Olympic swimming fans everywhere are talking about cupping these days: a discussion brought on by Michael Phelps' and Cody Miller's purple-dotted shoulders. Olympic gymnast Alex Naddour has also been seen sporting the hickey-like marks, and many other world-class athletes admit to using cupping.
According to Reuters, sales of cupping therapy equipment rose by 20 percent in the three days following Phelps' big win.
The International Cupping Therapy Association also reported a "50 percent increase of healthcare practitioners seeking out their cupping certificates" during that same timeframe. Acupuncture physicians have also reported an increase in inquiries about the treatment.
Cupping is an ancient medical treatment; its Chinese roots date back to 300 or 400 A.D. Egyptian and Middle Eastern cultures also have ancient records of the practice.
Cupping is still regularly used in traditional Chinese medicine (TCM) in Chinese hospitals and elsewhere. Suction cups of varying sizes are attached to the body, and the suction draws blood to the surface of the skin. Hence, the bruise-like marks.
The treatment is said to improve blood circulation, thereby speeding up healing, reducing pain and easing muscle soreness. According to Dr. Houman Danesh, a pain management specialist at Mount Sinai Hospital in New York, cupping helps "jumpstart the body's natural healing process."
Phelps and Naddour both swear by the treatment. At a recent press conference, Phelps said he gets cupping done before most meets,4 and Naddour told USA Today that cupping has been a "secret … that keeps me healthy. It's been better than any money I've spent on anything else."
While some media outlets have derided the athletes for promoting quackery, studies tend to support its use. For example, a 2014 review of 16 studies done on cupping suggests it can indeed be beneficial for pain. According to the authors:
"Cupping combined with acupuncture was superior to acupuncture alone on post-treatment pain intensity … Results from other single studies showed significant benefit of cupping compared with conventional drugs or usual care…
This review suggests a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment, heat therapy, usual care or conventional drugs."
A study published in Evidence-Based Complementary and Alternative Medicine earlier this year found cupping significantly reduced chronic neck and shoulder pain, compared to no intervention.
In the cupping group, the intensity of the neck pain was reduced from a severity score of 9.7 to 3.6. Among controls, pain was reduced from 9.7 to 9.5. The study also evaluated measurable physical effects, including changes in skin surface temperature and blood pressure.
Both measurements showed statistically significant improvements among those who received cupping. An earlier study comparing cupping to progressive muscle relaxation found both treatments provided similar pain relief for patients with chronic neck pain after 12 weeks.
However, those who received cupping did report significantly greater "wellbeing" and higher pressure pain thresholds compared to those who practiced progressive muscle relaxation. Research published in 2012 also reported beneficial results on patients with arthritic knee pain.
A meta-analysis of 550 studies published in PLOS One that same year found cupping "is of potential benefit for pain conditions, herpes zoster, cough and dyspnea." According to the authors:
"Meta-analysis showed cupping therapy combined with other TCM treatments was significantly superior to other treatments alone in increasing the number of cured patients with herpes zoster, facial paralysis, acne and cervical spondylosis. No serious adverse effects were reported in the trials."
This video may not be available in all countries.
Myofascial decompression therapy is the name given to the cupping treatment among athletic trainers. In the video above, you can see Phelps getting the cups placed along his back using a hand-held air pump that extracts the air from the cup once it's placed on the skin.
TCM practitioners will typically use glass cups. Oil is first applied to the skin to prevent excessive friction and pain as the flesh is sucked into the cup. When using glass cups, the vacuum is created by lighting a cotton ball soaked in rubbing alcohol and holding it inside the cup.
The fire burns out the oxygen inside the cup, so when the flame is removed and the cup placed on the skin, the resulting vacuum creates suction. If the suction is too strong, you can ease it by gently pressing a finger near the rim of the cup, letting in a little bit of air.
The cups can be left in place or slowly moved around, the latter of which is referred to as cupping massage; the effect being similar to that of a deep tissue massage. Cups are typically left on for three to five minutes. The resulting welts will typically vanish in a couple of days, much like a regular bruise.
Leonid Kalichman, Ph.D., a senior lecturer at Ben-Gurion University of the Negev in Israel, has written more than 150 papers on physiotherapy and rheumatology. He believes that by causing localized inflammation, cupping helps trigger cytokine production that modulate your immune system response.
In a recent review paper on cupping research, published in the Journal of Bodywork and Movement Therapies, Kalichman and his co-author Efgeni Rozenfeld note that:
"Mechanically, cupping increases blood circulation, whereas physiologically it activates the immune system and stimulates the mechanosensitive fibers, thus leading to a reduction in pain.
There is initial scientific evidence that dry cupping is able to reduce musculoskeletal pain. Since cupping is an inexpensive, noninvasive and low-risk (if performed by a trained practitioner) therapeutic modality, we believe that it should be included in the arsenal of musculoskeletal medicine."
While more research may help explain the exact mechanisms behind cupping's healing power, many patients are satisfied knowing it works for them — regardless of the how or why. As noted by Jessica MacLean, acting director of the International Cupping Therapy Association:
"When people get the treatment and they recover really fast, they don't care about the scientific evidence — they just care that it works."
The following anecdotal success story was reported by Desert News Utah:
"It works for 33-year-old Maria, who was at Master Lu's … for acupuncture and cupping therapy for several herniated discs in her lower back. She said she's tried many options, but the pain gets so bad at times, she can't move. 'As soon as I had it done, it was immediate relief,' she said. 'I never went back to anything else.'
Maria … injured her back lifting and moving a lot of boxes. She said that in addition to immediate and long-lasting pain relief, the acupuncture and cupping procedure is 'relaxing' to go through. She will have about three appointments within the week and then not need to return ntil pain flares up again from overuse, Lu said."
Cupping is easy to do and vacuum sets can be purchased online for as little as $30. However, I would strongly recommend going to a trained TCM practitioner. Licensed doctors of TCM have a minimum of 3,000 hours of training and know how to perform cupping safely and effectively.
Care to avoid excessive suction must be taken when treating certain areas of the body. While your back and thighs can safely handle heavy suction, it could be risky to cup certain areas of your neck, for example, unless you know what you're doing.
Cupping is also not done on your head or face, so if you have a headache, you would typically treat your neck, shoulder and/or back muscles; the cups would NOT be placed on the temples or forehead. Cupping is also contraindicated for certain serious health conditions.
So, could cupping work for you? You'll simply have to try it before writing it off. Studies and anecdotal evidence suggest cupping can be a helpful adjunct to other therapies for pain. In some cases it may even work as a stand-alone treatment, although this is not the norm. The good news is, if it works, you'll notice a difference. And if it doesn't, no harm will come to you.
The procedure itself is typically painless (provided excessive suction is not used), and the bruises — which indicate that stagnant blood has been drawn from the tissue to the surface — will typically disappear within days. If blood stagnation is not an issue, you will not experience any bruising at all.
Step into a softly lit oasis with oversized, reclining loungers. Settle in. Lean back. Close your eyes and turn your feet, neck and shoulders over to a skilled and intuitive massage therapist. This is your hour, your space, your time to cherish Footopia.