Cupping + Gua Sha Therapy

Cupping is an age-old treatment that is part of Chinese, Egyptian and Ancient European medicinal systems. However, it shocked people in 2004 when Gwyneth Paltrow donned the telltale red circle marks at the opening of a movie, and further gained popularity in 2016 when Michael Phelps showed up in the Summer Olympics with marks of cupping over his back. While it was initially meant to be used for lung problems such as pneumonia and bronchitis, cupping is now popularly used for relief from pain and injuries such as sprains, strains, and inflammation.

As a treatment in traditional Chinese medicine (TCM), Gua Sha utilizes a smooth material (jade stones and even spoons) to stimulate a specific area of the body. Unlike what’s popularized on TikTok, Gua Sha is not limited to just the face, but can be used on the back and shoulders as well. 
Cupping and Gua Sha have become popular treatments for:
  • Facial Care (face + neck)
  • Sports Therapy
  • Rehabilitation
  • Overall Health + Wellness

What does a treatment look like?

Cupping
Depending on the goal of treatment, a cupping session may be exclusively placement of fixed cups on specific soft tissue areas, and mobility and passive range of motion movements of the body performed. This type of cupping often leaves the telltale red circle marks on the body at the attachment points. This is often used for targeted muscle rehabilitation or pre/post sports event treatment for athletes.

Alternately, mobile cupping might be integrated into a massage therapy session for fascial release, flushing muscles with fresh blood, or aiding in breaking up stagnation. The gliding motion of the cups is much like a reverse massage, meaning the skin and muscles aren’t compressed but rather pulled into the cup. This causes increased blood flow, which in turns helps to nourish and deliver oxygen to the tissues. This encourages the healing process with the therapeutic aim of removing congestion and pain. This method of cupping usually doesn’t leave any visible marks on the skin.

Gua Sha
Much like cupping, the tools used are specific to the goal of the treatment. Larger 'scraping' tools are used to glide over the skin to address the soft tissues below, breaking up adhesions and encouraging circulation. Some of the smaller tools are used for delicate areas such as the face. There are also Gua Sha tools that allow acupressure points and deeper adhesions to be worked on.  These techniques and tools also encourage the healing process with the aim of removing congestion. Although the work does not generally leave marks, if the tissues are holding a lot of congestion, petechiae (small red spots under the skin) may appear, and take a few days to fade.

Benefits of Cupping + Gua Sha

Cupping therapy is based around the idea that suction from the cups draws the skin up and mobilises blood and energy around the body, encouraging the body’s natural healing process. Gua Sha has also been found to be helpful in increasing circulation and energy flow.  Usually used in conjunction with other treatments, these tools promote blood and lymph circulation, and may be effective for the treatment of:
  • Musculoskeletal pain and discomfort
  • Headaches and migraines
  • Sporting injuries
  • Post surgery and scar rehabilitation (with lymphatic drainage)
  • Asthma + Chronic cough
  • Gastro-intestinal disorders

and promoting:
  • Stimulation of the lymphatic system to increase detoxification and drainage
  • Increase in blood circulation
  • Pain relief and softened muscle tissue
  • Release of tissue adhesion, increasing flexibility
  • Reduced inflammation
  • Support of the immune system
  • Improved digestion
  • Healthy skin

Precautions
Cupping and Gua Sha are generally very safe to use and has no side effects. However, these tools will not be used if any of the following apply to you:
  • Open wounds, dermatological problems or sunburn
  • Patients with bleeding disorders or are on blood thinners/anti-coagulant therapy
  • Recent trauma and inflammation
  • Suffering from high fever
  • Appear excessively famished or exhausted
  • During pregnancy
What do your cupping marks mean?
Well - a lot actually! They give us a sneak peak into our health.
 
Pink to light red: healthy
Red: moderate blood stagnation
Dark red: severe blood stagnation
Dark purple with or without spots: stagnation + toxins
No color: deficiency or imbalance
​
Who knew cupping could tell so much?!

What are 'cups' and 'gua sha' tools?

Traditionally, cupping was done with glass globes, where fire was introduced into the globe to remove air (cause suction) and applied to the skin. These cups are still very effective and used by some practitioners, but in my practice I use the hard silicone/plastic cups with the 'gun' that extracts air (to cause suction), and the soft pliable silicone cups that create suction by depressing the cups.

