In this short video, Dr. John Stan, DrTCM and Robyn Guidon, R.Ac. discuss a hotly debated topic – cupping marks, and whether they are a bruise or not.

Below you’ll find an article written by Dr. John Stan, DrTCM, and inventor of FasciaBuddy Square cups, diving deeper into the significance of cupping marks.

One of the most common questions practitioners hear is, “What do the cupping marks mean?” Unfortunately, the answers often fall into one of two extremes: either they are dismissed as “just bruises,” or they are explained as the body “releasing toxins.” I don’t believe either explanation tells the whole story.

I prefer to think of a cupping mark (Cm) as a capillary bed flush—a controlled physiological response to fascial decompression. When tissues become chronically tight, restricted, or congested, the tiny capillary beds that nourish those tissues can become compressed. This limits the efficient delivery of oxygen, nutrients, water, hormones, and cellular signals while slowing the removal of metabolic waste products. The local tissue environment becomes less vibrant and less able to move and heal efficiently. We have all felt it, ropy, dense… how can a cell be happy in there?

By applying negative pressure, cupping lifts and decompresses the tissues, opening space within the fascial matrix and allowing those capillary beds to engorge. With each pull on the pump a level of internal decompression occurs. A stronger internal pressure within the cup combined with time will generate a stronger Cm. I encourage practitioners to think about what “cupping dose” they intend to deliver to the tissues they are treating.

I propose that a “cupping dose” is equal to the “Pull Intensity (PI)” within the cup multiplied by time (T). With this idea, we can then predict the type of Cm that will occur as the resulting Cm will be proportional to the cupping dose (PI x T) multiplied by a variable that I am calling “Tissue Response Potential (TRP).

TRP is a variable that reflects how likely a particular area is to produce a Cm under that same dose.

A simple way to think of the TRP is that it is a combination of factors that consider the tissue health and location of the cupping zone, plus patient modifying factors. This would include the following:

• tissue thickness
• fascial density
• depth of capillary beds
• tissue health
• anatomical location
• patient modifiers such as age, medications and connective tissue quality.

With all this in mind a therapeutic cupping dose, will therefore cause some capillaries to undergo extravasation, creating the familiar cupping mark with its varying degree of intensity (pink to dark purple) based on the following relationship:

Cupping Mark Intensity is proportional to: (Pull Intensity × Time) × Tissue Response Potential

Rather than describing cupping marks as “toxins leaving the body,” I explain to patients that it is a capillary bed flush—a localized vascular response that rehydrates the interstitial environment, stimulates circulation, and initiates the body’s natural repair processes.

Interestingly, repeated treatments often produce lighter marks using the same cupping dosage. My clinical observation is that as tissues regain better hydration, mobility, and resilience, the capillary beds become healthier and less fragile. The result is improved movement, less pain, and a reduced tendency to mark under the same decompression dose.

The goal of cupping is not to create the darkest mark possible. The goal is to deliver the right dose of fascial decompression for the tissue being treated. The resulting cupping mark provides valuable clinical feedback about how those tissues responded and helps guide your treatment strategy moving forward.

Stay tuned as we continue exploring fascial decompression, Tissue Response Potential, and how to use cupping marks to guide more effective treatment.

Copyright John Stan, DrTCM June 24, 2026