About ten years ago, Pieter de Smidt was looking to add to his array of manual therapy skills for soft tissue treatment. 

de Smidt, PT, DPT, Cert. MDT, MTC, owner of Reset-Wellness Physical Therapy in Houston, TX, was well-versed in instrument-assisted soft tissue mobilization (IASTM), which still proved painful for some patients. But after seeing the benefits of ‘distracting’ the tissues by using taping, he decided to expand that repertoire. 

“Cupping seemed to be an obvious answer,” recalled de Smidt. “I figured maybe we should try distracting the tissue rather than always shearing the tissue. This was something people could tolerate.”

These days, de Smidt still tends to start with an IASTM-based treatment, but if this proves painful, he can do a simple contrast with IASTM on one side and cupping on another, and asking the patient which feels more comfortable. 

What is Functional Cupping?

While cupping may be somewhat new as a modality of manual therapy in Western medicine, the concept itself has been traced back as far as 1500 B.C., when the ancient Egyptians were said to have utilized the process. A specially-designed cup — don’t just pick up any instrument — is applied to the skin for a few minutes under suction, allowing it to affect the underlying tissue, particularly the fascia.

Functional cupping works by applying the cups in relevant areas followed by initiating dynamic, functional movement and affecting positive change in movement restrictions. The goal is to restore movement while decreasing pain in areas of previous restriction. Simplified, the cup is placed where restriction is felt, allowing the practitioner to move the body to the outer limits of that particular movement. As a result, tissues begin to soften, increasing the range of movement. 

Best of all, the client or patient has a strong degree of control over their own movement with the cups in place, and can dictate and control their own levels of discomfort. Many times, people assume cupping is a painful experience due to the prevalence of dark, purple spots that will appear on a person’s skin in areas where the cups were applied. However, this is simply the result of blood flowing to the affected area due to the suction pressure. Some believe the darkness of these spots has relevance as to how the injury is progressing, though this theory is not commonly held in Western medicine.

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