Olympians Love Cupping! What's the evidence it works?
Why is Cupping Therapy suddenly so popular with Olympic athletes? What does cupping do and why do Olympians love it? The 2016 US Olympic athletes, amongst them Michael Phleps and the US Swim Team found that cupping reduced sore muscles from training while improving range of motion, both of which enhances athletic performance!
As a licensed Acupuncturist (L.Ac). and bodyworker the best way to describe the actions and benefits of cupping therapy is with the term often used by PT’s who have embraced this ancient therapeutic tradition: myofascial decompression. Cupping Therapy has long been part of Eastern Medicine but has also been used by many other cultures around the world. The suction used by the cups with either manual suction methods (no heat) or traditional Fire Cupping method helps to lift and separate stuck muscle and fascial layers of your body. The marks are caused by an increase in local microcirculation. What causes myofascial compression? Injuries as well as repetitive, poor postural habits create myofascial patterns of tension and pain. Cupping therapy or myofascial decompression helps release these layers. Do the marks left by cupping hurt? In my own experience and that of all my patients, the marks do not hurt like a bruise often does and the area that received cupping therapy will generally feel significantly better afterwards. A few people occasionally experience pain with cupping therapy however most people find it painless and actually pleasurable.
Where’s the evidence that it works??
Interesting new research that should be duplicated on a larger scale was published by Chirali in the third edition of the book, Traditional Chinese Medicine Cupping Therapy (2014). The author conducted a small initial study in 1996 with over a 14 day period with 6 patients receiving cupping therapy every other day. The researchers took three blood sample from patients within the two week period: baseline, Day 7 and Day 15. Chirali and Metin Erduran, the biochemist did not ‘know’ what they were looking for but one of the values all patients had in common is significant: they all experienced a reduction in Erythrocyte Sedimentation Rates (ESR) or Sed rate. ESR often high in those with myofascial pain. SR or Sedimentation Rate is often indicative of high levels of inflammation and often found in autoimmune chronic pain conditions. In a follow up study, researchers also found a reduction in ferritin and fibrinogen levels, other inflammatory indicators, in those patients who received cupping therapy (Chirali, 2014).
Research is often driven by clinical experience: my clinical experience and observation with 22 years as a professional bodyworker is that myofascial compression creates tension and torque in the body. When my massage clients ask what I feel in those areas, I respond that the tissue feels sticky. As a licensed Acupuncturist when I insert a needle into a trigger point the tissue is sticky: meaning I can viscerally feel the tissue sticking to the needle; which is abnormal. Most of the time, acupuncture needles simply glide in and glide out. The stickiness in tissue can dispersed by many modes: bodywork, acupuncture and the Olympic favorite - cupping therapy or myofascial decompression - and optimally a combination of all three!
The problem with many current studies:
A meta-analysis on other research being done on the the effectiveness of cupping therapy cited ‘low qualitative material’ meaning the studies used subjective measurements of pain relief and thus were not verifiable through double blind studies. Research skeptics will tend to dislike studies where placebo can influence of subjective outcomes and therefore potentially taint evidence of efficacy. In general this is a problem facing many CAM modalities: how to evaluate pain management efficacy? How do you objectively measure pain relief? Pain is often by it’s very nature, subjective. There are however, objective measurements of pain; such a measuring biochemical markers in inflammation, before during and after a course of cupping therapy.
What to avoid! DIY!
I would avoid doing what many current popular media articles are suggesting - simply buying a cupping set yourself and winging it. If you do opt to DIY, please do not perform cupping therapy on or near an major artery! If you do not know where major arteries are, please do not cup yourself! Secondly, there is evidence of tissue damage when cupping is performed badly, most often meaning it is simply done too intensely (too much suction) or too long. If you prefer better outcomes to possible DIY debacles seek out a professional who knows the right areas to apply cupping therapy with the correct amount of intensity and correct amount of time. An interesting point made by a meta analysis of the local metabolism and neck pain was that cupping was always more successful in combination with acupuncture (Emerich, 2014).
Find an Licensed Acupuncturist L.Ac. in your area who offers cupping! Cupping Therapy is a central part of my Master’s in Acupuncture training and and my current professional practice. Not all L.Ac. offer cupping. By the way did you know that all L.Ac.’s in the US must attain a Masters of Science in Acupuncture; which can take 4-5+ years to earn. My Master’s degree included over 900 hours of clinical experience with an additional 2,000 hours of course work: half the course work was in biomedicine classes, including Organic Chemistry, Biochemistry and Microbiology. L.Ac.’s must also pass 3-4 very rigorous national exams in Biomedicine, Point Location, Theory and Diagnostics in order to attain our license to practice acupuncture. Not all L.Ac’s perform Cupping Therapy and more and more massage therapists and PT’s are offering it. Go to someone with proper training and knowledge. It’s a valuable experience!
Chirali, Ilkay Zihni (2014) Traditional Chinese Medicine Cupping Therapy, Third Edition. Churchill Livingstone Elsevier, 247-310
Emerich, M., Braeunig, M., Clement, H. W., Lüdtke, R., & Huber, R. (2014). Mode of action of cupping—local metabolism and pain thresholds in neck pain patients and healthy subjects. Complementary therapies in medicine, 22(1), 148-158.
Cao, H., Liu, J., & Lewith, G. T. (2010). Traditional Chinese Medicine for treatment of fibromyalgia: a systematic review of randomized controlled trials. The Journal of Alternative and Complementary Medicine, 16(4), 397-409.