Updated: November 5th, 2020

Michael Phelps and other Olympic athletes have been proudly sporting distinctive purple bruises in Rio, which has brought new attention to an ancient Chinese medicine technique called “cupping.” In this article, our faculty explain the basic tenants behind the practice, how it works, and why it’s important to see a qualified professional for best results.

What is cupping?

Cupping is a practice used by a variety of healthcare practitioners to improve the circulation of fluids and blood in different regions of the body. The name comes from the principle tool involved, a plastic or glass cup placed over the skin to create suction against the underlying tissues. The practitioner places the opening of the cup over the skin and then creates suction using a hand pump to draw air out of the cup through a built-in valve. Another method, called fire cupping, involves heating the air inside of the cup with a lighted alcohol swab or cotton ball and then quickly placing the cup on the skin. As the air in the cup cools, the pressure inside the cup decreases, creating suction. The cup can remain in place or be moved along the skin in order to create the desired effect. Oil or lotion is used to provide a better seal and to prevent irritation.

Why is cupping used?

While cupping has been practiced in a number of cultures, its use in Chinese medicine is well known. The treatment context for cupping derives from an important Chinese medical principle that recognizes the effect of climate on the health of the body. These climatic factors include wind, cold, heat, and dampness. Many of us notice sensitivity to one or more of these weather conditions, which stir up chronic symptoms like seasonal allergies and pain.

Why do athletes use cupping?

World-class athletes are vulnerable to an invasion of these climatic factors because of the harsh conditions to which they are exposed. Many of them endure temperature extremes, wind, and rain, especially during times when they are taxing their body’s resources through exertion. Cupping is one of several techniques believed to pull out the climatic factor that may be causing pain or illness.

Cupping is particularly helpful for treating symptoms of deep muscle or joint pain and possibly heaviness. Cold, damp environments are believed to interfere with the proper circulation of fluids and blood in the area of pain. It is not surprising to see members of our USA swim team with the characteristic round purple marks since they are exposed to a wet and cold environment every day.

For swimmers in particular, being immersed in water may make it more difficult for their bodies to sweat out some of the metabolic waste products that are being created through their exercise. Since the cups are frequently moved along the muscle in the areas of stagnation, it is easy to see how this may enhance the circulation of blood and fluids in the area.

Gentle cupping is also used to enhance the circulation of fluids and blood when the body is weak. But gentle cupping does not result in the type of bruising that we are seeing on Olympic athletes, which indicates that more forceful techniques are being used in these areas.

Who else might benefit from cupping? Are there safety concerns?

Cupping can be used for a variety of conditions that indicate pathology at a deep level, including Lyme disease, arthritis, and autoimmune diseases. But a comprehensive Chinese medical assessment is needed to prevent aggravating symptoms or even drive the pathology deeper. For patients with chronic conditions or serious illness, cupping should be used only within the context of a carefully designed treatment. Cupping is safer for patients who are in relatively good health.

There are areas of the body that should never be cupped, including over the internal organs, on the back or abdomen of pregnant women, over thin skin such as on the face, or across the spine where it might injure the intervertebral discs. Cupping should not be repeated until the treated area has a chance to heal. There are also safety issues regarding blood borne pathogens that must be observed.

Within the Acupuncture and Oriental Medicine programs at Maryland University of Integrative Health, the technique and clinical context for cupping is taught in a number of courses including the foundational theory classes, the Asian bodywork and Chinese medical therapy class, sports medicine and the faculty-supervised student clinic. Students are well prepared to use cupping appropriately with their patients after graduating.

How can I start receiving cupping treatments?

Anyone interested in having a cupping treatment should see a qualified acupuncturist or Oriential medicine practitioner trained in cupping techniques. While the treatment technique can be very beneficial, it can also cause significant bruising and cramping and is contraindicated for people with certain health conditions.

To find an acupuncturist who may be qualified to perform cupping treatments near you, visit MUIH’s Find a Practitioner page.