Will Cupping Boost Your Performance?

Michael Phelps of United States competes in the semi final of the Men's 200m Butterfly on Day 3 of the Rio 2016 Olympic Games at the Olympic Aquatics Stadium on August 8, 2016
Michael Phelps of United States competes in the semi final of the Men's 200m Butterfly on Day 3 of the Rio 2016 Olympic Games at the Olympic Aquatics Stadium on August 8, 2016. Ian MacNicol / Getty Images

Michael Phelps had just won a record 19 gold medals, but all anyone cared about were the dark marks on his back. Though it may look like a painful injury, it is actually the sign of an ancient Chinese therapy, known as cupping, used to alleviate muscle tightness, and increase circulation.

“These athletes are pushing their bodies to the limit, and this is a great non-chemical way to relieve the punishment being sustained,” says Noah Rubinstein, clinic director at The YinOva Center. Over his years of practice Rubinstein has used cupping, usually paired with acupuncture sessions, to treat a wide range of clients from Broadway actors to professional football players.

Though cupping continues to have skeptics, it is growing in popularity with world-class athletes thanks in part to several studies that say it can provide short-term pain relief. Phelps is not the first elite athlete to subscribe to the therapy; fellow Olympian Natalie Coughlin and Denver Bronco DeMarcus Ware have tried the treatment. If you're considering joining them, here’s what you should know.

What Is It?
Cupping may have originated as early as 3,000 B.C. in China, and is now practiced worldwide. The idea has stayed the same, though the technique has evolved. In the most common method, specially designed silicon cups are placed against the skin, and a flame or pump is used to pull out the air inside, creating a vacuum. The light suction produced lifts up the skin, separating it from the muscle fascia; this prompts the body to send more injury-repairing white blood cells to the area. Healers in China referred to this result as the removal of “stagnation."

Does It Work?
Rubinstein, of course, is a proponent of the practice. “First and foremost I have seen very rapid relief of pain and muscular dysfunction,” he says. “You’re seeing a lot of focus on the backs and the arms at the Olympics, which is where those injuries are commonly seen. The effects are like a reverse massage, where muscles that are overworked and going into spasm are forced to release from each other.” While there are multiple studies showcasing a positive effect in test subjects such as knee arthritis and neck pain, there's documented evidence of placebo effect at work too. In other words, patients think it works and so, to some extent, it does. In Rubinstein's opinion, the regimen is beneficial, but not without limitations. “It is not a cure-all. Sometimes people will come in and look for a non-medical way to treat something that is best assessed by a general practitioner.”

What Does It Feel Like?
Rubinstein assures the marks left on Phelps’ back make the process look harsher than it is. “The cupping process is actually very comfortable,” he says. “The end results look much harsher than you would imagine after doing it.” Sessions commonly take no more than 15 minutes, and the only feeling is a slight release when the cups are removed. There is no tingling or pain. “The relief experienced after is much like that of a massage, and the markings last only a few days.”

Should You Try It?
"Lack of scientific support notwithstanding, I think from a physiological standpoint, there is some merit to it," says Dr. Daniel V. Vigil of the David Geffen School of Medicine at UCLA. "The effects that cupping has on the body are fairly well established to speeding up muscle nutrition. Perhaps we're just waiting for the right study to prove that it works." According to the New York Times, studies have not pinpointed any established risks with cupping. And, as Vigil points out, while more research needs to be done and the benefits might be driven by placebo, if it works for you, consider it another tool in the recovery toolbox. And it will get you one​ step closer to training like an Olympian.