The Science Behind Cupping & IASTM: What They Are, How They Work, and Who They’re Best For

TBR Wellness & Rehab
May 22
3 min read

At our clinic, we believe education matters just as much as treatment. Two techniques we often incorporate into sessions are cupping therapy and IASTM (Instrument Assisted Soft Tissue Mobilization). While these tools have become increasingly popular in the wellness and sports performance world, many people still wonder:

What do they actually do? Are they evidence-based? And who should, or shouldn’t receive them?

Let’s break down the science behind both approaches and how they may help support recovery, mobility, and pain reduction.

What Is Cupping Therapy?

Cupping therapy uses suction/decompression created by specialized cups to gently lift the skin and superficial tissues. Unlike traditional massage, which generally applies compression into the tissue, cupping creates a decompressive effect by pulling tissue upward.

There are different styles of cupping.

How Cupping May Help

Current research suggests cupping may help through several mechanisms:

1. Improved Local Blood Flow

The suction created by the cups increases circulation to the treated area. Increased blood flow may help bring oxygen and nutrients to tissue while supporting recovery processes.

2. Neurological Down-Regulation

One of the biggest misconceptions is that cupping “breaks up toxins” or “breaks apart fascia.” Current evidence does not strongly support these claims.

Instead, many researchers believe cupping works largely through the nervous system. The sensory input from the cups may help reduce protective muscle guarding and alter pain perception.

This is one reason people often report:

decreased tightness
improved movement
temporary pain relief
a feeling of “release”

3. Mobility & Tissue Glide

When used dynamically (moving with the cups or moving the body during treatment), cupping may help improve range of motion and tissue mobility.

Some studies have shown improvements in:

chronic neck and back pain
athletic recovery
shoulder mobility
flexibility and range of motion

However, research quality is still evolving, and cupping should not be viewed as a “miracle cure.”

What Is IASTM?

IASTM stands for Instrument Assisted Soft Tissue Mobilization.

This technique uses specialized stainless steel or ergonomic tools to assess and treat soft tissue restrictions. You may have heard of techniques like:

Graston®
HawkGrips®
Therapro tools
scraping therapy

IASTM allows practitioners to apply a more focused mechanical stimulus to tissue than hands alone.

How IASTM May Help

1. Sensory Input to the Nervous System

Like cupping, IASTM is thought to work heavily through neurological mechanisms.

The tools stimulate mechanoreceptors within the skin and soft tissue, which may help:

reduce pain sensitivity
improve body awareness
decrease protective muscle tension

2. Improved Range of Motion

Research has shown IASTM may help improve joint mobility and flexibility, especially when combined with movement and exercise.

This can be particularly helpful for:

athletes
chronic stiffness
postural restrictions
repetitive strain patterns

3. Supporting Tissue Remodeling

Older explanations claimed IASTM “breaks up scar tissue” or “releases adhesions.” Modern research suggests the effects are likely more complex.

Rather than physically “breaking tissue apart,” IASTM may help stimulate localized healing responses and improve how tissues tolerate movement and load over time. Not physically breaking up tissue.

Why We Use These Techniques

At our clinic, cupping and IASTM are not used as standalone treatments. They are tools incorporated into a larger treatment approach that may also include:

movement assessment
mobility work
soft tissue therapy
nervous system regulation
corrective exercise
breathwork and stabilization strategies

The goal is not just temporary relief, but improving how the body moves and functions as a whole.

Are The Marks and Bruising Normal?

These marks are called Petechiae.

With cupping and some forms of IASTM, temporary redness or discoloration can occur.

This is usually:

not harmful
temporary
different from traditional bruising

The marks are believed to result from superficial capillary changes and increased blood flow in the area.

However, excessive bruising is not the goal of treatment.

Who Should NOT Receive Cupping or IASTM?

While these techniques can be beneficial for many people, there are situations where they may not be appropriate.

Cupping and/or IASTM may not be recommended for:

Individuals on blood thinners
People with clotting disorders
Open wounds or active skin infections
Severe varicose veins
Uncontrolled diabetes with poor tissue healing
Acute fractures or recent trauma
Active inflammatory skin conditions (eczema, psoriasis flare-ups)
Severe osteoporosis
Certain pregnancy situations (depending on area treated)
Individuals with compromised sensation or neuropathy

These techniques should also be used cautiously with:

very sensitive skin
fragile skin
chronic steroid use
history of easy bruising

A proper assessment is always important before treatment.

Research & Further Reading