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Thanks, Michael Phelps, for glamorizing cupping quackery!

So, in case you hadn’t noticed, I was taking a brief vacation, a long weekend if you will. As a result, I hadn’t planned on posting new completely original material until Wednesday or Thursday. (Monday’s post, some of you noticed, was a modified crosspost from my not-so-super-secret other blog.)

Then something happened.

You know you’re a committed blogger when your vacation can be interrupted by an overpowering urge to write about something in the news. Longtime regular readers (or even not-so-longtime regular readers) can probably guess right away what I’m talking about. Of course, I gave it away with the title of this post, but to drive the point home, let’s take a look at this photo:

Michael Phelps, Rio 2016

Yes, it was all over the news Sunday night, with stories abounding over the purplish red circles on Michael Phelps’ shoulders and back as he helped the US swim team win Olympic Gold in the 4×100-meter relay. As Monday passed and I tried to stay away from skeptical news, I got more and more annoyed, as I saw credulous story after credulous story about the use of cupping by the U.S. Olympic team. It’s nothing new, either. Almost a year ago, Michael Phelps posted this to his Instagram account:

Thanks @arschmitty for my cupping today!!! #mpswim #mp ? @chasekalisz

A photo posted by Michael Phelps (@m_phelps00) on

He’s not alone, either. Eight months ago, American swimmer Natalie Coughlin posted this photo of herself undergoing the treatment:

Laughing because it hurts so bad. Gonna leave a mark! #AthleteLife

A photo posted by Natalie Coughlin (@nataliecoughlin) on

And even a longer time ago, nearly three years, to be precise:

Gee, I hope my #GoldenGoggles dress is open-backed.

A photo posted by Natalie Coughlin (@nataliecoughlin) on

And Olympic gymnast Alex Naddour:

Worse, given that NBC has the rights to cover the Olympics, NBC Sports has been delivering some truly irresponsible and credulous “journalism” about cupping:

Notice the tropes about this “ancient Chinese tradition” being merged with a “modern American one, winning.” It turns out that the head athletic trainer for the US Olympic Swim team, Keith Robinson, fully buys into this particular form of prescientific quackery:

“There is a psychological component where Michael has been doing this to feel good for a long time, about two years,” Mr. Robinson said. “Anything you can do to get the body to feel good — you have to use an educational assessment on it. You have to make sure that what you’re doing is causing a physiological intent to recover.

“I’m not just going to throw a stick of butter on him,” Robinson said, adding, “I’m going to make sure I have an educated approach to it.”

While there’s no question that many athletes, coaches and trainers believe in the treatment, there’s not much science to determine whether cupping offers a real physiological benefit or whether the athletes simply are enjoying a placebo effect.

If the goal is just to make the body “feel good,” then why bother with the nonsense that is cupping? A good massage would be The entire rationale behind cupping, as a hundred credulous stories tell us, is this:

In traditional Chinese medicine, the theory is that cupping can influence the flow of energy or “qi” through the body, says Bauer. If someone’s flow is blocked or stagnant, a practitioner might use cupping to impact the flow. Western practitioners may focus more on what the therapy might be doing to muscles or blood flow.

Is there any evidence for this? Certainly, as I’ve discussed in many posts about acupuncture, there’s no evidence that “qi” even exists, much less that acupuncture or cupping or anything else can influence its flow for healing effect. As for scientific evidence, there are studies. Heck, there are even systematic reviews. Typical reviews include this one, which suggests “a potential positive short-term effect of cupping therapy on reducing pain intensity compared with no treatment, heat therapy, usual care, or conventional drugs” and this PLoS review, which suggests “potential effect in the treatment of herpes zoster and other specific conditions” but concludes that “further rigorously designed trials on its use for other conditions are warranted.” However, even reviews in woo-friendly journals aren’t that enthusiastic; e.g. this one, which concludes that “there are few RCTs testing the effectiveness of cupping in the management of pain,” that “most of the existing trials are of poor quality,” and that “more rigorous studies are required before the effectiveness of cupping for the treatment of pain can be determined.” Personally, though, I tend to believe Edzard Ernst, when he did an overview of systematic reviews:

In essence, this means that the effectiveness of cupping is currently not well-documented for most conditions. This is in sharp contrast to the many claims made by the proponents of this therapeutic modality, including those practicing traditional Chinese medicine or complementary and alternative medicine.

All five systematic reviews relied on primary studies from China. Several groups have demonstrated that nearly 100% of all acupuncture studies from China generate positive results [9,10]. This finding raises considerable doubts about the reliability of these data. Table 1 also shows that the quality of the primary studies is often poor. Trials of poor quality tend to produce false positive results.

