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Pain Relief, Michael Phelps Style

What you need to know before you try cupping

When Michael Phelps took his place on the platform and readied himself for his first Olympic swim in Rio, the Internet chatter briefly turned from medals to marks. Viewers were wondering what the big round marks were that covered Phelps’ upper body. Were they from a fight or a reaction or an allergy?

According to Richard Sedillo, PT, and a Certified Orthopedic Manual Therapist at Arizona Manual Therapy Centers in Scottsdale, Arizona, the circles on Phelps chest and back was from a therapy called ‘cupping.’ “Cupping is a therapy technique that is often used on patients with back, shoulder and neck pain such as swimmers, tennis players and golfers,” Sedillo says.

“Phelps was cupped around his scapula, his deltoid, and biceps tendon points, which often get irritated with use,” Sedillo says. “The cup is suctioned to the skin to draw and hold the skin and superficial muscles inside the cup to help activate the lymphatic system, promote blood circulation and repair deep tissue. Cupping causes the skin muscles to be pulled and the results is immediate pain relief – hence a really good treatment option for Olympians who need to be recover quickly and be pain-free.”

Dr. Skye Sturgeon, associate professor and chair of the Department of Acupuncture & East Asian Medicine at Bastyr University, Kenmore, Washington, claims that while cupping looks brutal, it isn’t painful.

“In context, cupping is a procedure that’s been done since 6,000 years ago,” Sturgeon says. “It is common in cultures all over the world, but believed to have started in China. It can also be used to treat respiratory conditions such as bronchitis and a common cold with a cough.”

Olympic athletes engage in a variety of techniques that help to warm up their muscles. “Before a swim race, the athletes shake out their muscles to loosen them up,” Sturgeon says. “If their muscles aren’t relaxed they are more prone to injury and can have a spasm when exerting muscles to their maximum performance.”

He explains that the location of the cupping is in major muscle groups along the back of the shoulders and spine. “It causes superficial capillary damage and no underlying tissue damage, which causes the body to cure and repair itself,” he says.

However, Sturgeon says that cupping should never be done over broken skin, active lesions or any dermatological problems. “It can be used to treat cramping on the abdomen but this should not be done on someone who is pregnant,” he says.

Trina Lion, an acupuncturist at Mercy Medical Center, has used cups for 11 years and cautions that patients on blood thinners or who are in a weakened condition due to medical care or recuperation would not be prime candidates for cupping.

“That said, a cupping treatment can be limited to the affected area (a knee, an ankle) to improve swelling, circulation, and range of motion in one location,” Lion says. “Cupping should not result in extreme pain or reduced mobility. On the contrary, cupping should improve comfort level and range of motion.”

Sturgeon says that cups have to be disinfected with a high level disinfectant, such as 7.5 hydrogen peroxide. “Cups should be air dried,” he says. “After use, microbes and other infectious materials could wind up being sucked into the surface of the cup. These safety procedures are common practice.”

“The amount of bruising varies considerably depending on practitioner technique, the cup materials (glass, plastic or silicon), and the patient’s condition,” she says. “For example, leaving any cups on for a long period of time, using strong suction as in “fire cupping”, or cupping on a patient prone to bruising can result in dark marks.

Lion explains that cups vary in diameter and can be used in different places on the body. “The varying materials also have different uses,” she says. “To remove the suction, the practitioner must place a finger inside the lip of the cup to break the seal. Plastic cups often have a valve, so that the degree of suction can be varied according to the patient’s comfort level. The practitioner places the cup on the patient’s skin and then uses a reverse pump to draw air out from inside of the cup via the valve, creating a suction within the cup.”

She explains that glass cups are heavy and so are difficult to place on narrow areas (tips of shoulders). “Silicon cups are placed on the skin and then pressed to remove the air and create suction. Like glass and plastic cups, they also come in different sizes,” he says. “Bamboo cups are still used in some countries, but rare in the United States.”

Olympians other than Phelps engaged in the cupping procedures too, but with Phelps’ medal success, it looks like the treatment served him well.

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