Cupping therapy has gained considerable attention in sports medicine over the last several years, particularly after being spotted on high-profile athletes during major competitions like the Olympics. This ancient therapeutic method, traditionally used to promote healing and relieve muscle stiffness, has been adopted by athletes and sports healthcare professionals as a complementary treatment to conventional sports medicine practices. The application of cupping in sports medicine is often aimed at enhancing recovery, reducing muscle soreness, and improving range of motion, among other benefits.

Cupping Therapy (CT) is an ancient treatment currently used in sports medicine to treat a broad range of conditions including musculoskeletal pain, especially pain in the back, neck, and shoulders. The practice dates back to ancient Egyptian, Chinese, and Middle Eastern cultures. Cupping aims to relieve muscle tension, improve circulation, and reduce pain and inflammation, among other health benefits.

What is the rationale for using cupping in sports medicine?

• Enhanced Recovery: Sports performance professionals use many methods to speed up recovery and reduce downtime. Cupping is believed to facilitate muscular recovery by increasing blood flow and lymphatic circulation to the affected areas.
• Pain Reduction: By potentially modifying pain perception through neurological pathways, cupping might offer relief from muscle tension and soreness, which are common after intense physical activity.
• Improved Flexibility: The suction from cupping may help in loosening connective tissues and thus reduce stiffness and improve flexibility and range of motion, which are crucial for optimal athletic performance.
• Cupping is a relaxing treatment modality not unlike massage and acupuncture, and some of its benefits may be a result of stress reduction that is not easily objectified or investigated.

What does the science say about how cupping works?

No single theory can explain cupping’s full spectrum of effects. Proposed scientific mechanisms of action include:

• Increased Blood Flow: One of the most frequently cited mechanisms is that the suction from the cups increases blood flow to the area where the cups are applied to remove toxins and waste from the body. This could potentially aid in muscle healing and reduce muscle soreness.
• Anti-inflammatory Effect: Some studies suggest that cupping might help reduce inflammation, potentially contributing to pain relief. The mechanism is thought to involve the modulation of the immune system’s activity, though specifics are not well understood.
• Pain Modulation: Cupping may influence the body’s pain perception by modulating neurological signals. The theory is that the therapy might activate nerve fibers in the skin to send signals to the brain that alter pain perception.

What are the reported benefits of cupping?

1. Reduced Muscle Stiffness: Athletes report feeling less stiffness in their muscles following cupping therapy, potentially allowing for improved performance and reduced injury risk.
2. Decreased Inflammation: While the exact mechanisms are not fully understood, some propose that cupping may aid in reducing inflammation, thereby aiding the recovery process.
3. Psychological Benefits: There is also a psychological aspect to cupping therapy; athletes may experience a placebo effect or a psychological boost, believing in the therapy’s effectiveness, which in turn can positively influence performance.

What are the clinical findings?

• Muscle Pain and Soreness: Some research supports the use of cupping for reducing muscle pain and soreness, particularly in athletes. A review published in the Journal of Alternative and Complementary Medicine found that cupping might help alleviate short-term pain and stiffness. Other studies report that cupping increases pain thresholds and reduces inflammation. There is growing evidence that wet cupping is effective for musculoskeletal pain, nonspecific low back pain, and neck pain.
• Chronic Pain Conditions: There is limited but growing evidence that cupping has the potential to treat chronic pain conditions like fibromyalgia and arthritis. Cupping has been found effective to manage carpel tunnel syndrome. Cupping has been shown to treat cellulitis.
• Other Conditions: Cupping has been shown to treat delayed onset muscle soreness, and plantar fasciitis.
• There is evidence that cupping can induce comfort and relaxation on a whole systems level resulting in endogenous opioid production in the brain that leads to improved pain control. It increases blood circulation and activates the immune system.

Cupping is safe and has been found to be beneficial for centuries. For athletes considering cupping therapy, it’s essential to consult with sports medicine professionals who consider it as part of a holistic approach to health, recovery, and performance enhancement, rather than a magic cure-all.

CAO Sports Performance Center is dually focused on physical therapy and sports performance. Our team of renowned physicians, therapists, and coaches work together to help you recover well and achieve and maintain healthy sports performance. Contact us to schedule a consultation to learn how to recover well and enhance your performance on and off the field.

References

• Al-Bedah AMN, Elsubai IS, et al. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2018 Apr 30;9(2):90-97. doi: 10.1016/j.jtcme.2018.03.003. PMID: 30963043; PMCID: PMC6435947.
• Trofa DP, Obana KK, et al. The Evidence for Common Nonsurgical Modalities in Sports Medicine, Part 2: Cupping and Blood Flow Restriction. J Am Acad Orthop Surg Glob Res Rev. 2020 Jan;4(1):e1900105. doi: 10.5435/JAAOSGlobal-D-19-00105. PMID: 32672728; PMCID: PMC7028774.