Cupping Therapy, Part 6- Types and Styles


Types of cupping

  1. Weak or light cupping: This is just as it says, light and easy.  One pump or so, left for a short time, to begin the stimulation of the movement of the fluids.  This is great for first timers, children, the skeptical, and frail.


  1. Medium or strong cupping: As you work up to this level, you will see more stagnation and more movement of the fluids.  This is, in my opinion, the best technique.  You can work up to it either over multiple visits/treatments or during a treatment.  Basically an extension of weak cupping.


  1. Moving cupping: (Negative Pressure Massage) this is a great technique for muscle pain, and for stress care (Emotional, mental, spiritual or energetic).  Use the meridian charts to move the energy and stagnation out, as well as to enhance or reduce the flow of Qi energy.  You can use oils to help the cups slide across the skin.  It is difficult on bony areas and areas that are in corners etc… Finnish cups are either silicone or a form of latex that are flexible and work really well for muscle tightness.   You can also affect the myofascial system greatly with this technique.  Similar is a technique of pulling or moving the skin that is held under the cup.


  1. Needle or puncture cupping: Also called wet cupping.  In this technique, though, we are using cupping along with acupuncture and are only attempting to get one drop of blood.  This causes a healing event and can help the body with swelling and with chronic issues.  Proper technique requires good cleaning and sterile equipment.


  1. Moxa or hot cupping: Sometimes a piece of paper is set alight and placed in the cup.  Usually when the cup is placed on the body the paper burns away and sticks to the top of the cup.  It can burn the patient.  It can be infused paper with certain herbs, or have certain prayers of sayings written upon them to enhance more subtle healing.  I do not prefer this, as again we are playing with fire… on many levels.


  1. Empty or flash cupping: This is a misnomer really; it is very quick and repetitive to get some redness.  We are not leaving the cups on more than a couple moments.  Good for use on the face, and some areas that have lots of vascularity or lymph tissue.   This is also good for the very fatigued as it can increase Qi energy movement.


  1. Wet or bleeding cupping: Found typically in western medicine and Middle Eastern medicine.  Here, cuts are placed in the skin then the cups pull out the stagnant blood or morbid humors[1]… This is a big hazard for infection, but even so,  it is quite popular.  The blood needs to be properly discarded and cleaned.  I find it disagreeable and rather advanced.  I do not think I would have it done to me unless I was in a dire condition.


  1. Herbal cupping: Placing herbal liquids or tinctures in the cup can help deliver them into the tissues directly.  Works great with tinctures made with alcohol.  No burning is necessary.  We can do this one with the vacuum cups.  It can be messy and may cause some irritation on the skin.


  1. Water cupping: The cups are placed in very hot water and then placed on the body; this heat transfer causes the vacuum phenomenon.  It is primarily used with either horn or bamboo cups.  We do not use it because it can also burn the person as well as create a wet mess.


  1. Fire cupping: This involves the use of spirits such as rubbing alcohol as the fuel.  The fuel is rubbed inside the cup and set alight, then the cup is placed on the body.  The fire depletes the oxygen in the cup and creates a vacuum and suction.  We do not do this type of cupping for a few reasons.  First of all, fire burns stuff.  The cup can become hot and can burn the skin or scorch the skin.  It only allows for a single application per cup at a time.  You cannot easily adjust the suction.  This is perhaps one of the oldest ways to cup.



Cupping Therapy, Part 5- Markings



First of all, the marks are NOT bruises.  Bruises are areas where the blood has left the vessel because the vessel has been crushed or torn. The ‘frank’ blood has escaped into the surrounding tissues.  “Frank” blood is blood that is liquid red.  Nothing special.


In the more holistic forms of health care we have four examination points to consider to get a whole picture of the patient’s overall health.   In more focal techniques that are used in hospitals and ‘Western’ medical offices they usually rely of only the main complaint.   Most of these were developed thousands of years ago before x-ray or MRIs became even a dream.  The four diagnoses are; looking, listening, smelling/tasting, and touching (palpation).


