Olympic Games shine a light on the 'cupping' technique

With the start of the 2016 Summer Olympic Games in Rio de Janeiro, the use of the ancient 'cupping' technique by various athletes, to supposedly improve their recovery time and allow for better performance, has been one of the most commented upon aspects of the Games thus far. However, scientists are divided over whether or not the technique has actual physical benefits beyond the creation of a placebo effect.

When Michael Phelps, the most decorated Olympian in history, took to the pool on Sunday 7 August, the second day of the 2016 Summer Olympics, to compete in the 400x100 relay, media commentators worldwide immediately drew attention to the round bruises covering his right shoulder, a result of cupping treatment. It isn't just him who has become a fan – several other notable members of the US team have also been seen competing with the marks dotted on their bodies, including fellow swimmer Natalie Coughlin and gymnast Alex Naddour.

Cupping, an alternative therapy originating from China, has been practiced for thousands of years. It is still performed widely across Asia and in the Middle East. According to the Associated Press, it is so popular that it is performed by street vendors in the Chinese province of Yunnan. Proponents argue that cupping can help with pain, back problems and other physical ailments.

The practice involves very simple tools - plastic or glass cups and a vacuum pump. The process is also simple, with the cups placed over muscles, and then, using the pump, an area of vacuum pressure is created that draws blood to the surface, breaks capillaries, and forms the perfectly circular purple bruise on the skin. A mechanical vacuum isn't always needed, as traditionally, a burning cotton bud is placed inside a glass cup, which creates the vacuum inside as the hot air cools.

However, although some of the best athletes in the world now swear by the technique, there has actually been little research that support the purported benefits of cupping. A 2012 study published in the journal PLOS One reviewed 135 trials of cupping therapy from 1992 to 2010 and found that cupping has potential effect in the treatment of herpes zoster (commonly known as shingles), acne, facial paralysis and cervical spondylosis (an age-related degradation of spinal disks in the neck). Admittedly, these are not pressing conditions that afflict elite athletes and the article concluded that 'further rigorously designed trials on its use for other conditions are warranted.'

What scientists can agree on though is that even though they can't prove that cupping has any real physical benefits, the technique does not seem to be harmful in any way. This is particularly important as athletes tend to be a superstitious crowd - when they find a technique or an alternative therapy that they believe helps them to heal or boost their performance, they tend to stick with it. This of course then leads to the idea that such therapies are useful even without real physical benefits as they produce a placebo effect.

The placebo effect is important as athletes may begin to believe that by halting the activity or therapy that they believe is beneficial, they will suffer a drop in performance or a spike in physical pain. In fact, some studies have suggested that caving into such superstitions may help to ease athletes' minds and help them maintain confidence in their abilities. A 2006 study in the Journal of Applied Social Psychology found that commitment to rituals is greater for especially important sporting events, serving as a sort of 'psychological placebo'.

So cupping may just be another health fad, where there isn't enough evidence to prove that it really works to alleviate pain and soreness, but at the same time, there just isn't enough data to adequately disprove its effectiveness. But if it isn't harmful and gives Olympians' the psychological push they need to go for gold, then it really shouldn't matter either way.