Gua sha tools are often made of jade, rose quartz, crystalline, and now man-made materials. They are carved to have a firm, flat and smooth surface. The term translates from Chinese to “scraping,” but these stone tools aren't meant for exfoliating. Instead, Gua Sha tools are pressed onto the skin to release adhesions (knots) and bring balance to the soft tissues.
Traditional Glass "Fire" Cups:
​glass globes, mostly used by Traditional Chinese Medicine (TCM) practitioners. These cups come in a variety of sizes and are made of thick glass. Fire is introduced into the cup to extract air, and immediately placed onto the skin to produce suction. These do not burn, but they can get a very deep pull on them. Often these are used still for clearing lungs, or healing organs by placing them on accupoints or organ nerve bundles that feed the affected organ in need of healing. 
Hard Silicone or Plastic Pump Cups:
​these are used with a pump attached to the cup to create a suction. I generally use these for deeper treatments such as sports or injury rehabilitation, as well as pre and post sport event treatments. These are used in a pattern for the muscles being addressed, and then the corresponding joints and muscles are put through range of motion and passive mobility movements. The goal of this treatment is to hydrate and bring fresh blood to the soft tissues which aids in health and healing.  This treatment generally leaves red circle marks. They are more like a hickey, but not a bruise. Not painful to touch. The level of darkness (or lightness) indicate the amount of blood flow or stagnation in the area. The marks take anywhere from a couple of days to a couple weeks to completely fade, depending on the individual.
Soft Silicone Cups:
​these pliable cups create suction by depressing or contorting them and pulling the skin up into them. These can be used for deeper tissue work, but are also used for areas where it is harder for hard cups to adhere (like elbows and knees). These cups may be used for the same protocol as the hard silicone cups.  I use these cups in most of my treatments to address fascial release and to bathe muscles in fresh blood for healing.  These generally do not mark as much as the hard silicone, but depending on the body, they may leave a dark circle as well. 
Facial Cups (for the face):
These small but specifically made cups are for work on the tissues of the face. As our skin is thinner on this area, the cups are smaller, and the technique differs from traditional cupping therapy.  This is a wonderful addition to a face massage for post operative work, sinus issues, and of course for relaxation.  These are often used with lymphatic work performed on the head, face and neck.  Read more here.
Gua Sha tools:
A variety of shapes and sizes of tools are used for scraping, combing, and stimulating acupressure points throughout the body.  Tools can be made from stone, jade, steel and resins.  These tools can be used on muscles throughout the body, including the face.


​History

Cupping
It would be amiss of me not to give you a brief insight into the long history of these tools, because it is easy for modern day medical experts to dismiss cupping and gua sha therapy as just another celebrity fad.

The history of cupping goes way back into antiquity and was practiced by numerous cultures. Reports of cupping have been found in Chinese, Hindu and Egyptian scriptures. The cups and techniques may have changed but the effect has remained the same. The father of medicine, Hippocrates (400 BC), was also familiar with cupping. Cupping was used right up to the 19th century in hospitals but fell out of favour with the advent of recently developed chemical drugs which was perceived to be the direction of where medicine was heading.

Cupping gradually began to die out in America and Europe in the early 20th century as physicians regarded cupping as ineffectual. Cupping is still practiced in Japan, China, Northern Europe, Germany, Poland, Greece, Turkey, Brazil and many other countries and people in these countries, still keep a set of cups or jam jars in their first aid boxes.
 
Gua Sha
Historical records on Gua Sha go back to the Paleolithic Age. When people fell sick or became unconscious, hands or stones were used to rub parts of their body to help alleviate the symptoms of disease. Gua Sha has long been a folk therapy widely used by the ancient Chinese. In the Ming Dynasty (1368-1644), the treatment was systematically written into major medical records. Today, the use of stones to scrape the skin and treat diseases is in line with TCM practices.

​
Information from The Myths & Truths behind Myofascial Cupping Therapy, Dr. John Marshall, March 21, 2016; ChinaCulture.org, Gua Sha, Yin Yin

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