What Is Cupping Therapy? (Or Why Athletes Have Red Spots)

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Cupping therapy- does it work and important cautions
Wellness Mama » Blog » Health » What Is Cupping Therapy? (Or Why Athletes Have Red Spots)

Many people got curious about cupping therapy after seeing the red round marks on Olympic athletes like Michael Phelps during the summer Olympics.

Cupping is essentially a form of body work or therapy that uses suction from the cups to achieve the desired results. This may stimulate blood flow, relieve pain, and provide many other health-promoting effects.

However, before going out and trying cupping therapy for yourself, it is a good idea to understand what it is, what it’s used for, and the potential pitfalls.

What Is Cupping Therapy?

Cupping therapy involves placing a plastic cup on the skin and pumping air out of the space inside the cup. This creates suction that breaks capillaries, the small blood vessels near the skin surface, and results in red (or purple) marks where the cup was. These were the circles seen on many athletes in the Olympics.

There are two types of cupping therapy: wet and dry. Dry therapy uses the action of the suction cup alone. Wet cupping (more commonly practiced in Persian medicine, called Hijama), involves bloodletting inside the suction cup.

Dry cupping can be done two ways:

  1. In a single area (also called static cupping)
  2. By moving the cup around to several places (more like a massage but with suction instead of pressure)

Origins of Cupping Therapy

Historical records document cupping use in Chinese medicine over 3,000 years ago. Other records indicate that the ancient Egyptians and Greeks practiced it as well. Hippocrates, known as the father of medicine, even used it. Nowadays, cupping is practiced as part of traditional Oriental (Chinese, Korean, and Japanese) and Persian medicine.

Interestingly, the Chinese and the Egyptians both discovered cupping independently thousands of years ago. When the same healing tool is found in opposite parts of the world (before there was the internet, mind you) and the tool is still practiced thousands of years later, it is a testament to its benefits.

Traditional Chinese Medicine (TCM) historically placed cups on specific acupuncture points to stimulate the points. For example, someone with allergies and colds would be thought to have a stagnation of the lungs. In that case, a cup is placed on an acupuncture point for the lungs, and will often turn into the darkest color of bruises even though all the cups are placed on the skin with the same negative pressure. TCM practitioners consider that cupping works better the darker color the mark is, because the darker color means more stagnation is released.

Before there were plastic suction cups, practitioners used glass cups and flame (fire cupping). Burning a piece of cotton inside the cup removed oxygen from the air, causing negative air pressure. When the practitioner immediately put the cup on the skin, the skin underneath the cup would be sucked into the cup.

Modern Use of Cupping

While cupping is used in TCM for overall health, conventional physiotherapists use it too. Modern biomedical literature lists cupping as a pain-relief tool or as a tool for myofascial release. Many massage techniques involve manipulating blood to flow into the muscles to release trigger points and flush out inflammation. Similarly, cupping therapy can do the same thing for areas of the body with less fat tissue, such as the back and shoulders.

In a review article in the Journal of Bodywork and Movement Therapy, Rozenfeld and Kalichman (both academic physiotherapists) described the physiological effects of cupping:

Mechanically, cupping increases blood circulation, whereas physiologically it activates the immune system and stimulates the mechanosensitive fibers, thus leading to reduction in pain.

Sometimes a musculoskeletal issue that is stagnant in its healing process can be stimulated into healing by slightly irritating the tissue or initiating some inflammation. This concept applies to prolotherapy, where a foreign substance (usually dextrose) is injected into an injured joint to stimulate inflammation. Similarly, because cupping creates localized inflammation, it can have this effect on a stagnant injury in addition to stimulating more blood and lymph flow to that area.

Does Cupping Therapy Really Work?

Many people, including celebrities and athletes, attest to the benefits of cupping therapy. Mechanistically, it makes sense that cupping therapy can reduce pain and support healing.

When it comes to clinical evidence, however, the jury is still out, according to Dr. Brent Bauer of the Mayo Clinic’s Complementary and Integrative Medicine Program (source). This could be for a few reasons:

1. A Limited Number of High Quality Large-Scale Clinical Trials

Presently, the clinical evidences supporting the effectiveness of cupping for low back pain and neck pain are promising. The medical world feels they need more rigorous clinical evidence before they can conclude that it really works.

2. Placebo Effect

When medications are tested, it is usually tested against a placebo—a sugar pill dressed up as the medication. This ensures the effectiveness of the medications is truly because of the medications and not because the patient thinks they have taken it. Placebo effect can account up to 30% of the results in medicine. For this reason, scientists believe it best to compare any treatment against a placebo rather than a no-treatment group.

