Cupping Therapy for Frozen Shoulder: A Gentle Yet Effective Approach

Frozen shoulder, or adhesive capsulitis, can be a deeply frustrating and debilitating condition—not only for those living with it, but also for the therapists trying to help them. It’s a condition marked by pain, inflammation, and an often dramatic loss of shoulder mobility, particularly in external rotation and abduction. Massage therapists often encounter clients suffering from frozen shoulder, yet many are hesitant to treat it because of how painful and limited the shoulder can be, especially during the more acute phases.

That said, there are therapeutic options that don’t require aggressive movement or deep pressure—and cupping therapy, especially in its static form, is rapidly gaining ground as a low-discomfort, high-impact intervention for frozen shoulder. When applied with skill and an understanding of the underlying muscular structures involved, cupping can help relieve pain, increase range of motion, and improve circulation to the affected tissues.

In this article, we’ll explore the nature of frozen shoulder, the muscular and fascial structures involved, and how massage and manual therapists can confidently use cupping techniques to help clients regain comfort and function. We'll also look at how cupping is remarkably accessible for therapists to learn and implement—especially with the help of accredited online CE courses like those offered by Niel Asher Education.

Understanding Frozen Shoulder: What Are We Dealing With?

Adhesive capsulitis is typically characterized by three distinct phases:

1. Freezing Phase – Gradual onset of pain, especially at night, with increasing stiffness. Range of motion starts to decline.

2. Frozen Phase – Pain may lessen somewhat, but stiffness becomes more pronounced. Active and passive movement are both severely restricted.

3. Thawing Phase – Gradual return of mobility over several months, sometimes years.

The exact causes of frozen shoulder are still not fully understood, but it is believed to involve inflammation of the joint capsule, thickening of connective tissue, and adhesions that limit the movement of the glenohumeral joint. Risk factors include trauma, prolonged immobilization, diabetes, thyroid dysfunction, and previous shoulder injuries.

From a therapist’s perspective, the biggest challenges are twofold:

• The pain clients experience even during light palpation or movement, and

• The limited ability to apply traditional massage or mobilization techniques without provoking discomfort.

This is where cupping therapy becomes incredibly valuable.

Cupping Therapy: An Ancient Practice for Modern Pain Management

Cupping therapy involves the application of suction to the skin, using cups made from glass, plastic, silicone, or bamboo. The suction pulls the skin and superficial fascia upward, which increases blood flow, stimulates lymphatic drainage, and can influence deeper fascial layers depending on the technique used.

There are various methods of cupping, including:

• Static cupping (cups left in place)

• Dynamic cupping (gliding cups along muscle fibers)

• Flash cupping (brief application and release)

For conditions like frozen shoulder, static cupping offers a particularly gentle yet effective option. Cups can be placed on key muscles surrounding the shoulder joint without requiring movement from the client, making it ideal during painful or acute phases.

Why Cupping Works for Frozen Shoulder

Cupping may help frozen shoulder in several ways:

• Pain Reduction – The negative pressure from cupping can desensitize nociceptors (pain receptors) and promote the release of endogenous opioids, which reduce pain.

• Improved Circulation – Cupping draws blood to the area, helping reduce ischemia and promote healing in tissues that are often restricted or poorly perfused.

• Myofascial Release – The suction helps release fascial adhesions and muscle tightness without aggressive pressure, reducing joint restriction.

• Lymphatic Drainage – Particularly helpful for reducing swelling and inflammation around the joint.

• Neuromuscular Relaxation – Cupping can downregulate overactive muscles, particularly those compensating for lack of shoulder mobility.

Key Muscles to Target with Cupping for Frozen Shoulder

A thoughtful, anatomy-informed approach can significantly enhance the effectiveness of cupping therapy. Some of the most relevant muscles and tissues for frozen shoulder include:

Subscapularis

This is often considered the primary muscle involved in adhesive capsulitis. Located deep in the armpit, direct access is difficult—but cupping over the anterior shoulder and lateral border of the scapula can still stimulate this region indirectly.