Exactly. Basically, reading the “evidence” for cupping tells me that there is no compelling evidence that cupping is effective for any condition. Certainly, there is no credible evidence that it helps athletic performance, be it in swimming or any other sport. Moreover, by the principles of science-based medicine, in which prior probability based on basic science is taken into account, the clinical evidence that weakly suggests a benefit can justifiably be called into serious question based on the extreme ridiculousness of the therapy and the lack of any sort of plausible rationale grounded in basic human physiology suggesting that it should work. In other words, the whole physiologic rationale for cupping is bullshit. As we know from other similar modalities, when that’s the case seemingly “positive” clinical trials become much less convincing.

Unfortunately, even though all of this is true, NBC Sports provided the template for a thousand local TV stations to do stories on cupping. For example, my local NBC affiliate sent one of its anchormen, Steve Garagiola, to a quack clinic to undergo cupping himself:

In this case, Lisa Vel of Renew Detroit Health is given carte blanche to lay down some howlers, like her appeal to antiquity in which she claims that “ancient Chinese medicine” like cupping has been practiced for 5,000 years. As I noted the last time I discussed cupping, even if it does date back 5,000 years, arguably so does bloodletting. If I were to argue that there must be something to bloodletting because it’s been practiced for thousands of years, you’d laugh at me—and rightly so. Yet, for some reason, when it comes to cupping (and, let’s face it, acupuncture and a lot of other traditional Chinese medicine quackery) this appeal to antiquity comes across as persuasive. I like to point out that 4,000 years ago in ancient Egypt, medicine and religion were one in the same, and the cause of a lot of disease was believed to be evil spirits. Indeed, what made Hippocrates’ views so revolutionary in ancient Greece is that he was among the first to argue that diseases had physical causes that could be addressed and were not caused by the gods or evil spirits.

Just out of curiosity, I checked out Renew Detroit Health’s website and immediately noticed a whole lot of quackery, primarily functional medicine, or, as I like to call it, making it up as you go along. Of course, as I’ve also mentioned many times, functional medicine embraces just about any form of pseudoscience and quackery you can imagine, complete with lab kits that cost $200 to $400 per kit. So it’s no surprise to me that Renew Detroit Health offers cupping. It’s also no surprise to me that my local NBC affiliate would so readily fall for this pseudoscience. After all, it did a when I first moved back to my hometown.

Sports celebrities are, of course, not a source of reliable health information. For one thing, athletes are notoriously superstitious. How many times have you seen stories of athletes who wear the same article of clothing endlessly as long as they are on a winning streak, no matter how disgusting it becomes? Or what about athletes who refuse to shower or shave as long as they are on a winning strak? You get the idea. Athletes have a distressing tendency to embrace pseudoscience, as long as they think it can give them an edge. For example, they believe that IV hydration helps them when it doesn’t; that kinesiology tape protects them from musculoskeletal injury when it doesn’t; and that acupuncture works when it doesn’t.

Yet, none of this stops advocates of cupping and other pseudoscience from promoting it as though it works, even though there is no evidence that it does. In fact, there is evidence that cupping can cause harm, up to and including full thickness skin necrosis that is, for all intents and purposes, no different than a full thickness burn. Just to jog your memory, I’ll repost a photo I posted before of this very phenomenon:

Yes, this can happen, and, yes, those are basically indistinguishable from bad burns, even though the injury is not due to heat.
Yes, this can happen, and, yes, those are basically indistinguishable from bad burns, even though the injury is not due to heat.

That’s what irritates me. Just because an Olympic champion like Michael Phelps believes that cupping works does not mean that it actually works. It doesn’t, and it can in some cases cause harm. It’s basically all risk, no objectively demonstrable benefit.

Sorry, Mr. Phelps, but all those nasty hickeys from cupping are all for naught.
Sorry, Mr. Phelps, but all those nasty hickeys from cupping are all for naught.

Unfortunately, that’s not the message we’re getting from the press. Oh, sure, there is the occasional nod to skepticism in some—but by no means close to all—stories in which it is mentioned, often almost in passing, that there is no evidence that cupping does any of the things its proponents claim that it does, that all it does is to produce what are, in essence, huge hickeys. However, even that little bit of skepticism, when it even manages to make its way into a story, is promptly overwhelmed by the glamor, attractiveness, and excitement of genuine Olympic athletes using this quackery. A better advertisement for cupping and traditional Chinese medicine is hard to imagine! Yet, that’s what most of the news media are providing us, brief infomercials for quackery.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

193 replies on “Thanks, Michael Phelps, for glamorizing cupping quackery!”

