cupping, H. Cao, et al (2012), found that cupping therapy was significantly superior to other treatments alone in patients with certain medical conditions that they would be treated in hospital for, including chronic neck pain.
• R. Bridgett, et al (2018), conducted a systematic review suggesting that cupping therapy may be beneficial for perceptions of pain and disability, increasing range of motion and reducing creatine kinase when compared to mostly untreated control groups.
• S. Kim, et al (2018), explored the effects of cupping therapy in a systematic review. Cupping was found to produce significant improvement in function and quality of life in patients experiencing neck pain.
Scraping:
• A. Nielsen, et al (2007), investigated the analgesic effect of Gua sha in patients with chronic neck pain and found that it provided immediate pain relief, increased microcirculation in the treated area, and altered levels of certain substances in the blood related to inflammation and immune response.
Taping:
• MD Thelen, et al (2008), conducted a systematic review and found some evidence supporting the use of taping in reducing pain and disability in individuals with musculoskeletal conditions, such as patellofemoral pain syndrome and ankle sprains.
• S. Williams, et al. (2012) examined the effect of therapeutic taping on sports-related musculoskeletal injuries and concluded that taping could provide short-term pain relief and support for injured tissues, potentially enhancing performance and reducing injury recurrence.
Expand Treatment Options
Adding additional modalities to your practice expands your treatment options, sets you apart from other therapists and allows you to service a wider range of clients if you don’t have a specific niche.
Clients might request cupping, scraping or taping for specific conditions, injuries and chronic pain or you may suggest them. Learning these modalities will allow you to provide more services that may increase your client and referral list, client satisfaction and client retention.
Cupping, scraping and taping can be easily applied in various clinical settings. The order in which cupping, scraping and taping are applied will vary depending on the assessment results, treatment goals, the practitioner’s professional preferences, and the client’s condition. They can be selected individually or combined within each treatment to create a customized experience for each patient.
Whether you are applying relaxation-based treatments, sports massage related or rehabilitative therapy, these modalities can be applied as an adjunct therapy, making your practice more versatile.
“Everybody loves when an experience exceeds expectation, and massage clients are no exception,” said Gowing. “So when a therapist incorporates tools like cupping, scraping and taping into their treatment session, the client feels as though they have gotten more then just a massage—especially when they leave the treatment room with tape applied or they have a cup or scraper for self care.
“They have something to take home, something that empowers them, something they can use to continue the benefits of treatment, long after the therapy session,” Gowing added. “This drives a powerful feeling of added value for the client.”
About the Authors
Paul Kohlmeier is a research nerd at heart and enjoys lecturing on evidence informed materials to elevate the practice of manual therapy. Kohlmeier runs a mobile massage practice and is co-owner of Cupping Canada and Cupping USA with his wife, Michelle. He is the education manager and responsible for course creation and teacher training program for Cupping Canada, as well as a production manager for the 60 Minute Series and the Cup, Scrape, Tape Symposium.
Nikita Vizniak (aka ‘Dr. Nik’), BSc, DC, ERYT, RMT, CES is a collection of ~214 bones, ~472 joints, and soft tissues that loves to learn, teach and help people reach their optimal potential. He is an author, clinician and professor of clinical cadaver anatomy, exercise therapy, orthopedics, joint mobilizations, and a globally recognized subject matter expert.
Michelle Roos, LMT, LE, is an entrepreneur, author, and mobile massage therapist in South Florida. She is the owner of education company, Mobile Massage Mastery and helps therapists create and elevate their mobile massage practice. She is co-owner of Cupping Canada Inc and Cupping USA, with her husband Paul Kohlmeier..
Brad Norris is a recognized and awarded educational professional with over 30 years experience teaching at both the secondary, post-secondary and professional corporate level across multiple disciplines advancing curriculum in the fields of physical education, rehabilitation and movement science.
With 33 years of clinical experience as a massage therapist and 28 years of teaching experience at Holistic College Dublin, Aubrey Gowing possesses extensive expertise in the field. After transitioning to an instructor role in 1994, Aubrey became a registered ITEC instructor, approved to teach various components of Holistic Massage, Anatomy & Physiology, and more.