Infraspinatus and Teres Minor

These rotator cuff muscles are often tight, tender, and inhibited in frozen shoulder cases. Cupping over the posterior scapula can reduce pain and improve shoulder rotation.

Pectoralis Major and Minor

Tight pecs contribute to anterior shoulder restriction. Cups placed over the upper chest and anterior shoulder help open the front of the shoulder girdle and reduce internal rotation bias.

Upper Trapezius and Levator Scapulae

These muscles are often overactive in clients compensating for lack of glenohumeral mobility. Cupping over the upper back and neck can calm these muscles and ease secondary tension headaches.

Deltoid (especially anterior fibers)

Direct cupping over the deltoid belly helps address tenderness and tightness without requiring deep pressure.

When to Use Cupping in the Treatment Plan

One of the key benefits of cupping therapy is that it can be used during any stage of frozen shoulder. In the freezing and frozen phases, static cupping provides a low-discomfort way to stimulate circulation and begin reducing restrictions. In the thawing phase, cupping can be paired with gentle mobility work to support more active rehabilitation efforts.

Most therapists find that clients report less pain and improved range of motion after just a few cupping sessions. Cups can be used bilaterally (where tolerated), or in combination with heat therapy, stretching, or gentle myofascial release to optimize results.

Overcoming Therapist Hesitation: A Gentle, Learnable Approach

It’s no secret that frozen shoulder can make therapists nervous. The pain is real, the restrictions are severe, and the recovery process can be long. However, cupping provides a way to actively engage with the condition without provoking pain or relying on aggressive techniques.

Many massage therapists assume cupping is complicated or difficult to learn, but that’s simply not the case. In fact, cupping techniques—especially static cupping—are among the most accessible manual therapy modalities, both in terms of training and application.

There are now comprehensive, accredited online cupping therapy courses that make it easy for therapists to learn the fundamentals of cupping, understand contraindications, and apply techniques confidently in clinical practice.

A great place to start is the online CE cupping courses available through Niel Asher Education, designed specifically for manual and massage therapists. These courses provide clear instruction, downloadable materials, and certification, making it easy to integrate cupping into your treatment approach for a wide range of conditions, including frozen shoulder.

👉 Learn more about the available courses here:
NAT Online Cupping Courses

References

1. Lauche, R., Cramer, H., Haller, H., et al. (2011). "Effectiveness of cupping therapy in patients with the fibromyalgia syndrome – a randomized controlled trial." The Journal of Pain, 12(5), 556-563.

2. Cao, H., Li, X., & Liu, J. (2012). "An overview of systematic reviews of clinical evidence for cupping therapy." Journal of Traditional Chinese Medical Sciences, 2(1), 3-10.

3. Farhadi, K., Schwebel, D. C., Saeb, M., et al. (2009). "The effectiveness of wet-cupping for nonspecific low back pain in Iran: A randomized controlled trial." Complementary Therapies in Medicine, 17(1), 9-15.

4. Gupta, S., & Sharma, V. (2019). "Myofascial cupping: A novel approach for treating musculoskeletal pain." Journal of Bodywork and Movement Therapies, 23(1), 205–210.

5. Qureshi, N. A., Ali, G. I., Abushanab, T. S., & El-Olemy, A. T. (2017). "Cupping therapy: A review of the evidence." Public Health Frontiers, 5, 1-11.

Disclaimer

This article is intended for educational purposes only and does not constitute medical advice. Manual therapists and healthcare professionals should always follow local regulations and professional guidelines when applying cupping therapy.

Cupping should only be performed by trained and qualified practitioners, and clients with certain health conditions may not be suitable candidates for this treatment. Practitioners are encouraged to consult their licensing board and pursue certified training before offering cupping therapy in their practice.

Always seek professional medical guidance before beginning any new therapy or treatment, especially for conditions such as frozen shoulder.