When I saw the pictures of Phelps, I thought he did fight with a giant octopus – which would have been so much cooler than the TCM nonsense.

“You have to make sure what you’re doing is causing a physiological intent to recover”

O_o Whaaa? That is a vacuum of a sentence. More of the same alt-med ‘blame the patient when the smoke and mirrors fails to actually do anything’ – “So you actually managed to drink 5L of carrot juice and do 8 coffee enemas a day while living on a raw vegan diet? And you realigned your chakras and unblocked your chi but you’re still sick? Sorry, you must not have manifested the physiological intent to recover.”

Ooh, pun. Sorry.

you have to make sure what you’re doing is causing a physiological intent to recover

Looking at the pictures of these people with big red bruises, I have some troubles with this “causing a physiological intent to recover”, too. Their physiology is certainly intent on recovering from the bruises, I will give them that.

People with self-mutilation tendencies may want to avoid these types of news.

Funny, Phelps wasn’t doing this for his other gold medals. This is nuts. It’s not helping circulation – by causing bruises and petechiae, it’s interfering with it.

On the upside, someone with cupping bruises is a pretty useful indicator that they’re a prize cockwomble you should avoid wasting any time on.

Cupping, something best utilized for coffee or tea. Although, I’ve heard that some also engage in cupping as a marital aid.

On a more serious note, whyinhell do people think that just because someone is famous, they have any clue in the universe about things medical? That’s even more odd when one is listening to an athlete and trainer, rather than oh, say a physician.
That’s about as bad as getting marital advice from a priest. 😛

As for the aforementioned 5L of carrot juice, sounds yummy, although I doubt I could drink that much, I could give it the old college try.
But, that’s because I happen to like carrot juice. I also enjoy a fair number of raw vegetables – well washed, of course. 😉

As I posted elsewhere, out of curiousity I tried fire cupping (the air inside the glass cups is briefly heated with a flame to create the vacuum when applied). I found the heat felt good while it lasted, but didn’t like the suction sensation. It did help relax a trigger point in my back that I had, which I think the heat helped. I ended up with mild bruises on my back, but the cups were only on for about 10 minutes max (no clock, so I can only guess).

I wouldn’t try it again; I would rather have a nice massage with heat applied to relax the muscles. But, to relax a trigger point on me, there’s often a fair amount of pressure needed to break the muscle spasm, (which is a LOT of pain until the muscle relaxes) so I can see the “hurts so good” mentality.

I use heat all the time for my back, a good, hot bath does wonders to release spasms.
That’s even more effective than the tizanidine and hydrocodone (I only take both at bedtime, after all, muscle relaxers are merely CNS depressants and opioids are by nature CNS depressants).

Well it is more unscientific and outright illogical to claim something a quackery because ‘there is need for more’ proper scientific evaluation. And it is unscientific behaviour to write so emotionally and claim it pro-science. Just be factual, it will be less sensational, less read (unfortunately), but will be scientific nevertheless!

Any up for anaesthetic free trespassing? It makes lovely circular marks. If there’s a more ancient treatment let me know.

Ahhh–I was waiting for this! Even the venerable BBC was touting this without a hint of skepticism. They had the head of some acupuncture clinic as the “authority” as the guest and the presenter just lapped up everything he said about “the energy” and all the babblespeak about how it supposedly works. It drove me nuts at 4:00 in the morning, so I was happy to see this when I got up.

I notice that none of the Chinese athletes has these silly bruises (yet). Phelps may be a great athlete, but I honestly find it difficult to take him seriously and have quit watching the swimming–it’s pretty boring anyway. I hope he doesn’t decide to do any cupping on his baby son.

Why is it that people who ordinarily go on about China’s many human rights issues, and other problems, fall so totally in love with their pseudoprescientific “medical” practices? Why does the phrase “ancient Chinese practice” inspire such faith? Would that woman in the pictures here bind her feet because it was an “ancient Chinese practice”? Gaaaaaaaahhhh!

Just because you are the fastest swimmer alive does not mean you understand anatomy.

Western practitioners may focus more on what the therapy might be doing to muscles or blood flow.

Well, as far as what it’s doing to blood flow, it’s rupturing blood vessels in the cupped area, causing blood to flow into the tissues. Internal bleeding FTW! Yay!

Saw an entirely credulous story on my local news today and knew that Orac would probably have a post up about it today. I suspect that there will be a surge of people undergoing cupping, now. Perhaps we’ll also see an increase in the adverse outcomes that Orac discussed before.

