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Cupping your clients

Cupping therapy is used by a variety of sports professionals and Olympians, including swimmers, and baseball, soccer and tennis players.(Michael Phelps is oft-credited within the media for helping introduce the therapy to the masses, thanks to the visible brusing seen during the 2016 Rio Olympics.) Celebrities got on board with the treatments and gradually, cupping therapy found its way to the mainstream public. Cupping helps to activate blood vessels in the muscles, increasing blood flow to a particular location. This blood flow has a significant effect on stiffened or weakened muscles, making it a great choice for athletes. Cupping has been known to be suitable for many other issues, such as increasing circulation, body aches, aiding the respiratory system and facial paralysis (Bell’s Palsy).
  

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In the western massage world today, the most common area treated with cupping therapy is the back, although it can also be used on the legs, knees, chest and shoulders. The back is where the central line of the nervous system is located, therefore, cupping therapy can have a huge impact on the nervous system as well. There are a few different types of cupping therapies, found below. 

If used incorrectly, or too harshly on a patient, cupping can cause serious nerve pain or inflammation within the body. Clients can have adverse reactions to poorly administered cupping therapy; there is a correct approach to cupping therapy and a correct way to administer it.

For first-timers
When a patient comes into your clinic requesting a cupping therapy treatment or a “cupping massage,” there are a few steps you must take before you put your hands on your client – or a cup.

You must first be informed on whether or not this is your clients’ first cupping therapy treatment. The client must be well informed of what the treatment will entail. As a health-care provider, you are required to sit down with your client and inform them of the risks and benefits of the treatment they are about to receive. Explain to the client what is to be expected during the treatment, as well as the potential  side effects may be once they leave your care. Some side effects include: bruising, light-headedness, extreme thirst, or tenderness where the cups were applied. When explaining to a client what cupping is and how it works, it may be calming for the client to be allowed to hold the cups in their hands or for you, as their therapist, to demonstrate how the cups are used by showing them on your own arm. You must also inquire about why your client may be seeking cupping therapy to ensure that this treatment is the most effective one for them.

Be aware of your language when explaining the benefits of cupping therapy – explain them without using any forceful or persuading language  that would make your client believe they are required to go through with the treatment. Lastly, don’t forget that each client will have his or her own pain tolerance and what may be perfectly fine for one client could be extremely painful to another.

Once you have explained all of this to your client and received their consent to go through with the cupping treatment, they may get on the massage table. Before applying the cups, gently massage the area using lotion or oil. This helps to decrease nervous system firing to any clients feeling anxious about the treatment and it helps to warm up the tissues before the cups are applied. As a therapist who practices cupping, you should make it a rule that every cupping treatment must first begin with a massage to the area being treated.

Assessment and treatment
The next step is to palpate the area and find where it is the client is experiencing their pain, discomfort or weakness. Once found, a cup can be applied to this area. Begin the cupping with light-medium suction. Always follow up by asking your client how they are feeling and if the suction strength is OK, or enough for them. If it is enough for your client, do not continue to a strong suction. You must only add more suction to the cup once the client has given you their consent to do so.

While the cups are in place, you may leave them there for the desired and safe amount of time, or you can choose to move the cups to create extra movement within the fascia and a more intense stretch of the affected muscles. Moving cupping is one of the most painful cupping techniques, and if your client has never experienced it before make sure they are aware of that fact. It is also a very draining technique; if your client has come in complaining of exhaustion and lethargy, moving cupping should not be administered.

Warming up the tissues should have already been done at this point, and oil should be applied to the area being treated. When you begin moving the cup it should move freely and without any great deal of effort. If the suction is too strong and it is difficult to move the cups, do not force it. Forcing the cups to move will cause extreme pain to your client. However, if you feel moving cupping will benefit your client, the cup can be removed and placed on the same area with less suction before you try to move it again. A client’s first treatment with a moving cupping massage should not exceed more than five minutes, and it should only build up to a maximum of 15 minutes per treatment.

Future of cupping
Despite not being as thoroughly studied as other techniques, the body of evidence continues to grow for cupping therapy.

Cupping therapy has shown many benefits and proven to be very helpful to clients and therapists over the years.

As therapists, it is our duty to make sure our clients are well informed of the treatments they are being provided, and that they leave their treatment feeling better or more hopeful that their presenting ailments are being looked after in a professional manner.

Cupping Techniques

• Dry cupping. This technique is done with glass cups. A cotton swab is lit on fire, swirled around the inside of the cup and quickly removed. The therapist then quickly places the cup on the clients skin. The fire removes the oxygen in the cup before it is placed on the clients skin, creating a suction effect.
• Cupping with manual pump. This technique is normally done using plastic cups, but they have can also be glass as well. It is done using a pump that hooks on to the top of the cup. The therapist holds on to the pump and places the cup in the desired location. The pump is then used to suck the oxygen out of the cup, creating the suction. This can allow for different levels of suction (ex. one pump = light suction, two pumps = medium suction, three pumps = strong suction and so on.
• Moving cupping. Once the cup is placed on the skin, after having applied oil or lotion, the therapist can gently glide the cup along the affected area. This combines both massage therapy and cupping to cause a myofascial release.  
• Silicone cupping. This uses flexible silicone cups. The cup is popped inside out, placed on the client and released on the skin to create a suction effect. This type of cupping often causes the least amount of bruising.

REFERENCE
Chirali, I.Z. (1999) Traditional Chinese Medicine: Cupping Therapy. Churchill Livingstone.

DESIRAE WALKER is a registered massage therapist working in Fredericton, N.B. A newcomer to the massage therapy profession, with a passion for helping and educating others, she is trained in cupping therapy and believe it can be a huge benefit and a wonderful add-on to a massage therapy treatment.