The looking diagnosis is used here in the cupping technique because we need to see the marks left by the cups to determine how much stagnation there is.  Looking diagnosis takes into consideration the skin, eyes, hair, tongue, tone and color of the lips etc.  These can give a good indication of how healthy the person is generally.  However, people that use many products such as hair gels, conditioners, makeup, cover-ups and such can be more difficult to diagnose correctly.   To use looking diagnosis on a patient beforehand we hope to determine the following.  Skin tone and color, determine if the skin is too dry, or there are mottled portions (colored patterns) also look for moles, skin tags, scars and the like.  These can determine changes in the cupping technique, placement or time of treatment.


Listening diagnosis:  Not only listening to the patient as to why they are getting cupping it is important to know their expectations of what they think it will do for them.  Also the tone and volume of voice can indicate other issues such as weakness, nervousness, etc.  In traditional Chinese theory as well as Ayurveda certain sounds relate to specific organs or energy centers.


Smelling and tasting of a patient is rather weird, but having that knowledge can help you determine other factors of the health and dis-ease processes of the patient.  Here, with cupping we do not need to smell or taste anything.  The practitioners of old would smell breath, urine, taste skin etc to find core causes of disease.


Felling diagnosis is also called palpation.  We will use this to feel for very tight areas and how loose or tight the tissue is we are cupping on.   In traditional Chinese medicine and acupuncture practice we use the pulse to determine problems.  In cupping you can use touch to find where to put the cups, where to avoid putting them (like on boney areas) and the like.

So now that you have completed cupping on a person you see a variation of colors, textures and other ‘signs’ what do they mean?


The first spot.  Darkened purple to almost black spot.  This is a severe stagnation sign and there is good chance that the toxins have now been released for the body to process.  It is the most desirable sign in cupping.   It means you have gotten much of that dark, stagnant blood up to the surface. We will recheck each three or four days until there are not any more spots to do.  We try to give at least five days for each spot to completely ‘heal’, although some bilirubin signs may remain for up to two weeks.  This is also a sign that the overall system is challenged.


The second:  Moderate stagnation:  This is a more red than purple spot.  A good sign toxins have been released as well, but they were not as stagnant as long. You may notice this after a couple sessions on the same person.  It means you have gotten some of that deep dark stagnant blood to the surface.  It may mean you only have a few more treatments before you are ‘clear’. There may be blisters or clear fluid as well.  This level would require some visits to clear out. I usually suggest after the first visit to wait five days and then do another session.  The spots will generally turn a yellowish green as the bilirubin of that stagnant blood is processed.


The third: ‘Healthy’ do not be fooled by this.  Look carefully.  You may have not put the cups on strong enough or left them on for enough time,  although it can be seen on someone who  has a healthy system and who is  releasing toxins effectively.  Still this therapy can help them ‘stay on top’ of it.  Sometimes the client is too dehydrated to have cupping do anything. Sometimes they are too tight.



Massage and heat before cupping will help this open up.

The fourth:  Spotted with pink to lavender background.  Lots of congestion and toxins that are having a hard time moving.  This can be painful even.  Consider heat with or before cupping to help them release toxins.   The tissues are too tight to release the stagnant dark blood but you have managed to pull some of it forward.  The background may be a greenish lavender color. These people need lots of work.


The fifth: Lavender to yellow appearance.  This is the worst case as it usually means (traditionally) that there is a nerve or bone problem.  A sign of severe stagnation that cannot be released yet. This sign is not good and luckily not too common.  I have found it in people with very chronic diseases that are usually on significant amounts of prescription medication.   There are other treatments that will help these people become more comfortable and stable before more treatment.   Remember, cupping is no silver bullet; however   it is a great tool and will help the body regain homeostasis.



Sixth: Blisters, you may see water filled blisters and no other redness under the cup.  This is a different kind of stagnation bordering on outright dryness.  Think of a river bed.  It is not wet enough to be muddy, but if you pick up dirt and squeeze it, water may come out.  The patient needs  much more fluid and fluid movement.  Treat as much as you can, even daily.   Best to release the fluid if the blisters are big, and cover.  Continue treatment after the blisters have healed.  Make sure the patient does lots of hydration (in and out) before next treatment.  They  may benefit more from massage therapy.


Seventh:  Redness around the cups.   This is from a histamine response.  These people may have allergies or some form of autoimmune disorder.  Other than that, any of the above can occur.  They may have itchiness after treatment.  Itchiness is a histamine reaction and goes away quickly.  If the histamine reaction (a reddish halo) is large, it can be an indicator that the body is already in an inflammatory response somewhere (or everywhere).  If it does not show it could be normal for darker skin or show that the histamine reaction is too slow.  People that take antihistamines may show no halo.  Remember, the interior of the circle will be any of the above possibilities.