The use of placebo to test the effectiveness of TCM itself is controversial. First, it’s hard to come up with a physical placebo for acupuncture or cupping therapy that can isolate the belief that you’ve had improvement from the treatment itself. Second, TCM is a mind-body medicine approach rather than just the body, so we can’t truly isolate the mental from the physical healing with TCM.

3. Average vs. Individual

Because randomized control trials look at people collectively as a group they may miss out on individual differences. Back pain, for instance, could result from a myriad of causes, such as sciatica, herniated disks, tight back muscles, SI joint disorders, or simply poor posture. Cupping therapy may be more effective against some of these causes and not others. In order to know for sure more thorough clinical study is necessary.

In real life, a clinician—be it a doctor, physiotherapist, or TCM practitioner—should be able to help identify causes health issues and treat with an individualized approach. Personal experience and a clinician’s expertise should help decide whether cupping therapy is right for you.

Managing the Risks of Cupping Therapy

Cupping is considered a relatively safe procedure and cupping cups are available without prescription. This means anyone can purchase them and do cupping on anyone. However, complications such as injury and infections can happen, so it is important to get cupping therapy from a qualified practitioner.

Risks of injuries from cupping include:

  • Muscle sprains or deep bruises from very heavy suction
  • Burns from fire cupping (only get fire cupping from well trained practitioner)
  • Infections from dirty cups

In order to safely and effectively enjoy cupping therapy, be sure to:

  • Receive cupping therapy from a qualified practitioner such as a TCM practitioner or acupuncturist. If you are receiving cupping therapy for myofascial work, consult your physiotherapist, massage therapist, or chiropractor for the best way to go about it and specific contraindications that you should be aware of.
  • Pay attention to the pain levels and communicate with your practitioner as you are receiving cupping so they can remove the cups or adjust the pressure. It can feel uncomfortable to have suction cups on your skin, but the pain should not exceed a 2 out of 10.
  • Only receive cupping therapy from hygienic clinics that sterilize their tools, and clean their cups between patients.
  • Avoid cupping around areas with small, sensitive muscles and nerves. This includes the neck and jaws.
  • Don’t try cupping near open wounds and fresh injuries.
  • Avoid cupping if you are on a blood thinning medication or have a bleeding disorder.
  • Avoiding leaving cups on for more than 15 minutes as the risks may exceed the benefits by this point.
  • Always check with your primary doctor and any other necessary health professionals before beginning any type of therapy, including cupping.

Have you tried cupping therapy? What was your experience? Please weigh in.


Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.


18 responses to “What Is Cupping Therapy? (Or Why Athletes Have Red Spots)”

  1. Hannah Avatar

    From my research and experience in Chinese Medicine cups should never be left on the skin in one spot for longer than 1 minute. 30 seconds is ideal. I love cupping therapy so much I even bought my own cupping kit!

  2. Tyler Avatar

    I have not tried cupping yet but have seen many more people lately with the markings of it. It has seemed to help quite a few of my friends, including athletes and competitors.

    I also did not know cupping had been around for so long and used as such an ancient medicine. It’s my assumption that they are valid techniques of medicine if they have been used by such sophisticated cultures and remained around so long.

    It would be hard to compare cupping against something to really test its therapy benefits. But at the same time I do believe that the mind can have profound effects on the body if we believe in it.

    Thank you for the great read!

  3. Joan Avatar

    I get massages once a month as I have fibromyalgia. My massage therapist uses the cupping on my back and shoulders and it helps tremendously. The results last much longer than just a regular massage.

  4. Kathy Daniels Avatar
    Kathy Daniels

    I have had cupping done several times. It is my favorite type of massage – particularly if I have a painful, swollen or irritated area on my body. My massage therapist is trained in several forms of massage. She is excellent at cupping and was trailed over in Thailand – where she is from. She can tell immediately when the cups are applied, if my body part is injuried or sore by the color of my skin. The redder or more purple it is, the more inflamed and irritated it is. I had never heard of this until the Summer Olympics 2016 and some of the athletes were having it done. I have great pain relief and more improved range of motion and ease of movement for a longer period of time after cupping than with a traditional massage. I really appreciated your article and it let me know how good my Kae really is.

  5. Carol Avatar

    I go to an asian Acupuncturist who is in his 90’s and doesn’t speak English very well. He still runs marathons and is always proud to show his trophies. He uses acupuncture needles some but does the cupping but always uses some little device to puncture my skin in the area, places the cup over it, leaves me while he sees another patient, comes back and removes the cup and says “see, blood clot, now you be better,” and then he shows me what looks like a chubby caterpillar shaped jellied blood thing. It works, no pain after but I still dont understand. I originally went to see him because of my cold hands and feet but he concentrated on where my pain was. I still get cold hands and feet but no pain in my back anymore. it takes 2 weeks for the bruise to disappear.

