Cupping: it’s not just for Olympians

Cupping: it’s not just for Olympians

 All eyes were on swimming legend Michael Phelps as he climbed out of the pool after the 4 x 100m freestyle relay this week in Rio – and on the large, purple dots all over his shoulder. He hadn’t fallen asleep on his medals, as one wit mused.

The bruises were left by cupping, a traditional Chinese acupuncture technique that has taken this summer’s Olympics by storm.

Michael Phelps seen with cupping marks Credit: Reuters

Social media accounts have been buzzing with pictures of athletes displaying the marks, caused by blood capillaries rupturing under the skin.

They train extremely hard for four years, so they are not going to waste time on something that doesn’t work or may harm themDr Ming Cheng

Cupping – where glass cups are either pumped with air or heated inside by a flame and then applied to the skin to improve blood flow, promoting healing and muscle recovery – is proving particularly popular with the US team (the bruises were clear on gymnast Alex Naddour and swimmer Natalie Coughlin), but the technique has been used by Chinese Olympians for years.

Celebrities such as Victoria Beckham, Jennifer Aniston and, of course, Gwyneth Paltrow are also fans of this alternative therapy, but the fact that top athletes are embracing it is giving the practice a new buzz.

Chinese swimmer Wang Qun was seen with the marks in 2008 Credit: afp/getty images

“Athletes train extremely hard for years, so they are not going to waste time on something that doesn’t work or may harm them,” says Dr Ming Cheng, associate professor of traditional Chinese medicine at Middlesex University.

“We are getting more professional sportsmen and women coming to us and asking for treatment.” But cupping isn’t just for use after extreme exercise – enthusiasts say it can be useful for common ailments such as back pain or stiff joints.

“Cupping is a modality of acupuncture and has been around for more than 2,000 years. It’s good therapy for musculoskeletal problems, particularly muscle strain and tension, neck pain, frozen shoulder, lower back pain, sciatica, sports injuries, tendonitis and tennis elbow,” says Dr Cheng.

“We treat everyone from young people with sports injuries to older people who’ve injured their back gardening or playing golf. We can also use it to treat indigestion.”

The treatment involves applying glass cups to acupuncture points on the body, he explains. “The cups are left on the skin for 10 to 30 minutes. The vacuum effect then sucks up the skin, drawing muscle and soft tissue to the surface, as well as blood capillaries that rupture slightly. It promotes healing by drawing blood to the affected area and relieves tensions, sprains and tenderness in the muscles and tendons.

“In Chinese medicine we believe that illness is caused by energy, or Qi, becoming blocked and cupping is one way of unblocking these. It’s very safe and the purple marks are bruises, not burns – no heat is applied to the skin.

“It is, however, very important that cupping is carried out by someone who is properly qualified – look for practitioners who are members of the British Acupuncture Council or the association of Traditional Chinese Medicine. This means they have had to meet professional standards.”

The method is being used by some physiotherapists, alongside more mainstream techniques. “Cupping can provide pain relief safely with no known significant negative side-effects,” says Chris Ireland, clinical adviser to the Acupuncture Association of Chartered Physiotherapists. “In one session of cupping, neck and shoulder pain intensity can be reduced. It can also be effective in the treatment of conditions such as lower back pain.”

Ian Stones, a qualified traditional acupuncturist and member of the British Acupuncture Council, who practices in Hove in Sussex and Farnham in Surrey, says the method can be carried out to different strengths.

“The dark purple rings you see on athletes are evidence of strong cupping where the flame has burnt for longer and the cup has been applied as quickly as possible afterwards.

“I prefer to use a pump to create the vacuum in the cup as you can get better control to create a weaker vacuum and have a gentler effect. Cupping shouldn’t hurt but you may notice a pulling sensation. People say it’s incredibly relaxing too and great for relieving stress and tension.”

He says it isn’t suitable for everyone though, and should be performed with caution on pregnant women or people taking aspirin or warfarin to thin their blood.

Not everyone is convinced about the benefits of cupping. “There’s no solid scientific evidence that cupping therapy is beneficial for people with arthritis or joint pain,” says Phil Conaghan, professor of musculoskeletal medicine at the University of Leeds and spokesperson for the charity Arthritis Research UK.

“There have been a couple of trials suggesting some level of effectiveness for conditions including carpal tunnel syndrome, however these trials did not give enough good-quality evidence to recommend cupping.

Researchers have shown that cupping is associated with reports of reduced pain intensity but that is likely to be the placebo effect, which we know can be very powerfulDr Martin Jones

“It’s important to note that what works for one person might not work for another. If people are considering cupping therapy or any alternative therapy, they should always seek medical advice before making any treatment changes.”

Dr Martin Jones, a lecturer in sport psychology at the University of Exeter, is also sceptical about recommending cupping. “We don’t fully understand the mechanisms by which it works and what the long-term effects could be. If I was working with an athlete and they wanted to try cupping, I’d advise them that they were delving into the unknown.”

Anecdotal reports and professional athlete testimony does not constitute evidence of an effect, he says.

“Researchers have shown that cupping is associated with reports of reduced pain intensity, but that is likely to be the placebo effect, which we know can be very powerful. The other possibility is that the pressure of the vacuum stimulates nerve pathways and possibly inhibits pain ‘signals’ travelling to the central nervous system – in the same way that rubbing makes your knee feels better if you bang it on something. However, at present it is unclear to what extent cupping induces such mechanisms.”

Dr Jones says the fact that athletes are using cupping would probably increase the placebo effect. “You’ll probably get more people believing in cupping now because Michael Phelps has been using it – despite the lack of evidence in athletic populations.”

For the Olympians, of course, even if cupping does work purely by placebo, that mental boost could be enough to give them the crucial “marginal gain” against their opponents.

Dr Jones says cupping should only be carried out by a professional. “My concern would be that people could try to do this themselves with a tea cup and a lighter. This definitely isn’t something that you should try at home.”