The ‘Halo’

Here we see a different pattern with a normal treatment time.   The inner area of the circle is somewhere between moderate to normal in appearance, it may even have some lavender look to it.  However, on the outer rim is a halo of moderate to severe stagnation.  This is mostly due to tightness of the tissue as when the patient is over stressed, poorly hydrated, or needs more treatments.   Occasionally the center will look lavender or dark only to disappear when the cups are removed.  This is a deeper set of toxins and will take longer to get the desired result.


Note:  People with very dark skin will show up differently.  Be observant and watch for the same signs but in darker colors.   Try not to be fooled by those of more olive skin, they can frequently show greenish or yellowing which is not Jaundice or anything to be concerned with.



Spinal Specific Massage…


For over 17 years I have been a chiropractor working on people with all sorts of ailments.  Of course, the most common is back pain.

I have performing massage as a therapy for nearly 20 years now and have found that to be a great adjunct to the chiropractic manipulations and adjustments I do.  I want to take some time to explain this technique and offer some training.
Spinal Specific.
It is a kind of chiropractic technique that I was taught in  chiropractic school.  Full Spine Specific is the actual name of this technique, also has been known as Meric Recoil, and most see it as part of the ‘Diversified’ technique.  Really, Diversified covers just about anything you cant find another box for.   So, what do I mean by Spinal Specific Massage?  The spine and back is a very complex area to work on consisting of everything from the occiput to the tailbone and everything between the shoulder blades and hips.  In that space we have 53 separate bones to look at, five layers of muscle, a multi-dozen joints and ligaments, and tendons!

This is an area that is prone to hold stress; chemical, emotional and physical.  No new news there right?  Fact is, 80% of the population has back pain that requires treatment from some provider.  I tend to think it is 100% have back pain at some time, but most let it go or do not handle it.  Back pain left un attended to can get worse, can get better, can stay the same.  Most experience more frequent flare ups, lost sleep, work, quality of life, all kinds of things.

In this technique there is no adjusting or manipulations of the bones or joints, nor is there any diagnosis or prescribing.  It is a real massage technique with different protocols for different conditions.  The main focus is disc injuries, followed by scoliosis, Retro and Antero listheses,  Facet imbrication, Lumbago, Lumbalgia, spasms, Piriformis syndrome, Psoas Syndrome, Spasms, post surgical pain, Failed Back Surgery Syndrome and more.

Taking the basics of massage we have Effleurage, Petrissage, and then deep tissue.  These are extensively used in Spine Specific Massage.  More focus is placed on specific muscles, their arrangement and relationship anatomically and physiologically as well as their synergists and origins and insertions.   From being a massage therapy instructor and Anatomy and Physiology Professor for the past eight or so years I have found that the back, being the main area of work, is very sparsely studied in detail.

Cupping Therapy, Part 4

How Cupping Works; the physiology of cupping.

Theory of fluid motion:  The fluids in your body are based in water- most around 95%. The blood is about 60-70%, with many different components. It includes proteins, minerals, oxygen and carbon dioxide, among many others.  We are going to consider it all the same for a moment.  When fluid is moved from its space in the body, it will flow back or be replaced by the body to maintain and regain a sense of homeostasis or balance.  Water likes to flow to its own level…

Cupping will move fluids to areas they are not commonly in, and this will cause a replacement effect. The fluid will be removed and replaced with the right mix of water and dissolved things (solutes)…


We know that life is motion and motion is life.  Fluid motion that is smooth and easy is the best way to maintain our health.  Think of a creek… if it flows easily, it collects no crud and does not become stagnant. A lot can grow there, happily and well.  Too fast and nothing can grow.… Get it?

This is part of the series ‘Cupping Therapy’ I have the complete book with diagrams available on Kindle.  The class is held at my office in Parker Colorado.  Please check out our office The Natural BodyWorks LLC.





Cupping Therapy, Part 3


What Cupping is good for…Indications

(unfortunately, the diagrams are not getting on the blog, sorry about that.  I am working on it.  You can buy the book complete on Kindle…)

Chronic issues of pain, fatigue, or disability

Pain and fatigue are good signs that the body does not move as much as it should to enable movement of toxins, acids and nutrients to and from all areas of the body.  Cupping helps to kick start this and get those fluids moving.

