Cupping and Other Olympic Shenanigans

The Olympics are awesome, I mean truly incredible, but every four years the Olympics brings with it pseudoscience and pseudo-performance enhancements that the TV announcers/networks love to exploit.

I mean we still hear announcers talk about getting rid of lactic acid, and that myth has been long debunked.

In the Olympics, winners and losers are literally separated by hundreds of seconds; minuscule differences can be the difference between gold and not-placing, so athletes will do ANYTHING to gain a slight edge, whether that means using evidence-based practices or not.

This means the Olympics are home to pseudoscience techniques "designed" to gain that extra edge for Olympic Gold performance. Four years ago in the London Olympics, it was kinesiotape (hint hint - not an effective treatment of pain (3)); this year it's cupping (see picture below).

Photo Credit: www.people.com

Photo Credit: turnthere.blogspot.com

So what is cupping?

Cupping was used thousands of years ago in ancient china (may not be true), and in today's modern use, it is basically a suction cup designed to increase blood flow, remove toxins, and enhance recovery to selected body parts.

Just watch the swimming portion of the Olympics and you'll be sure to see some "info" on cupping - usually lacking any actual evidential statements. At least USA Today did some decent investigative journalism, debunking the whole cupping thing.

One thing the media continues to promote is the "fact" that cupping was used in ancient chinese medicine, so it HAS to be legit…right?

I still can't see how this is a reason to do cupping… I see it as more of a reason NOT to do cupping.

How is the "fact" that something was used thousands of years ago, a good reason to use it now?
If we used many of the practices from thousands of years ago, where would we be?
Heck, if we used some of the sports performance/sport medicine practices from a couple of centuries ago, many would laugh.
So let's not use this as a reason for it's use.

Now, if we look at the actual literature on cupping, we find a very uncompelling story. In fact, a meta-analysis reviewed all randomize controlled-trials (RCTs) and found that while cupping may be a beneficial treatment for herpes zoster and other specific conditions, it's efficacy as a treatment for pain or for enhanced performance are unfounded (1).

Basically, a systematic review of all cupping studies show two things. 

1. The effectiveness for cupping in a sporting environment has not been found.  It is NOT an effective treatment for pain or performance and elicits NO physiological benefits for an athlete.  The athlete may receive psychological benefit (aka placebo), but actual positive physiological responses are unfounded. 
2. The few studies showing benefit of cupping have come from China, which have been known to have extreme bias and un-reliable results, not to mention the actual studies are very spotty (2)

If we actually think about cupping, physiologically, we can understand why it may be a poor modality choice.  

First, why would we want to place an extreme form of stress upon the athlete? Cupping damages the surrounding tissues, which is NOT something we'd want for an athlete looking for acute recovery.  

For an event such as the Olympics, where recovery from day to day is imperative - we want to preserve tissue health and restore parasympathetic nervous system function… NOT provoke it, which cupping very well can.  

As for myself, I've gone through cupping, and it is not comfortable, not relaxing, and can leave burning/sensitive skin for sometime after.  

Light massage, contrast baths, traction, meditation, light ART or joint manipulations, that won't stress the CNS or surrounding tissues, are all better options.  

Not to mention the BEST recovery and performance modalities in the tool kit are... 

SLEEP, NUTRITION, & HYDRATION.  

Yes, I know, not very sexy, not article worthy, no network specials here...but it's the truth. 

At the end of the day, although compelling, we know sports celebrities are poor sources of reliable performance information, and just because Michael Phelps (cupping) or Kerri Walsh Jennings (Kinesiotape) use a certain modality doesn't mean it has any efficacy. 

Sure, Phelps may receive some psychological and mental benefit from cupping - which is fine and dandy - most athletes have some form of ritual or superstition they use as a placebo for performance, but I'd wish networks and broadcasters would give a "warning" to those watching at home that these methods are unsupported and to ONLY perform under an experienced practitioner. 

This herein lies the problem I have with these types of things - cupping, kinesiotape - is now every HS and college Joe Schmo will want to get cupping treatment.  

We saw the response with Kinesiotape from the last Olympics - You can now see it at every youth, HS, and college sporting event - being applied by un-qualified practitioners, sometimes even by the athlete themselves.  

We will now see it with cupping, and the problems is not necessarily the fact that cupping lacks efficacy, it's in the fact that cupping, done by unqualified practitioners can, in fact, be harmful.  Left on too long, used with too much heat, done on those with sensitive skin - and you'll see irritations, rashes, infections, bleeding, etc.  

Not to mention you can get cupping kits on on Amazon for ~$20.  So now, stupid athletes and parents will by applying cupping, expecting to be like Michael Phelps, only left to be disappointed. 

Also, here's what can happen when cupping goes wrong…

Photo Credit: (nextshark.com)

So while, cupping may help Phelps gain a psychological edge on his competition, let it be known it does not provide a physiological benefit.  Also note that he has WORLD CLASS sports medicine and practitioners applying this method. 

I just wish networks and broadcasters would take some responsibility on this front, and not continue to promote such methods, and for once get out of the "Olympic Cinderella" mode and not try to make a fairly tale story out of every thing at the Olympics.

As for you athletes out there - please heed HEAVY hesitation before deciding to get a cupping treatment.  Save your money, and instead invest it in your sleep, nutrition, hydration, and a good foam roller (which has as much efficacy as cupping, but it's not as sexy).

Go Get 'Em!



References:

1. Cao, H., Li, X., & Liu, J. (2012). An updated review of the efficacy of cupping therapy. PLoS One, 7(2), e31793.

2. Lee, M. S., Kim, J. I., & Ernst, E. (2011). Is cupping an effective treatment? An overview of systematic reviews. Journal of acupuncture and meridian studies, 4(1), 1-4.

3. Parreira, P. D. C. S., Costa, L. D. C. M., Junior, L. C. H., Lopes, A. D., & Costa, L. O. P. (2014). Current evidence does not support the use of Kinesio Taping in clinical practice: a systematic review. Journal of physiotherapy, 60(1), 31-39.