As I noted the last time I discussed cupping, even if it does date back 5,000 years, arguably so does bloodletting.

Remember, some cupping practitioners do combine it with bloodletting (wet cupping).

On a more serious note, whyinhell do people think that just because someone is famous, they have any clue in the universe about things medical? That’s even more odd when one is listening to an athlete and trainer, rather than oh, say a physician.

Well to be honest, if I was naive on the subject, I would assume that they have recieved advice from their physician, since it is in the interest of athletes to listen to their physician. I think the argument from authority involved here is not the authority of the athlete, but of the physician we imagine advising them behind the scenes.

When your last name is Hickie, you grow up with no choice but to learn of all things love-bite-ish, as well as how many lewd phrases rhyme with one’s last name. Since Phelps did not look like the victim of a salt vampire creature from the original Star Trek, I knew this was cupping.

If an athlete does this a lot, it’s basically reverse blood doping, as they are putting a lot of blood they could use for their muscles into the extravascular tissue space. Maybe this stimulates new blood cell production, but the time frame for that is probably on the order of several days to weeks. Either way, it doesn’t make sense. And since you hear the athletes saying this provides “myofascial release” and increases circulation to the underlying muscle, perhaps a researcher could test this using a combination of ultrasound, MRI with NMR or perhaps PET. Not that this would convince many to stop doing this. Just watching this, one can see that what gets pulled into the cup is skin and the underlying subQ fat–not any muscle. Given it’s painfulness, maybe there is some gate theory of pain happening which makes the athlete focus more on the pain of the cupping than their muscle soreness, but you could whip yourself and get the same result.

Long story short: everyone loves a winner and whatever that winner says gets taken as gospel.

Just saw this mentioned in the online version of the German journal “Der Spiegel” (comparable to Time or Newsweek for our American friends). Quite good article, explaining the background of cupping and leaving no doubt that there is absolutely no evidence that it has any effect, even citing Edzard Ernst. The title of the article (translated): “The mumbo jumbo with the sucking cups.”

Seeing lots of this on my facebook feed, looks like there are going to be some classes in DIY cupping going on in my neck of the woods.

Given the more is always better viewpoints of some in that community I fear we may see some cupping injuries when people figure if it is starting to look damaged you probably need to do it again and again to bring in the healing. *frets*

It was also preposterous to think that mould could save your life.

So what if it’s a placebo effect? If the user thinks it works, it works for their mind.

Nothing surprises me when it comes to the credulity of athletes. Aside from gulping all manner of supplements (and acting surprised when these are later found to contain banned ingredients), they are enthusiastic users of chiropractic and all manner of woo and highly superstitious as Orac noted.

Wade Boggs would eat only chicken before baseball games.

I also place primary blame on ignorant and foolish media reporting for perpetuating belief in woo through false balance and even failing completely to give an evidence-based viewpoint. The Cleveland Plain Dealer (and even worse, ESPN) were guilty of this in reporting on quack therapy administered to a former Browns quarterback, Bernie Kosar.

http://www.espn.com/nfl/story/_/id/8833397/bernie-kosar-former-cleveland-browns-quarterback-finding-help-concussions
http://www.cleveland.com/healthfit/index.ssf/2013/02/who_is_bernie_kosars_doctor_an.html

Would those image-conscious athletes still love cupping if they knew the practice was as much European than Chinese in history? That it was used well into the 20th century in some rural areas to treat colds? My mother told me it was used in her parents time. And there’s a hilarious scene in Polanski’s The Mighty Vampire Hunters where the processor gets rows of cups on his back after being nearly turned to a block of ice…

“Ancient Chinese” nonsense sells better than ancient western nonsense, obviously!

But of course. Cupping was recommended by Hippocrates. “Wet cupping” (in which a small cut is made in the skin before the cup is applied, for instance, is basically a form of bloodletting.

A lot of athletes are supersitious, so it’s not suprising that woo would find a foothold among them. Tried cupping and did really well on your next race, even if it was months later? Better do it every time.

This is where the quackademic “integrative medicine” centers at real science institutions do further damage by promoting this nonsense. CBS News interviewed Dr. Adam Perlman, executive director for Duke Integrative Medicine, who conceded that there was no scientific evidence cupping works but also “I was pleasantly surprised to see cupping marks. It really speaks to this level of integration we’re seeing with many things that are considered complementary medicine,”

The CBS article also has a quote from Dr. Michael Smith, who is medical director and chief medical editor of WebMD and who is quite credulous about (some of the) claims made about cupping. That explains why WebMD is so bad when it comes to alt med.

