Hijama, known since ancient times, has been used in folk medicine for therapy and body detoxification. The earliest records of hijama come from Islamic countries and ancient Egypt, thousands of years before Christ. Today, hijama, popularly known as cupping therapy, is practiced worldwide and has gained significant popularity among professional athletes due to its effects on the body. Interestingly, similar practices of “bloodletting” for health improvement are found throughout history in many civilizations, including Ancient Greece and modern cupping therapy.

Hijama therapy can be divided into three phases:

• Massage

• Dry cupping – placing suction cups

• Wet Cupping – making slight incisions (up to 2mm) with a surgical scalpel to release toxins.

Although skin incisions might sound alarming, they are only about 2mm deep and cause minimal pain, more like a mild stinging sensation. The procedure is performed under safe conditions, with the skin being treated with medical substances for disinfection.

The benefits of hijama are extensive, and the post-therapy sensation varies individually. The color of the “marks” left on the skin after hijama reveals a lot about the condition of the treated area. These marks usually disappear within 7 days of the treatment. 

The main effects of hijama include:

• Body detoxification 

• Increased mobility of soft tissue and joints

• Increase in red blood cell count 

• Improved microcirculation

• Separation of muscle fascia (connective tissue) using vacuum, which is unique to this method. 

Cups or suction devices are placed on reflex zones and painful areas along the entire back, or on specific regions like the shoulders or knees. Typically, the inner thigh, abdomen, and neck regions. 

In some Muslim countries, hijama is a part of everyday life, with people regularly visiting their therapists, known as "hijama practitioners." 

An interesting fact is that the analysis of the contents from the cups, i.e., the blood residue left in the cups after hijama therapy, contains only about 10-15% blood; the rest is toxins, lymph, and water. The blood drawn is capillary, subcutaneous blood that does not reach the liver, the body's natural filter. This process helps the body eliminate unwanted substances (toxins) and encourages the production of new, healthy red blood cells.

In modern times, hijama is most commonly used by professional athletes as part of their recovery after intense physical exertion during the competitive season. A notable example is one of the greatest swimmers of all time – Michael Phelps, who appeared at the Olympic Games after qualifying with marks on his back and shoulder region, which was a big shock to the public. His medical team then revealed that this was done to increase circulation, range of motion, and speed up the athlete's recovery process.

It's important to note that people who undergo extreme physical exertion have different needs compared to recreational athletes. Therefore, when determining the frequency of hijama sessions, many factors are considered. The recommendation is that the interval between therapies should be about 30 days, while athletes can undergo hijama immediately after the marks on the skin have passed. 

Contraindications, i.e., conditions where hijama is not recommended, include skin diseases, blood disorders like anemia and hemophilia, malignancies, menstrual cycle, and pregnancy – hijama therapy should not be performed in such cases.

Like other therapeutic methods, hijama has evolved over time, especially in the way vacuum is created. Traditionally, the vacuum was created by heating a glass cup with a stick and ignited cotton, but this was a highly invasive and unsafe method. Today, each cup has a valve on top through which the amount of vacuum desired is regulated, thus eliminating the risks of unwanted situations. 

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