Asian Journal of Medicine and Health

Cupping therapy has re-entered mainstream sports medicine and rehabilitation practice, and a subset of clinicians now apply the cup while the underlying tissue is actively or passively moved, a variant commonly described as dynamic or moving cupping. This critical narrative review examined the available evidence on dynamic cupping applied to lower extremity musculoskeletal conditions, with particular attention to the consistency of the treatment parameters used across studies. Literature published in English between 2006 and May 2026 was identified through PubMed, PubMed Central, Semantic Scholar, the Directory of Open Access Journals, and publisher platforms including Elsevier ScienceDirect, Frontiers, Springer Nature, SAGE, Taylor & Francis, Karger, J-STAGE, and Cureus, supplemented by backward citation tracking through recent systematic and umbrella reviews. A genuinely dynamic protocol, defined as either active limb movement performed while a stationary cup remains applied or a cup that is manually slid across the skin, was described in a small number of controlled and uncontrolled studies targeting the hamstrings, hip and knee region, and lower leg. These studies varied markedly in cup material and diameter, negative pressure or displacement depth, treatment duration, number of cups, movement pattern, session frequency, and comparator condition, and the outcome measures ranged from joint range of motion and isokinetic power to pain and disability indices. A larger body of static and pulsatile dry-cupping trials for knee osteoarthritis, plantar fasciitis, and hamstring tightness offered indirect context but frequently reported null or conflicting between-group findings, and mechanistic dosing evidence linking negative pressure and duration to blood flow and muscle stiffness has so far been generated almost exclusively on upper limb tissue. Confidence in any single parameter combination for the lower extremity therefore remains low. Reporting of cupping interventions was inconsistent with the Standards for Reporting Interventions in Clinical Trials of Cupping, further limiting comparability. Future research should prioritise dose-ranging trials conducted directly on lower extremity musculature, transparent parameter reporting, and adequately powered sham-controlled designs before dynamic cupping can be recommended for specific lower extremity conditions with confidence.