What are those mystery bruises on Michael Phelps?

Cupping has received ample attention over the last few days thanks to a number of Olympic athletes, including all-time most decorated Olympian Michael Phelps. It’s a common treatment tool used by acupuncturists in the Integrative Medicine department at Baylor Scott & White Health, but what exactly is cupping? And does it work?

FUN FACT: Those circles are the end product of an ancient healing technique called cupping. #Rio2016 pic.twitter.com/BsP1PPjqBQ

— #TokyoOlympics (@NBCOlympics) August 8, 2016

Cupping is a medical modality within traditional Chinese medicine. Its roots go back thousands of years.

During the procedure, glass, plastic, or bamboo cups are used to create suction. This can be done in the traditional way by quickly inserting a flame into an inverted cup and applying it to the body or in the more modern way by using a manual pump to pull the oxygen out of the cup.

The lack of oxygen in the cup creates negative pressure, lifting the skin and the superficial muscle layers. This releases fascial constrictions, promotes more direct blood flow, and activates the lymphatic system, which reduces muscle tension and pain. In Chinese medical terms, it eradicates meridian stagnation, which can be responsible not only for pain but chest congestion, allergies, digestive disorders, swelling and a number of other disorders commonly treated by cupping.

Imagine your muscles as sponges saturated with thick, dried mud and healthy, oxygenated blood as water. Cupping lifts the mud out in order to allow water to flow back into the sponge, giving it increased flexibility.

Recipients of this treatment may have multiple bruising sites, which last anywhere from a couple of days to a couple of weeks. They look a little scary, but the bruises are the result of simple, superficial blood vessel ruptures. They are temporary, safe and not at all painful when the cupping is performed by a qualified practitioner. In fact, when cupping is properly used it will often provide quick and dramatic symptom relief.

Cups are typically left on for a few seconds to five minutes and should not be left on for more than ten.

There are different forms of cupping including stationary cupping, sliding cupping (cups are moved along specific pathways) and wet cupping (combination of cupping and bloodletting). It’s best left up to an acupuncturist or another qualified practitioner to determine which form, if any, would benefit your body.

Cupping is also a fantastic diagnostic tool, alerting us to internal disharmonies which require intervention.

All information gained from cupping can provide insight into what’s happening within the body. The surface of the skin often bruises in different shades and patterns from person to person even when the pressure and location of the cups is the exact same. Sometimes this has to do with body composition, while other times coloration highlights different underlying issues.

Within traditional Chinese medical diagnostic methods, the varying shades, patterns and moisture produced on the skin via cupping are important and give insight to what is really happening in the body. This could be poor blood circulation, chronic inflammation, impaired peristalsis, etc.

Measuring the reaction to cupping will propel me to ask additional questions about pain, digestion and the menstrual cycle. We can then adjust their treatment plan accordingly and may very well refer back to a physician to help with these issues.

In the state of Texas patients must usually be evaluated by a physician or dentist prior to receiving treatment by an acupuncturist (or a physical therapist or occupational therapist, who also use cupping). That being said, if the acupuncturist can provide more information back to the physician then we can treat as a team.

But what about the bruising? The dark marks you see are a result of longstanding stagnation due to trauma and/or lifestyle, or repetitive movement (like preparing for the Olympics!). That being said, cupping should be part of a larger treatment plan, like acupuncture or herbal therapy, in order to address the underlying issue that caused the stagnation in the first place.