    1. Hannah Avatar

      I’ve just recently learned that those “blood clots” are usually parasites!

  6. Liona Avatar

    In the cupping treatments you didn’t mention Moving cupping with silicone cups or Cupping using a Medi-cupping machine?

    Anita Shannon of Ace cupping has several youtube videos showing how this is done. As a Certified Massage Therapist-Esthetician I’ve found adding moving or stationary cupping (without fire) can give me the results of 1/2 hr of deep tissue in 5 min. using cups.

    The added benefit of the medi-cupping machine allows me to adjust the vacuum suction from light for manual lymph drainage, facial or frail skin to deeper suction for back treatments or work on the hands & feet. It also has a variation in settings to add rhythm of suction, allowing me to attach cups and also work on another area of the body.

    I’ve found it personally very effective to rejuvenate facial skin to look 10 years younger than my age of 63 since it stimulates elastin and collagen production as it detoxify skin and increases blood circulation.

  7. Tammy Avatar

    I use a small cupping device on my face. I am amazed how beautiful my face looks. It has amped up my glow 100 fold! Go to Beautiful on the Raw and try it. She has one specifically designed for the face. You will not regret it. I promise. I glow!

  8. Virginia Avatar

    Hi Katie
    I’m Greek and vividly remember seeing this performed on my parents as a child. My mom would use regular glass drinking glasses and do the fire method. At the time I thought it was sort of medieval but I see now that a lot of what I saw as a child is used holistically today. I wish I was older at the time to know how to do many of these things and know all these cures. Makes you wonder how people knew about all these healings without being educated. I really enjoyed reading about this. The Greeks call them “venduza”. Thanks for bringing me back to my childhood.

  9. Meagan Avatar

    I love receiving fire cupping therapy from my acupuncturist!! I find 15 min of cupping on my back and shoulders/traps more effective than a 90 min massage. I carry a lot of tension in my traps and cupping has effectively removed some of it much more than massage ever could for me. As a busy working mom of two young children I rarely have time for massage, so cupping is my favourite time effective de-stressor! I also tend to have lots of energy a day after receiving cupping.

  10. Alicia Avatar

    I used to get severe lower back pain right before I got my period. It was so bad my chiropractor was amazed at the state of the muscles in my back. I was terrified of cupping, but I let my Doctor of Chinese Medicine do dry cupping on me for the first time (she was very gentle with the amount of suction used). Afterwards I couldn’t believe how amazingly good I felt. I wasn’t at all expecting it to really bring relief (I’m pretty skeptical – no placebo effect here). Ever since then I haven’t had back pain that bad.

  11. Felicity Avatar


    Small correction if I may, hijama is actually an Islamic not Persian practice =) Muslims commonly practice cupping around the world.

    Great article,


    1. Mediha Avatar

      Yup! Hijama itself is an Arabic word, but its definitely practiced by both Persians, Arabs, and Muslims alike. 🙂

  12. Julija Avatar

    My mum used to do fire cupping on my back to relieve caugh when I was a child. I loved it as a massage.

  13. Zeeshan Shah Avatar
    Zeeshan Shah

    Hi Katie! Thanks for another great, detailed post! Love your website and just bought your new cookbook….alll the recipes Ive tried so far are keepers! Especially the chocolate chip cookies which my kids LOVED! I am of Pakistani origin so the One-Pan Pakistani Kima was next. Delish!Curious about the background:)
    You and I share a similar story. I started my journey to get my health back a couple of years ago after being told I have Hashimoto’s. H-pylori and vitaminD deficiency too. With just 3 months of eating right and exercising I managed to get my antibody count down and the H-Pylori disappeared!
    We need to show the world that we are in control of our own health and that the best legacy we can leave our kids is the ability to make good food choices.
    Thank you once again, your love and genuine concern shines through in your work!

  14. Dee Avatar

    When I was younger I remember my parents having friends who were into fire cupping. I thought it was the weirdest thing on the planet! In recent years its gain some awareness but I still didnt know much about it. Thanks for such an informative post!

  15. deborah Avatar

    I Had a serious back injury about 13 years ago. I opted to forgo surgery and get treatment other ways. One of those ways was cupping. I saw a Chinese massage therapist 3 times a week and this was one of the treatments he used. Treatment took a long time, but i saw medical doctors along the way and they were skeptical, but it was obvious that i made improvements to the point where they said that surgery would no longer be effective for me. Now, I remain cautious with certain activities, but I’m pain free and have been for 10 years.

  16. Jenny Avatar

    Ever see “Zorba the Greek?” First (and only) time I ever saw cupping. I had never heard what it was called.

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