Can Cupping Really Speed Post-Workout Recovery?

Michael Phelps is sporting the trademark bruises from the ancient practice of cupping, but does the treatment work to help athletes?

Michael Phelps competes in the Men's 200m Butterfly Final on Day 4 — (Getty Images)
Aug 11, 2016 at 6:08 PM ET

Leading up to Rio, conversations were dominated by issues like Zika, economic inequality, athlete doping, corruption, and poop-filled bodies of water. Now that the games have started, focus has turned to the splotches dotting many of the Olympians, most noticeably Michael Phelps. So does this ancient practice, popularized in the West by none other than Gwyneth Paltrow, really help elite athletes?

Athletes who use cupping therapy (sometimes known as myofascial decompression) claim that it helps relieve muscle soreness. There are a few forms of cupping, but the “dry” cupping en vogue with Olympic athletes today involves placing a plastic or glass cup on the skin and using a pump or heat to create a vacuum seal. The pressure from the vacuum pulls the tissue  upwards, breaking small blood vessels in the process, which leaves distinctive, round bruises that serve as walking advertisements for the treatment.  

The practice definitely leaves the person covered in polka dots, but beyond that, it’s unclear what it achieves. It may reduce stiffness by increasing blood circulation (this is the same concept behind a post-exercise massage). Some claim it can increase local inflammation, bringing in proteins that improve healing. Alternative medical practitioners claims it helps to “restore the free flow of Qi,” the concept of life force in traditional Chinese medicine. It may also do absolutely nothing at all other than leave you looking like you went several rounds with a lamprey.  

In a 2010 review published in the BMC Complementary and Alternative Medicine, researchers looked at hundreds of prior studies on cupping and concluded that there wasn’t enough solid research to recommend it as a therapy—cupping may help with conditions ranging from chronic pain resulting from osteoarthritis to shingles to conditions like respiratory disease and acne; however, the studies on it are riddled with bias.

Among other things, that means the benefits could possibly be attributed to the placebo effect. The BMC review’s conclusions were backed up by systematic reviews published in Evidence Based Complementary Alternative Medicine in 2011, PlosOne in 2012, and, most recently, the Journal of Traditional Chinese Medical Sciences in 2015. So despite the fact that the therapy has been used for millennia, there’s scant evidence that it actually works.

But none of these studies are really relevant to the kind of cupping used by athletes like Phelps to treat acute muscle soreness. For one thing, more than half of them looked at the alternative method of “wet cupping,” a more complicated form that additionally involves making incisions on the person’s skin and suctioning out small amounts of blood. For another, most athletes are using cupping to treat exercise induced muscle pain, rather than chronic issues— whether the process will help clear up pimples isn’t exactly a relevant finding. It’s isn’t simply the case of weak studies on the subject; the research just isn’t there.

If cupping is effective at speeding along post competition recovery, there’s no reason to think non-professional athletes wouldn’t experience the same benefits of muscular pain relief. In terms of physiology and anatomy, a non-athlete’s body is more or less the same as that of an athlete performing in Rio — humans have the same basic muscle groups and blood vessels and immune system. More likely, the process will be just as useless on a layperson’s as it is on an Olympian’s.   

Corey Snyder, a physical therapist with the University of Michigan’s Sports Medicine Program, emphasizes that while the foundation of sports medicine is evidence-based treatments for recovery, like manual therapy and strength training, cupping shouldn’t necessarily be rejected out of hand.

Whether competing in the Olympics or a local pick-up game, “many athletes are very competitive and looking for an edge … we don’t have a good scientific foundation for cupping. But if the athlete finds it helpful, we will support them because there may be a psychological component to it helping with the performance,” Snyder says.

Maybe science will vindicate this practice years down the road or maybe it will conclusively show that using cupping pre- or post-competition in a sporting event is as superstitious as wearing a lucky bracelet. Don’t run out and order yourself a set of fancy new cups to use after the gym quite yet.  Just because the man on the Wheaties box believes in it, doesn’t mean it will work for you.