Michael Phelps Swears By Cupping. Should You Try It?

There isn't much research to support this ancient practice, but athletes love it anyway.
Michael Phelps competes at the Rio Olympics with circular bruises from cupping on his shoulders and back.
Dominic Ebenbichler / Reuters
Michael Phelps competes at the Rio Olympics with circular bruises from cupping on his shoulders and back.

Michael Phelps won his first gold of the Rio Olympics on Sunday with telltale cupping marks on his back and shoulders, putting him in the company of alternative health-loving celebrities like Jennifer Aniston, Gwyneth Paltrow and Lena Dunham.

But Phelps isn’t the only athlete in Rio with the circular bruises ― several other American Olympians have found healing and relief in this ancient traditional therapy. Though cupping made an appearance at the 2008 Games in Beijing as well, this may be the first time it’s found such wide appeal among the members of Team USA.

Cupping, which has roots in ancient Egypt, the Middle East and China, is said to increase blood flow where it’s applied, and stimulate the body’s “natural energy,” or qi. Sections of skin are suctioned for several minutes, leaving round purple or red bruises on the surface.

Thanks @arschmitty for my cupping today!!! #mpswim #mp 📷 @chasekalisz

A photo posted by Michael Phelps (@m_phelps00) on

But how does this therapy stack up when tested scientifically?

In the case of athletes, there are no studies that seem to test cupping’s ability to enhance athletic performance. Other elite swimmers, including Phelps’ teammate Nathan Adrian, have said cupping is simply a good alternative to massage therapy.

However, there is research that suggests cupping may be effective in treating more than just an athlete’s sore muscles. Several studies have investigated whether cupping can be a helpful or complementary therapy for chronic pain, migraines, and facial conditions. These studies show that compared to other therapies, cupping may be as or more effective at relieving certain medical conditions. But they should all be taken with a grain of salt, because none have cleared the highest bar of therapeutic research: testing the intervention (in this case, cupping) against a placebo control. Having a placebo treatment would separate the effects of cupping from a study participant’s beliefs about its effectiveness, allowing for a more accurate measure of any medicinal properties.

The reason there are no placebo control groups in cupping studies is that scientists simply haven’t found a way to create a convincing placebo intervention for cupping, notes the Mayo Clinic.

What studies have found

Chinese swimmer Wang Qun was seen with marks from a cupping treatment a few days before the start of the Beijing 2008 Olympic Games.
Chinese swimmer Wang Qun was seen with marks from a cupping treatment a few days before the start of the Beijing 2008 Olympic Games.

Researchers at the University of Western Sydney’s Centre for Complementary Medicine Research found in 2012 that cupping, in combination with other traditional Chinese medicines or pharmaceutical medicines, appeared to be more effective at treating things like acne, facial paralysis, and herpes zoster than other traditional or pharmaceutical treatments alone. They came to this conclusion after reviewing 135 randomized controlled trials, although they do concede in the report that most of the studies had a high risk of bias.

Cupping may also provide some benefit when it comes to pain. A 2011 study of 7 randomized controlled trials found that people experienced significant pain reduction with cupping compared to typical treatments like pharmaceutical painkillers, anti-viral medications or heat pads. But like the 2012 meta-analysis, the researchers for this study also pointed out that most of the trials had a high risk of bias and weak methodology. They also noted that there may be a publishing bias, in that researchers only bother to publish positive results about cupping and other traditional therapies, which doesn’t allow others to examine and assess any possible negative effects.

Those with chronic headaches may also benefit from cupping. A 2008 Iranian study on the effects of “wet cupping,” which combines suction with controlled bleeding of the suctioned skin, found that participants experienced an average of 66 percent decrease in pain severity for up to three months after a wet cupping treatment, as well as 13 fewer days of headaches per month.

Does it matter?

Marcus Williams, a physical therapist at the Ohio State University Wexner Medical Center, has been using cupping on his clients for about two years now.

While he and his colleagues continue to keep an eye on cupping research as it’s published, they’re confident that cupping is a safe, non-invasive procedure they can use on clients who are suffering from soreness or chronic pain. Unlike traditional physical therapy techniques like massage, which applies force to muscles or tendons, cupping pulls skin and tissue away from the body, which is a unique way of relieving stress, Williams explained.

“We thought that was intriguing from the standpoint of patients who come in with tendinopathy or tendonitis,” Williams said. “If we can decompress and unload some of the structures that are getting overworked, it can be beneficial.”

Anecdotally, Williams has found that cupping is an effective way to relieve soreness or pain and will continue to use it “when appropriate,” and especially when other therapies fail to relieve the pain.

So, should you try cupping?

It’s going to take high-quality trials with placebo control groups to turn up more reliable information about the effects of cupping. But it doesn’t look like Phelps or any other athlete is going to wait for those results when they’ve got a medal to win.

If you have muscle soreness or chronic pain and traditional therapies have failed, it doesn’t hurt to try suctioning up a few square inches of skin to see if you can get some relief. But the jury’s still out on whether the suctioning actually helps, or if the placebo effect from the treatment is so strong that it can transform your perception of pain.

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