I know what would really help these athletes: some good old fashioned trepanning to let out the evil spirits. After all, I’m quite sure it’s an ancient practice.

What happens if one is wearing a Phiten titanium necklace during cupping therapy? Will bolts of qi lightening shoot out from their ass?

If the bruising is into the underlying muscles, I would believe, the actual performance of the athlete would decrease. The bruising at the very least would cause a temporary decrease in the muscles ability to contract.

A Humbolt squid would make a better training aid than an octopus. Humbolts are faster and much meaner than an octopus

“Cupping was recommended by Hippocrates.”

This association would make cupping even more attractive to wooites, who adore Hippocrates, especially the “let thy food be thy medicine” quote.

Oddly, they are much less apt to venerate some of Hippocrates’ other views, like when he advocated treating “hysterical” maidens by getting them married, since they were ostensibly cured by pregnancy.

But cupping is efficatious in Phelps’ case — the bumps make him more hydrodynamic, like dimples on a golf ball.

I have a theory that crop circles are evidence of cupping by extra-terrestrial aliens in an attempt to heal the Earth. It isn’t working.

# 11 darwinslapdog
Why is it that people who ordinarily go on about China’s many human rights issues, and other problems, fall so totally in love with their pseudoprescientific “medical” practices? Why does the phrase “ancient Chinese practice” inspire such faith?

I put it down to the food. It truly has evolved from ancient times and it is good and seems generally healthy so obviously ancient Chinese medicine is tool

whyinhell do people think that just because someone is famous, they have any clue in the universe about things medical? That’s even more odd when one is listening to an athlete and trainer, rather than oh, say a physician.

Aspiring athletes tend to look up to established athletes, especially in the same sport. (Same thing happens with doctors, scientists, and a bunch of other fields of work.) They will tend to imitate those established athletes because the latter are proven successes, and many of the aspiring athletes want to become winners at any cost. Some of those techniques, such as improved workouts and high-performance equipment, are legitimate ways of improving performance. Others, like anabolic steroids and other performance enhancing drugs, are regarded as illegitimate methods, but often the attitude taken is, “It’s only illegal if you get caught.” (These substances also may have long-term side effects, but they usually don’t show up until after one’s athletic career is over.) Cupping has not yet been shown to have a positive impact on performance (which is one reason the IOC hasn’t banned the practice), but the natural human tendency to lapse into post hoc ergo propter hoc will lead aspiring athletes to imitate a successful athlete like Phelps who undergoes cupping.

#13 Zach

Just because you are the fastest swimmer alive does not mean you understand anatomy.

Of course it does, just the way every baseball player has at least a Master’s in Physics. And, come to think of it, some of those Frisbee-catching dogs in the park must have doctorates.

I put it down to the food. It truly has evolved from ancient times and it is good and seems generally healthy so obviously ancient Chinese medicine is tool

But Chinese food, like “traditional Chinese medicine”, incorporates many Western elements of more recent vintage. For instance, the hot peppers we associate with the cuisines of southern China (as well as India and much of southeast Asia) have only been part of these cuisines for about 300 years–peppers are native to the Americas, and were introduced to China by Dutch traders circa 1700. Fortune cookies, which Americans associate with Chinese restaurants, are an American invention, as is chop suey.

Same thing with so-called traditional Chinese medicine. Ancient acupuncture involved sticking needles in the patient’s body, but beyond that any resemblance to modern acupuncture is purely coincidental. The use of herbs in Chinese medicine was only systematized in the 20th century as well. Remember that Mao Zedong always insisted on Western medicine (as the Chinese call it) for himself, but encouraged the spread of Chinese medicine because at the time China did not have the resources to deploy Western medicine nationwide.

#21 Dangerous Bacon

I also place primary blame on ignorant and foolish media reporting for perpetuating belief in woo through false balance and even failing completely to give an evidence-based viewpoint.

I think much of the problem here is that very few journalists have any science training—mainly coming out of a pure journalistic program or perhaps a history or English background probably English, since historians are taught to weigh and compare evidence even if their techniques are not the same as a chemist’s. And let’s face it, most scientists are unlikely to be scintillating writers.

On the other hand when one gets a scientist hard or social reporting it can be a real pleasure to see them in action.

Cupping has not yet been shown to have a positive impact on performance (which is one reason the IOC hasn’t banned the practice)

In tangentially related news, I do believe that I managed to convince a fellow in Walgreens that “alkaline water” was a complete crock the other night.*

O Krebiozen, where art thou?

* They don’t carry it, but he was asking at the register. I think he said he had been paying up to 10 dollars a gallon at Whole Foods and suchlike.

