Olympians are ‘cupping’ to speed up muscle recovery. Does it work?

Large hickey-like marks on athletes like Michael Phelps are not a trendy Olympic-ring tattoo — they’re a side effect of a therapy that’s been around for centuries.

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Trudeau_cupping

Cupping is making headlines again, with Prime Minister Justin Trudeau (pictured above) bearing the signature circular marks on his forearm last week. Maclean’s confirmed with his press secretary that Trudeau “does indeed use that treatment.” We first explained the alternative therapy in August 2016, when Michael Phelps was spotted with the eye-catching bruises at the Rio Olympics.

Growing up in a Chinese-Vietnamese home, I was surrounded by Chinese medicine. The dried herbs, Eagle oils and Tiger balms I understood. But as soon my father complained of muscle soreness and my mother brought out the glass cups, I averted my eyes. I thought I had mentally erased the image of my father’s back being being sucked into bulbous glass orbs. But when Michael Phelps and many other Olympians showed off purple crop circle-like bruises in Rio last weekend, I immediately knew what it was.

Cupping therapy isn’t new. It has existed in China and some African countries for thousands of years. In the beginning, practitioners would use cattle horns to create a vacuum on the skin — they’d physically suck the air out from a hole at the top of the horn. Cupping was first documented to remove “foreign matter” from the body in the Ebers Papyrus, an Egyptian medical document in 1550 B.C.  The Egyptians eventually introduced cupping to Greece and other European countries. In 300 A.D. China, the practice was recorded by Taoist herbalist Ge Hong in A Handbook of Prescriptions for Emergencies. In 2004, it started to see a spike in popularity in the Western world after Gwyneth Paltrow was photographed at a film premiere with the prominent marks on her back. 2016 isn’t the first year the distinct spots have made an appearance on Olympians either: Chinese swimmer Wang Qun was seen with them on her back at the 2008 Beijing Olympics.

How it works

The traditional practice is done by inserting a flame in a glass cup and quickly removing it. The flame heats the glass and exhausts the oxygen in it, creating a vacuum between the skin and the cup. The suction pulls the skin away from the body, breaking the capillaries beneath the skin’s surface. It’s similar to a hickey and, like the love bites, the marks can last up to a couple of weeks. The belief is that cupping brings more blood to an area, which promotes healing and prevents blood from ‘stagnating’.

There are many other forms of cupping, including some that forgo the fire and instead use a mechanical pump to create suction — this is the type that Michael Phelps and several other Team USA athletes have been undergoing.

Does cupping relieve muscle soreness?

There have been at least 550 clinical studies done on cupping between 1959 and 2008, according to a review published by the BMC Complementary and Alternative Medicine. However, many of the studies were found to have high risk of bias or were poor quality. Recent studies haven’t come to more definitive conclusions. A 2012 study suggested the therapy may help shingles, but the researchers also admitted a need for further (and better) studies before drawing any conclusions. A randomized controlled trial published in 2013 found cupping was no more effective for chronic neck pain than progressive muscle relaxation, a method of tensing and relaxing muscles.

Phelps’ trainer has said this is “just another recovery modality,” but there are several other unproven recovery options for elite athletes that don’t leave marks like cupping does. The science on massages, cryotherapy, alternating hot and cold baths, pain relievers (acetaminophen) and nonsteroidal anti-inflammatory drugs (NSAIDs) is also inconclusive. For now, simply letting muscles rest may be the best option.

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