History of prescription or recreational drug use. 

This is a great way to help other modalities when someone is in a detox state.  Those medications or drugs tend to hang in the subcutaneous fat and are difficult to remove.  Cupping can help them get the where they need to go to be excreted or detoxified by the liver.

Too much protein in the diet.

Proteins are difficult and take longer to digest.  They are however, nutritionally rich and can generally be refined into any of the main components we need; amino acids, carbohydrates, lipids.  Some proteins can remain in blood plasma and can make the blood (as a whole) thicker, more sludgy and less easily moved among the compartments.

Parasite or candida infection:

Some parasites and other infections slow the response of the body on purpose to make sure they (the infectious bug) live longer.  Some parasites can even wall off their area so that our normal immunity cannot get to it.   Cupping can help open up those areas to good blood and other fluids that will attract and activate your own immune system and cleaning mechanisms.

Exposure to environmental toxins, mold, pollen, chemicals etc.

The more chemical exposure, the longer treatment will take. The patient will also have to get out of the  environment that has the irritating chemicals.   Cupping can help the whole body process those irritating toxins and get some help for the liver, lungs and skin to work more efficiently.

Past traumatic events that tend to rear up now and again.

Yes, even PTSD can benefit.  You may have heard the term “The issues are in the tissues” which is the body’s way of segmenting and separating fluids for different reasons.  There is no reason to think that emotional/spiritual/consciousness issues do not react the same way.   Cupping can be a relaxing respite for them as well.  Breathing is essential in this type of treatment.

That feeling of being stagnant or ‘stuck’ in life, relationships, career etc…

Cupping can help you feel more fresh and light, giving you the edge on energy to start a good habit of health and wellbeing.  When the cups are on, you can also use meditative techniques to really contemplate your next action in life… etc.



As a general treatment to help the body’s natural processes work a little better.  When we are talking about toxins, we don’t only mean the normal toxins that build up from normal metabolism: carbon dioxide, lactic acid, carbonic acid, cellular debris, and excess water from metabolism.  Remember, our bodies normally handle this all by themselves; cupping helps it move even more.

We can also help affect those that are doing any form of detoxification, from alcohol, drugs; even just ‘bad’ energy can be moved with cupping.  Sometimes we can get what used to be called a health care crisis, where you have flu like symptoms from having all the toxins get stirred up in the system all at once.


As an example, think of a bucket of dirty water.  If you let it sit long enough the dirt will all settle to the bottom and the water will seem rather clear and pure.  Obviously there is lots of muck deep down and once you stir it up there can be that feeling of sickness all over again.  Cupping can do that sometimes, but keep at it, drink plenty of water and help flush out the system.  There are some supplements and herbs that can help with this process as well.  (We can go over them later)

Concentrate the cup placement on the back around the areas that serve the kidneys and liver.  (See diagram).

Also, in later sessions we can do some abdominal gentle cupping and see how that fares for you.


Cellulite:  This, I would consider a more advanced treatment and should be done by someone with a little more training and with the Finnish soft cups.  Great to get the fluids moving in the cellulite areas.  The cellulite will disappear at least temporarily, as it is merely toxins stuck in fat tissue.  Once the toxins are released the tissue will appear more normal. This can take months to clear from the body and needs nutritional, chemical, physical, and consciousness care as well.  There are vacuum devices that cost thousands that can do the work as well, but cupping is easy and cheap.


Colds and flu:  One of the main traditional uses of cupping, commonly with a sauna and herbal teas and salves.   This can be a great way to help break a fever. It opens channels that heat will escape from really quickly.  Be careful not to let the client become chilled.  Cover all spots by wearing a shirt. Too much Qi release can be problematic.

This is one time the cups can be used on the chest, although lightly will get a good enough result to help with congestion and that feeling of being un-well.


Stiffness:   This is a great way to loosen the tissues and promote blood flow which will remove the lactic acid that causes the stiffness.  Helps to re-oxygenate the tissues and get fluids moving again bringing oxygen, nutrients and fluids and therefore loosening the stiffness.