@Narad #39

$10 a gallon, for something they claim you can DIY by tossing a slice of lemon into your water, what the heck were they doing to it….wait do I really want to know?!

#37 Eric Lund

But Chinese food, like “traditional Chinese medicine”, incorporates many Western elements of more recent vintage.

I was only being partly serious here and partly sarcastic. And you missed my weasel wording. I said “evolved”.

Also, unless you are a food junkie, or more probably a history junkie majoring in food, you are unlikely know the origins of a lot of foods. One might even be able to convince a lot of Americans that turkeys were brought over by the Pilgrims: they came from Turkey obviously. Potatoes came from Ireland. Corn from Cornwall might be a tougher sell.

If you are old enough to remember the Cultural Revolution, it had a fairly large impact on thinking in North America and, quite likely, there was a lot of propaganda about traditional medicine in that mix so aging baby boomers probably have that at the back of their mind. .

I certainly remember articles about the barefoot doctors that the Communist Party trained though I don’t remember any mention of Traditional Chinese Medicine in them. They seemed to discuss the barefoot doctors as a way to some basic (Western) health care into rural areas when China just did not have the resources to send in trained doctors and and specialist staff.

Still it is only a slight jump from, what appeared to be a good attempt to get some very basic health care into rural areas to having woo-merchants in North America and Europe start selling Traditional Chinese Medicine here.

If cupping is ancient and Chinese, why are none of the Chinese athletes doing it?

#37 Eric Lund
Afterthought: Did you know that Sichuan pepper is native to Sichuan?

Me, a food history junkie? Perish the thought.

It is a mechanical doping with cupping . Cupping massage stimulates the Cutaneous Hypothalamus-Pituitary-Adrenal (CHPA) function for the release of prostaglandin E1, ß-endorphin and melanocyte-stimulating hormone for anti-inflammation and relaxation, as described in
http://www.actionlove.com/love/massage.htm
and http://www.actionlove.com/cases/case15780.htm

There are three main effects of cupping massage:
1. inducing local pain to stimulate the local cells to release endorphin ((“endogenous morphine”) for pain relief and feeling good (and high),
2. promoting the local blood circulation by loosening the tight muscle;
3. flexing the joints with nutrients and its induced prostaglandins release;
These effects can improve your performance in the field competition or/ and on the bed with your lover(s), maybe, more than one. I documented my discovery and experiental results in Chapter 7 of my book “”Resonant Excitation of Sexual Orgasms” in http://www.actionlove.com/love/book.htm when I troubleshooted my low back during 1987-1994 with the vacuum-cupping massage method . At that time, I had to apply the cupping massage to perineum and I got a surprise discovery – erecting harder and lasting longer. Cupping massage on the perineum is inconvenient after all. Thus, I invented “Aquila Anal-Breathing, Vagus-Nerve-Stimulation (VNS) QiGong” for stretching the pelvic floor muscle and the internal organs in the pelvic cavity to achieve more effective than perineal cupping massage as described in https://www.youtube.com/watch?v=Id7tGe-kR5g
Aquila Anal-Breathing Qigong is an evolution of my life experience!

Agreed completely, but one thing I did want to point out about bloodletting, which is mentioned in the article – for a few very specific conditions, like hemochromatosis and porphyria cutanea tarda, taking blood on a regular basis actually is a mainstream, clinically accepted disease management treatment with peer-reviewed research and experience behind it.. In the case of hemochromatosis the purpose is to reduce the amount of iron and red blood cells, and it’s done as part of ongoing disease management.

So it might not be the best example to use as a quack treatment…yes, overall, but not entirely.

I heard about this on the Today programme this morning (UK, Radio 4). To say I spat my cornflakes at the radio would be, well, quite true.

The non-impartial loon they chose to interview waffled on about, “It goes back to ancient times, I can give you thousands of scientific papers” when the presenter asked him if cupping had any scientific support. Unfortunately this was the last question she asked, and the only critical one, after he had had a couple of minutes to claim that “it works by liberating muscle energy” and other such drivel. ATP-ADP cycle, anyone?

Another chapter in the long story of why we need science journalists, not gullible spokesmodels reading the news. As soon as I saw those photos, I knew a bunch of people who never heard of this quackery would rush to the quack sites to read up on the BS they would begin using to defend this idiocy.
Sigh.
One would think the team doctors would try to stop this at least during the games.
NBC has a lot of apologizing and explaining to do.

It’s like Mark Spitz’s quote about how he told the Russians the mustache helped his performance — and next year, all the Russians had mustaches.

