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Practiced in various cultures for more than 3,000 years, cupping therapy is a traditional form of alternative medicine on par with acupuncture and Chinese massage (tui na). The technique uses cups and suction to create negative air pressure next to the skin to stimulate the flow of body fluid and energy. While research has yet to conclusively support the practice, therapists who use it say this age-old modality decreases muscle pain, improves lymph flow, and can even reduce cellulite. CUPPING PRINCIPLES Cupping therapy, as practiced in traditional Chinese medicine (TCM), is based on the concept of balance between yin (feminine) and yang (masculine) energy in the body. The energy, known as qi, flows in a closed network of channels and locks commonly referred to as meridians and pressure points. In TCM, chronic pain is regarded as an indication that qi is not flowing freely in the body: "tong ze bu tong; tong jiu bu tong (pain means no free flowing; free flowing means no pain)." Stagnated blood is considered the primary block that impedes the free flow of qi. Through negative air pressure, cupping breaks the capillaries to let out stagnated blood and sets off a chain reaction of repair and restoration, resulting in the formation of distinctive, circular skin markings on the treatment area. The body's metabolic process rebuilds the "managed bruising" of the local tissues, absorbs the bruises into the bloodstream for waste disposal, and restores the free flow of body fluid and energy. Skin marking from cupping usually disappears in 5–7 days. There are several ways cupping is administered. I utilize suction for my cupping therapies, using a pump to create the negative air pressure. A more traditional technique is to use fire (applying rubbing alcohol to the inside of the cup and lighting it on fire before placing it on the client's skin), although the obvious risks with this technique must be considered carefully, as they are not covered under many professional liability insurance policies. Another variation on cupping that is well outside the scope of massage practitioners is wet cupping, where controlled medicinal bleeding becomes part of the treatment. Although acupuncture is often used in conjunction with cupping, it is not essential to the therapy's viability. Massage can also be a component of cupping: when oil is applied to the client's skin beforehand, suction cups can then be moved easily around the body to address areas of pain. The objectives of cupping therapy include keeping meridians open, promoting circulation of qi and blood, dissolving stagnated blood, relieving chronic pain, moderating yin qi and yang qi, clearing "internal heat," and dispelling internal cold and dampness. Cupping therapy is another way of using external approaches to treat internal problems—a treatment strategy in TCM. 56 m a s s a g e & b o d y w o r k j u l y / a u g u s t 2 0 1 6