Chinese Cupping Therapy: Six Questions Answered...
1. Why were people talking about Cupping Therapy so much during the Rio Olympics?
Cupping has exploded into public attention during the Rio 2016 Olympics as Michael Phelps, the most successfull Olympian of all time has been seen with highly visible cupping marks on his shoulders and upper back, fuelling much renewed interest in the ancient technique.
2. What is cupping therapy?
Cupping is first mentioned in early Chinese texts (Ma Dang Dui medical manuscripts) around 168BC, but we also find mention is various other traditional medicine systems. Cupping involves placing a hollow vessel on the skin and creating a vaccum using fire or a vacuum pump in order to stimulate circulation to local tissue and mechanically lift the muscle and fascia with the aim of reducing pain and tension, or enhancing a traditional acupuncture treatment. It is commonly used for musculoskeletal problems and pain but traditionally has been used for a wider range of health problems for example chronic respiratory problems. It is usually used alongside acupuncture.
3. Why is Michael Phelps using cupping?
Michael Phelps is not the first athlete to turn to cupping. In the 2008 Beijing Olympics, swimmer Wang Qun was famously seen sporting the tell tale signs of cupping. Sports therapy interventions may be aimed at recovery, injury prevention or injury treatment . The Olympics are the culmination of a lifetime of swimming and 4 years of focussed work. Michael Phelps needs to be able to perform at his best without being limited by any injuries or pain that he might be carrying. Shoulder pain in elite swimmers is extremely common. One survey of elite swimmers found 91% had shoulder pain, 84% had positive shoulder impingement and 67% had tendinopathy of the supraspinatus. Many turn to anti inflammatory medicine, but the usefulness of these are disputed and additionally carry risk of stomach irritation or worse. Cupping is a low risk non-invasive intervention that has been proven to improve short term pain compared with other interventions. Phelps may be using cupping to help manage short-term pain, or to aid recovery through stimulation of circulation through the tissues and muscules of the shoulder and upper back. As a mature and ultra-succesful athelete with the weight of expectation on his shoulders, Phelps cannot afford to mess around with an intervention that may not compare favourably with another. You can be sure that he chooses cupping because he perceives it to be a worthwhile addition to his arsenal of therapeutic techniques.
4. How does it work?
There is a saying in Traditional Chinese Medicine that when the 'qi' is obstructed there is pain, but when the 'qi' flows properly there is no pain. Tension, trauma, inflammation, scar tissue, histological changes in the tissue structure during healing are all examples of physical causes of the obstruction of qi. Additionally emotional stress leads to voluntary (if unintentional) tension in the body. The simple strategy of traditional chinese medicine is to restore the correct function of qi circulation by treating the obstruction directly and addressing the cause of the obstruction. Pain is a complex experience involving inflammatory, neural or structural inputs (physical) with social and psychological influences. Cupping promotes circulation and gently lengthens the tissues by drawing them upwards into the vaccum space. Its is thought that this improves healing and reduces pain.
5. Is there any science?
The exact mechanism of how cupping works has not been established although hypotheses exist that suggest the analegic effect may be similar to that of acupuncture eg through counter-irritation or perhaps through drawing circulation to the affected area. Clinical studies on how this impacts recovery or pain is not yet conclusive.
However, a 2014 Systematic Review attempted to study all evidence to date on cupping therapy. The studies included both wet cupping (involves bleeding and is used in other clinics but not Belfast Community Acupuncture) and dry cupping (the type we use).
Of 55 trials identified, 16 were high enough quality to make it through to final inclusion in the study (this is good, it means they eliminated poor quality studies).
The results found overall that patients reported reduced short term pain intensity after cupping compared with conventional care, wait list, heat therapy and drugs.
6. What are the circular marks, they look painful?
The classic cupping marks are essentially caused by extravasation from the small superficial capillaries during the therapeutic process. Although these bruises might look painful in above systematic review only 10% of patients reported mild adverse effects of bruising or mild pain at the site of cupping. These marks are extremely common and should fade within several days. Phelps may have been shown grimacing during a treatment but there is no need for cupping to be painful. The strength of the vacuum may be varied to suit. Causing a patient pain may lead to further contraction of muscles, and the British Acupuncture Council states that cupping should not be a painful procedure and to seek a licenced acupuncturist.
Listen to Emma talk about cupping on BBC Radio Ulster
By Emma Van Loock Lic.Ac 2016