Neck and shoulders:  We are generally talking about the shoulders and trapezius muscles that tend to get very tight with emotional and mental stress.  You know those, top of the shoulders and on the back.  This is the best place to put the cups so that they can do the most benefit.  Feel for the tight spots or most tender areas and set the cups on those with three or four pumps.  Then give that about five minutes and recheck.


Abdominal or Belly cupping:  Here we should use the flash cupping or gentle cupping in the areas as listed in the diagram.  Make sure and do the areas of complaint first as this will help the whole system become looser.  (See Diagram)  This can be useful for the following conditions: Bloating, gall bladder issues, liver enzymes elevated, liver issues, splenic or immune issues, stomach problems, sour stomach, constipation, irritable bowel.

Also, since it increases fluids in the local area, it can be useful for pelvic work when someone wants to become pregnant.  Treatment below the belly button and on the back is indicated to help increase heat to the uterus and surrounding tissues.  DO NOT  use on a pregnant person, though.


Knees and ankles:  For this use the smaller cups.  I have used this with  acupuncture with really good success.  Be mindful of the veiny areas. The  cups may not want to stick unless there is lots of effusion in those  areas.  And then be careful.  Use the flash cupping and then try some other parts on the calf or up in the thigh so that you can influence the most movement of fluid against gravity.  Continue this for about five minutes and recheck often to make sure the cups are staying where you want them, and that the fluids are moving.


Facial cupping:  This is a good technique for rehabilitation of the face and can help reduce some wrinkles.  Do this very carefully; only a little bit of a pump. You should use the smallest of the cups for this to be able to work.  This is a very ‘Yin’ area, so caution is advised.



Cupping details.

Does it hurt?  It can feel uncomfortable, especially if the tissue is over congested and tight, or if you are dehydrated.  Drink plenty of good water before and after a session.  Some people will feel ‘flu-y’ after a treatment.  The best thing to do in that case is simply drink plenty of water and keep the cupped area  warm and covered.  A lot of energy (Qi) is released when you have cupping.  The marks are considered open spots that leak lots of vital energy which, if you are already fighting off some bug or somewhat sick, you may feel the sick feeling more.  Most people feel a ‘freshness’ at the areas of cupping, which is a great sign that energy is coming back to the area.


How long will those marks last?  That depends on how deep the stagnation and how ‘healthy’ your system really is.  Usually the marks last a couple of days.  Sometimes, with deep set stagnation that is chronic, a yellowish mark may remain for a couple of weeks.  This is an indication that much more work needs to be done.


What should one do about the marks?  Marks  are a natural and  expected result of good cupping.  Keep them covered and warm, as the ‘opening’ of that area will release a lot of energy and heat.  You can be more susceptible to chills and further trouble if they are left uncovered, especially for the first day or so.  Also, since the marks are more ‘open’ than the rest of the skin, be mindful of what you put on your skin.  Natural and medicated oils will be more potent.

Drink water or eat before coming for the treatment. You will relax even more and avoid uncomfortable nausea and dizziness which occasionally occur.


After cupping it is common to feel coolness, or a light feeling.  Your energy will go up or down depending on how your body reacts to the cupping treatment.  Best plan is to schedule 4 or 5 treatments over a month period to cleanse the entire area and facilitate healing in the most efficient way for you.


Cupping and Scraping (Gua Sha)

Here, we have a female patient in her mid to late 20’s that complained of chronic tension and pain in the upper back and shoulders.  She had tried scraping previously with great results.

Scraping or ‘Gua Sha’ is a technique of using some object such as a piece of wood, bamboo, bone, stone or metal in the shape of a dull blade to scrape the integument (skin) and rise stagnant blood to the surface.  Once the stagnant blood rises to the surface it will be cleaned and carried away by the normal processes of healing over the next few days.


The circle marks are from immediate cupping that was done.  Notice there really is not much in the way of discoloration one would expect.  This is likely because she is very active and does plenty of yoga and other streatching which keeps the skin and underlying tissues well hydrated and the fluids move freely.  She was indeed in excellent shape working out at least 3 times a week.  The other ‘bruising’ or purple mottling outside the cupping circles is from the Guasha.  I used what I call ‘the fish’ (top of the photo) for this with a light warming oil.imag0270

This technique is also great for chest congestion and was first used on me in about 1988 when I was quite ill in college.  It worked great I might add and spurred me on to eventually become a healer…

After the patient above had treatment we did perform a great chiropractic manipulation (mobilization) to open all the joints of the upper back and ribs.  This opened very easy as the muscles were much more relaxed.  She reported significant improvement that visit.

