Cupping Marks...Bruises or Not?

Author:  Paul Kohlmeier, BPE, RMT, R.Ac.

There are people in the industry that deny to some degree or another, that cupping marks are bruises. This argument is based normally on two points.

The first is based on the definition of a bruise in some dictionaries:
"An injury appearing as an area of discoloured skin on the body, caused by a blow or impact rupturing underlying blood vessels." -Google Search 'definition:bruise' and similar at and the Cambridge English Dictionary.

There are a couple of problems with this argument. Firstly, not all dictionaries use the words, "...caused by a blow or impact..." In fact, in the Merriam-Webster dictionary this part is left out, and also the dictionary of Interestingly, Wikipedia uses the language, " a type of hematoma of the tissue, the most common cause being capillaries damaged by trauma..." Trauma could refer to the pressure gradient of cupping.

This means that we are essentially arguing over semantics based on the mechanism of injury, ignoring the fact that the result is the same. The definitions all agree that the colour of a 'mark' is caused by the blood coming out of the ruptured blood vessels.

Additionally, the medical definitions of a hematoma tend to omit the mechanism of injury and just speak about the colour and that there has been a rupture in the underlying capillaries...and this is how we, as western medical practitioners, should be referring to the marks anyway. The problem here is that we shouldn't expect our patients to know the medical terminology, so we tend to use a synonym...and generally the synonym we use is "bruise."

The other argument is that cupping marks are not a bruise because there is no pain to the touch. This is an interesting argument as pain is totally subjective and as such can be bent to the argument at hand.

If a patient says that the cupping mark hurts, the practitioner is typically told that they have over treated the patient. Interestingly, my own cupping marks almost always are tender to the touch, regardless of the length or amount of treatment. Pain or tenderness is subjective to the individual and should be addressed on a case by case basis - pain or tenderness itself does not have anything to do with the definition of a bruise.

Leave a comment

Please note, comments must be approved before they are published