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Nov 19, 2023

Cupping for Lymphatic Drainage

Cups draw waste materials up from within the many layers of soft tissue for

Cups draw waste materials up from within the many layers of soft tissue for lymphatic assimilation and support the movement of lymph fluids along natural drainage pathways. To understand how this works involves knowledge of the lymphatic system, the benefits of cups, and what makes therapeutic cupping for lymph drainage so unique.

Cupping therapies have seen a huge growth in popularity recently, presenting a new tool with a wide array of therapeutic potential to the massage industry. While most notoriety has been from muscle relief, cupping offers much more to professional bodyworkers, and without those familiar, sometimes harmful, cupping marks.

In addition to the many benefits for the muscular system, varied methods of cupping can provide benefit to every other system of the body, including the integumentary, nervous, pulmonary, digestive, reproductive and circulatory systems.

Focusing on the circulatory system, cupping can bring about significant reactions within both of its further divided components, the cardiovascular and lymphovascular, or "lymphatic," systems. But just as the hands of a well-trained, versatile bodyworker can bring about different therapeutic results, cupping bodywork must also be altered when intentionally addressing the lymphatic system.

As part of the circulatory system, the lymphatic system is responsible for removing waste from the body, as well as fighting off infections and distributing certain nutrients from the digestive tract into the bloodstream.

This system consists of many lymphatic vessels, structures, organs and lymph fluids, all working to circulate these fluids throughout the entire body. Lymph fluids are composed of various materials, including proteins, water, cells, waste products and fats (intestinal lymph). Maintaining these materials’ circulation is crucial to general health and wellness.

Lymph collection, assimilation and drainage processes begin just under the surface of the skin, and within designated regions known as watersheds. The system progresses deeper into the body, becoming more complex in anatomy, intertwining with blood vessels, and weaving its route through layers of superficial connective tissues. The system travels along a logical network until reaching its terminal location near the heart, at the (left) thoracic and right thoracic ducts.

Unlike the circulatory system, which relies on the heart to circulate blood and valves within the vessels to move the blood along its route, the lymphatic system requires several actions to move lymph fluids. These actions are: intrinsic actions (contractions of lymphangia [lymph vessels] within the system), extrinsic actions (like deep breathing, muscle contractions and arterial or venous actions), and if needed, external, manual therapies.

While lymph vessels do not contain the same valves as blood vessels, they do possess several specialized types of flap valves, which control collection, movement, or retention (block backflow) of lymph fluids.

This delicate body system can become challenged or altered for many reasons, including surgeries, injuries, sickness, or even sedentary lifestyles. Manual lymph drainage therapy is one of the most subtle, yet powerful therapeutic modalities specifically designed to address the lymphatic system. This modality requires detailed knowledge of lymphatic anatomy, a high level of training, and gentle hands-on manipulation, all with one specific goal in mind: moving lymph along its natural drainage pathways.

Focusing on muscle health, lymph drainage plays a vital role in its maintenance. Muscular actions produce waste materials, like carbon dioxide (which is removed via respiration), metabolic wastes (including salts and urea, which are removed via urination, defecation and sweating), and water. While some of the water is expressed via perspiration, the rest is assimilated into the lymphatic system.

Cups facilitate a vacuum-like response within underlying tissues and can effectively influence systemic lymphatic movements. To understand how this occurs, acknowledging the three primary, physiological responses to cups on the body is key: Negative pressure, vasodilation and enhanced fluid exchanges.

First and foremost, negative pressure from cupping offers a multitude of benefits to the lymphatic system. Wherever applied, cups begin to take effect with negative pressure; they start pulling, lifting and decompressing soft tissues. This pulling action affects both the layers of anatomy where the lymph vessels exist as well as the vessels themselves; some methods of cupping can affect the various flap valves of the lymph vessels, thereby improving both the uptake and movement of lymph fluids.

This negative pressure manipulation evokes a suction pump–like effect within the system, meaning that with even the lightest superficial stimulation, gentle cupping will have a direct effect on both the superficial and deeper structures within the system.

This type of negative pressure manipulation also stimulates intrinsic flushing mechanisms, like those that naturally occur from the excretions of muscular byproducts. Cupping affects natural waste removal processes in several directions:

• It supports waste removal from within the layers of soft tissue as well as along the routes of drainage.

• The pulling action encourages waste to be "wrung out" of soft tissues and drawn upward to where initial lymph collection generally begins.

• When applied along the drainage routes, cups alleviate restrictions—like scar tissue—that would otherwise inhibit smooth movements of lymph fluids.