I will let you know what happened next…



Therapeutic Cupping, part 2


Application and practice of Cupping Therapy

Determine the goals of cupping. Make sure you and the person receiving the cupping understand the time it may take to get the desired result.  Try to become clear on the desired result and ascertain if it is attainable.  Then look up the points where cupping would be most useful.  Generally, the most painful areas are a good start.  You can get very complex with cupping and have the body look like a pepperoni pizza and get no real benefit.

Place the cups, then hold them in place with one hand.  Using the other hand, hold the pump gun, and place the end on the tip of the cup valve.  Without pushing or pulling the cup, and maintaining a good seal from skin to cup, pump two times to get the skin to rise.  (This of course depends on the style of cupping you are doing.)  You can then change the suction with the cup by changing the valve to release the vacuum and then reapplying the pump to ‘fine’ tune.

Check in one minute or so to see if there is any skin color change.  If not, consider more pumps.  You can pump a lot; I like to consider the comfort of the person receiving cupping.  Allow the cups to remain:

About 5 minutes for children

About 10 minutes for youth/adolescents and young adults.

About 5 minutes for women that are pregnant or menstruating (check precaution)

Use longer depending on what your goals are.  Severe pain requires more.

Generally you should do less in the summer months, as the skin sweats and can better clean itself. Less stagnation occurs, if the patient gets out and gets movement and sweats.


In the winter the skin is contracted and can take longer to get a good result.  It may take more visits.


After the treatment is complete, pull up the tab releasing the vacuum.  Remove the cup and clean immediately.  If there is difficulty removing the cup, use a finger to press the skin next to the cup to release the suction, letting the cup become free of the skin.


If there is bleeding in the cup:   Make sure you have alcohol and tissues to clean.  Surround the cup with some tissues before you remove it as the blood may flow.  Consider the flow pattern.  Make sure to not get any of the blood on you.  Use rubber gloves and consider it a toxic spill.  Be careful!  Discard that blood by flushing down the toilet.  Make sure and soak the cups involved in alcohol and soapy water, wash them well and dry well before putting back in the case.






Removing the cups:

With the vacuum cups, simply pull the tab at the top while holding the cup in place.  Sometimes if you do not hold the cup in place it will be uncomfortable.  Pulling the orange tab will release the negative pressure vacuum inside the cup and allow it to easily be removed from the skin. (See Diagram).














If the cup still is stuck, gently tilt the cup to the side and press with the other hand toward the cup on the skin next to the cup (See Diagram).  It will pop loose.  Notice there will be a whole new pattern you will see.  There is the bulge that will remain for a few minutes to an hour.  This is where the cup pulled the skin.  Then around that there will be a purplish ring, or gully. (See Diagram) This also will disappear in a few minutes to an hour.   The gully is not too significant therapeutically, so ignore it for now.










Finally around all of that will be the red flash, if any.  This was the histamine response from the skin, due to the pulling of the skin around the cup lip.  If any of these last more than an hour it is likely that the patient is dehydrated and/or has severe stagnation.






Treatment times and plans:

In general the time for one single treatment really need only be about 5 minutes.  That is about as long as it takes to really see the result of the cupping.  I do three pumps for the first visit, and after five minutes can add a pump or two if no results comes up.  Once you have added a pump or two wait another five minutes.


With cupping and massage, you can use moving cupping to start and then use some good oil to get more of the fluids going by doing some effleurage and light petrissage.  After doing a few minutes of massage go back to stationary cupping to bring up deeper fluids.


How often can you treat?

You can treat daily but not on the same spots.  With each moderately stagnant spot wait until it has changed to at least the yellow or brownish color before cupping there again.   This generally takes about 4 days.  If you are looking to treat a very large area, use the moving cupping to achieve this.


With any treatment there is a duration of care.  If you are receiving no result after three or so treatments go on to another modality.  Try scraping or try heating the body well before the cupping.  Some people are not suited for cupping.  This depends on their personal preference, age, their constitution and disease processes they are experiencing.    There are many reasons for this which we will discuss in the workshop itself.