@ Terrie

I do believe that it was the Russians who told the Americans about steroids lol. But I don’t think of steroids as woo.

It’s like Mark Spitz’s quote about how he told the Russians the mustache helped his performance

Ah, I had almost forgotten that my late mother had a five-foot-high poster of Mark Spitz on the inside of the semifinished basement’s bathroom door when I was a kid. I wish I had asked her what the hell that was all about when I had a chance, but thank you for reactivating the memory.

@Umar #10

It is quackery to claim myriad benefits of a therapy when only small lousy studies have been done on it. If Alexander Fleming had skipped the whole “science” thing and just advocated penicillin without any evidence, he would have been a quack. In fact it’s very clear that cupping practitioners (like all alt med providers) are far more interested in making money than proving their ideas hold merit, and they should be reviled for it.

I saw a different piece with an NBC broadcaster trying the treatment, Michelle Tafoya maybe? Asked myself, ‘is that cupping’? Which I only know as a term having been referenced here.

FWIW, I don’t think this pub will result in lots of copycat cupping behavior as Eric suggests or serves as an ad for cupping per se as Orac suggested. The piece I saw was very gee-whiz positive about the performance benefit claimed by the athletes, but emphasized that it was painful. Over-all, I took the frame to be: ‘This is what separates the superstars from “normal athletes” They’re so obsessive they’ll do something extremely painful and weird to have even a chance of cutting another .01 off their best time’.

Rather, I take the credulity as an ad for Alt Med in general. Cupping maybe too far over the top for you, but the principle of ‘daring, unusual, mysterious’ training methods permeates all levels of sport. Just check out the recreational distance runners shopping at GNC. In fact, if the influence of these pieces was specific to cupping that would be better, as most non-Olympians who tried it would react with ‘that was dumb, never do that again.’

Which is to say, the pieces about cupping aren’t about cupping. The practice is just a metonymy for the theme of the Olympian differance of Olympic jocks, a trope of what separates them form us, in that we can’t or wouldn’t follow that obsessive a path. But that general ideological principle of ‘medical miracles are out there!’ is necessarily employed in constructing the larger mythology, and will get a free ride into the viewers’ minds in ways that could manifest in an increased attraction to various more routine forms of ‘health/fitness’ pseudoscience.

Here is from manufacturer’s website:

«During Acucups® cupping massage, tension is released. When muscles relax, the body releases endorphins and creates a relaxing warmness throughout. Lactic acid is removed by the suctioning action and helps the muscles get the oxygen needed to maintain their health. Cupping massage will also help stretch out the muscles to release tension that has built up in that area and restore flexibility which will help guard against future injury. »

«Athletes worldwide are turning to cupping massage to give their body the necessary care after training, competitions, and games. »

This sounds scientific to me. If you can prove that endorphins are created and the cups remove metabolic by-products, then it is good therapy.

I think I am going to disagree with you (everyone?) on this. But, first let me note that I certainly agree that the publicity will most probably lead to all kinds of quacks making money off of this.
However, to say that the most accomplished swimmer in history does not have any idea what he is doing to his body? And, your proof is? If you look, the cup marks on Phelps are only on very specific muscle groups and only on one side of his body. There were no new marks when he swam the 200 butterfly prelims ( which might eliminate the superstition question?).
Phelps is not some new little swimmer trying a fad thing. At his age, he is very familiar with what his body does and what it responds to.
Essentially, the studies mentioned do not prove much one way or another. I could find no mention of any study that covered athletics and muscle soreness, etc. But, in a way, that is not the point. Cupping is quickly done and the results (whatever they are) are fast. Thus, it can be done in a warmup room before a race. The last thing you would want is a massage at this time. And, I think, this is what everyone is overlooking – there is a specific purpose when Michael does this. It is done to a very targeted area. It is done by an highly experienced athletic trainer.
As I earlier said, I agree with all that the fall out from this will not be good. But, to say that, “reading the “evidence” for cupping tells me that there is no compelling evidence that cupping is effective for any condition.” Seems to miss a BIG gold medal hanging around his neck.

Advertising copy ain’t science. You sound exactly the type of mark they want. Can I interest in some NEW! and IMPROVED! cups?

As I recollect Phelps has won multiple gold medals without cupping. Obviously (by your logic) not cupping is what wins medals.

What I mean is that Endorphins and lactic acid can be scientifically tested. If Endorphins were found to increase during/after cupping, then we have a biologically plausible justification for cupping. Same can be said about Lactic Acid.

