Cupping at the Olympics: The follow up
American athletes were sporting cupping marks at the Rio Olympics sparked a media frenzy. Some of the articles had a positive spin and some of the articles had a negative spin. One of the main arguments against cupping was that cupping lacks scientific evidence. Here is a suggestion for the pragmatic clinician, rather than writing it off completely, a more rational response would be to put treatments in perspective and discuss a hypothesis that is inline with the current scientific understanding of how the body works.
Pre-scientific roots of cupping
The use of cupping originated as early as 3000 B.C.E in a pre-scientific era and much of the reasoning once used to explain the effects do not make sense in the light of what we know today. Anecdotally cupping is used to alleviate pain, whether cupping works via a placebo effect, counter irritation or mechanotransduction are all up for discussion, I propose that for a starting point it is safe to claim that:
•Cupping serves as a comforting social interaction
•Cupping stimulates mechanosensitive nerve fibers (Aβ, Aδ and C)
•Cupping mechanically stretches the skin and underlying soft tissue
Hopefully it will not be long before there are some well designed studies that can more accurately assess its effectiveness and mechanism of action. Until that time comes, reading research articles and brushing up physiology and analyzing the evidence on both sides of the debate may help people prioritize the options, not demonize them. I have more posts on cupping in the works, but if you want to look at some cupping related research, I have provided links below.
Links for the curious
Dunn, S. L., & Olmedo, M. L. (2016). Mechanotransduction: Relevance to Physical Therapist Practice - Understanding Our Ability to Affect Genetic Expression Through Mechanical Forces. Physical Therapy.
Huang, C., Holfeld, J., Schaden, W., Orgill, D., & Ogawa, R. (2013). Mechanotherapy: Revisiting physical therapy and recruiting mechanobiology for a new era in medicine. Trends in Molecular Medicine.
Moortgat, P., Anthonissen, M., Meirte, J., Daele, U. V., & Maertens, K. (2016). The physical and physiological effects of vacuum massage on the different skin layers: A current status of the literature. Burns & Trauma.
Rozenfeld, E., & Kalichman, L. (2016). New is the well-forgotten old: The use of dry cupping in musculoskeletal medicine. Journal of Bodywork and Movement Therapies.
Tissot, F. S., Boulter, E., Estrach, S., & Féral, C. C. (2016). The body’s tailored suit: Skin as a mechanical interface. European Journal of Cell Biology.
Thompson, W. R., Scott, A., Loghmani, M. T., Ward, S. R., & Warden, S. J. (2016). Understanding Mechanobiology: Physical Therapists as a Force in Mechanotherapy and Musculoskeletal Regenerative Rehabilitation. Physical Therapy.