In TCM (Traditional Chinese Medicine), where cupping originates and has a tradition spanning thousands of years, cupping is practiced in both directions—upward and downward. The primary goal of cupping in TCM is to improve the flow of qi (life energy) and blood in the body, which is believed to promote healing and relieve pain. The techniques and directions are adapted depending on the treatment objectives and the specific needs of the patient.

In modern massage training, particularly in Western countries, there is sometimes caution around certain techniques. Some schools teach that cupping should only be performed in an upward direction to avoid the risk of blood clots. This caution is based on concerns that improper handling of blood vessels could lead to damage. There is a theoretical risk of causing blood clots if cupping is performed incorrectly, especially in individuals predisposed to clotting. However, it is important to note that there is a lack of extensive scientific studies explicitly showing that cupping in a particular direction directly causes blood clots.

Thus, there are different perspectives on cupping, with both Traditional Chinese Medicine and modern Western medicine offering their own methods and explanations. Regardless of the school or method, safety and the patient’s well-being should always be the top priority. If there is any uncertainty or risk of complications, caution should always be exercised. As with most aspects of health, there are no universal answers that apply to everyone; the approach needs to be tailored to each individual.