Most people here are so anti-alternative that they are anti-science. The title of this blog is a misnomer. It should read: profitblogs.com/ridicule

@rs
You put the anal in analgesic!

http://www.ncbi.nlm.nih.gov/pubmed/15135942

Who cares. If they believe it has some kind of benefit, then who are we to judge? This article is a waste of time. what’s your next Blog how people should or shouldn’t live their lives?

Agreed completely, but one thing I did want to point out about bloodletting, which is mentioned in the article – for a few very specific conditions, like hemochromatosis and porphyria cutanea tarda, taking blood on a regular basis actually is a mainstream, clinically accepted disease management treatment with peer-reviewed research and experience behind it.. In the case of hemochromatosis the purpose is to reduce the amount of iron and red blood cells, and it’s done as part of ongoing disease management.

I’m a physician and am well aware of this. However, such conditions and uses are very uncommon, which is why it didn’t seem worthwhile to mention these two rare conditions. If you count my residency I’ve been practicing medicine nearly 30 years now, and I’ve never seen a case or had a patient undergoing bloodletting for such conditions. Basically, mentioning this would have messed up the flow of the sentence and didn’t seem worth it. OTOH, after 11 years of blogging, I should have known there would be a pedant somewhere who would bring it up.

@Tenfold #57

Well to be totally honest and scientific, Tenfold, it’s simply bullshit to claim that the suction from cupping magically pulls out only lactic acid and other “toxins”, and only improves the flow of “oxygen”, “endorphins” and other “good things”. It’s completely nonsense.

Now, you’re right that this could be easily tested, but that’s toothfairy science. Why should anyone bother searching for the mechanism by which cupping works if it has not been demonstrated to work in the first place? That is the work that remains undone.

Regardless, what you’ll find on this blog is that the people here do not denigrate researchers who actually go out and test hypotheses (even wild ones) in well designed studies. But that has not happened with cupping – we only have small, crappy studies that you can’t draw any conclusions from.

If the language of Orac and commenters is a bit strong, a lot of that is indignation at alt-med providers who charge money for unproven medicine. In fact, they go beyond merely providing this therapy, but lie their asses off about it – the typical provider’s website is overflowing with wild hypotheses presented as facts, and anecdotes presented as data.

There is a proper way to conduct medical research, and it has not been followed with cupping. Its practitioners prefer to skip the hard work of proving safety and effectiveness, and have gone straight to charging people for it while lying to their faces.

Many athletes use cups and they really, boy I know. I played catcher a few times in the past (long past).

If you can prove that endorphins are created and the cups remove metabolic by-products, then it is good therapy.

I agree. Do they (or you) have any credible proof such a thing happens? I got $5 that says ‘no’.

Orac: “Basically, mentioning this would have messed up the flow of the sentence and didn’t seem worth it. ”

Not to mention screwing up the qi.

There must be a great mechanism I’m missing, explaining how cupping sucks lactic acid away from muscles. Well no there isn’t, but mechanisms are for science sissies.
And if this is how cupping is supposed to work, why on earth would you do it _before_ a race? Shouldn’t you be going it in the middle of competition, or would the drag coefficient of the cups cancel the slurped-out lactic acid (which is winding up in a mysterious location where it cannot affect the body?).

It is all so very strange. If only Hippocrates was here to explain it.

What Michael Phelp’s coach said reminded me of what I’ve heard people who have many tattoos say; that there is an addictive quality to the feeling of pain from getting one. And, even for those who practicing cutting, they say it makes them feel better. Neither one is my preference but to each their own.

The problem becomes when adherents start selling cupping as anything but hurting yourself to feel better in mind (while destroying your body).

There could be more by-products of metabolism besides Lactic Acid being sucked out of the Lymphatic System.

You would have to apply a gel on the skin, one that absorbs water-solubles, and then do the cupping. You would then take the gel and run it through a chromatography column or two and see what you get.

This may be an unproven therapy, but that is not to say that it doesn’t work. This has much more biological plausibility than say…homeopathy

No Luc Montagnier jokes, or I will expose Gallo as being a profiteer and virus-thief.

“..I don’t think this pub will result in lots of copycat cupping behavior..”

Sadmar, never underestimate your fellow man. After all Pokemon Go is a thing.

Ok, I’m done now. Sometimes I think commenting is addicting.

Best explanation for those marks all over Phelps was that he must have fallen asleep on all his medals. But yeah, it’s great to hear all this woofuckery talk on NBC Sports.

@72, one might wonder if those are actually ‘conscious uncupping’ marks…..
I’ll be here all week

Oh, look, a crop of fresh pseudonyms. Just by the by, when was “Stradlater” last seen?

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