• Restrictions can inhibit perspiration also, and cupping has proven to support this method of waste removal just the same. Have you ever seen a foggy cup over a tight muscle? This is another example of how therapeutic cupping can support clearing congestion or stagnation of waste materials from within the body.

• Similarly gentle, negative pressure from therapeutic cupping can stimulate areas of concentrated lymphatic activity, like locations containing lymph nodes. This further supports the filtration of lymph, as well as the circulation of lymphocytes (white blood cells) for immune functions.

• Additionally, this negative pressure can benefit lymphatic activity in the abdomen with great efficacy. With strategic placements and specific techniques, cupping in this visceral region helps dissipate lymphatic congestion and improve nutrient distribution processes—all without adding positive pressure, which can be uncomfortable for some people.

In addition to the negative pressure, cupping also stimulates vasodilation, which enhances fluid exchange processes. With the combination of these actions, cupping is renowned for its effects on total systemic circulation. The amplified microcirculation at the capillary level leads to an equally stimulated lymphatic response: The better the output, the greater the intake.

These exchange processes pertain not only to the circulation of blood and lymph, but also the ground substance that nourishes fascia, keeping soft tissue hydrated, supple and pliable. With well-hydrated soft tissues, drainage pathways that weave through them are more successful in their respective processes.

Therapeutic cupping for lymph drainage is done in a manner very different from the more familiar styles of cupping. The five most important elements to consider are pressure, technique, methods of application, knowledge of drainage pathways and acknowledging professional limitations.

1. Pressure. When choosing to use cups to influence lymph drainage, the pressure will always be lighter than it is with more familiar forms of cupping. With typical cupping applications, the most common pressure is stronger than what would be beneficial to the lymphatic system. Attempts to affect lymph fluid should be gentle, as lighter suction pressure will more effectively address surface anatomy where lymph travels through.

2. Technique. The intention with lymphatic drainage is to move fluid, not create areas of superficial stagnation that stationary cups typically promote. Just as with manual lymph drainage therapies, there are a variety of non-stationary techniques that will yield these results.

3. Methods of application. The movement of cups along the drainage pathways should be slower than with other moving cup applications: consider the intrinsic movements within the lymphatic vessels to how the movements with cups should be. Also, just as massage strokes are applied in multiple passes, so should the strokes be applied with cups.

4. Knowledge of drainage pathways. Superficial lymph fluids are easily influenced, so even the lightest therapeutic cupping can encourage the direction of flow, positively or adversely. It is very important to understand lymphatic anatomy and the directions of flow before attempting this type of cupping bodywork.

5. Acknowledging professional limitations . While this information may seem simple, therapeutic cupping for lymph drainage falls under the same general rule of bodywork: When in doubt, refer out. Like the high levels of training required to do manual lymph drainage, this style of cupping requires the same considerations and level of education to provide such a modality safely and effectively.

As bodyworkers, we appreciate the benefits of improving circulation, especially of blood and lymph. As a manual lymph drainage therapist, we understand the importance of optimal lymph movement and how crucial it is to general health and wellness.

As a cupping practitioner and educator, we realize the benefits of cupping to all body systems, especially how influential therapeutic cupping can be on the lymphatic system.

With this understanding, learning how cupping can affect the lymphatic system offers a whole new appreciation for these extraordinary tools.

• Gilmartin S. The Guide to Modern Cupping Therapy. Robert Rose publishing. 2017; ISBN 987-0-7788-0583-0

• Chirali I. Traditional Chinese Medicine Cupping Therapy. Churchill Livingstone Elsevier publishing. 1999; ISBN 978-0-443-10266-0

• A.M.N. Al-Bedah, I.S. Elsubai, N.A. Qureshi, T.S. Aboushanab, et al. The medical perspective of cupping therapy: effects and mechanisms of action. J Tradit Complement Med. 2019 Apr; 9(2):90-97. 4. 2018 April 30. Doi:10.1016/j.jtcme.2018.03.003 PMCID: PMC6435947 PMID: 30963043

• M. Arslan, N. Kutlu, N.S. Yilmaz, L. Ozdemir, S. Dane. Dry cupping therapy decreases cellulite in women: a pilot study. India Journal of Traditional Knowledge. Vol.14(3), July 2015, 359-364.

Shannon Gilmartin, CMT, started her massage therapy career in 2000, and began cupping practices in 2004, teaching cupping internationally soon thereafter. She has published numerous articles, been interviewed, authored "The Guide to Modern Cupping Therapy: A Step-by-Step Source for Vacuum Therapies," and co-owns Modern Cupping Therapy Education Company.

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