What the Cup! Cupping Therapy for Sports and Tactical Injuries 

This article was originally published in The Raider Patch: Magazine of the U.S. Marine Raider Association

“The octopus got me again!”

Cupping therapy, also known as vacuum therapy, is a negative pressure treatment applied over the skin to treat physical pain and injuries. Cupping increases blood flow, releases old blood and scar tissue deposits, and decompresses underlying structures (up to 4 inches under the surface!) A transient pattern of purple circle marks over the treated area is a signature side effect in stressed or injured tissues where old debris has been “drawn up.” Recipients appear to have been attacked by a particularly vigorous sea creature.

Skin response 15 minutes after a cupping treatment in a person with neck injuries, frequent dehydration in hot climates, and prolonged helmet wear.

In physical therapy and sports medicine, cupping remodels scar tissue, decompresses nerve fibers, and stimulates new blood vessel formation. Cupping is performed by placing plastic or silicone cups over problem areas, applying vacuum pressure either by hand or by a pump, and moving or leaving them in place for a prescribed period (e.g., 3-10 minutes). The person receiving treatment may relax the body part or move the area as the cups maintain suction. 

Example cup placement for chronic upper back and trap muscle pain.

Old school is a good school

Applied by the ancient Egyptians at least 3500 years ago via glass cups and fire, elements of vacuum therapy to treat pain and ailment have been a part of traditional medicine practices worldwide. Cupping therapy in the U.S. seems to have appeared during the 2016 Olympic Games in Rio when commentators and spectators noticed the large purple spots covering swimmer Michael Phelps’ body. 

At the time, many western medicine professionals brushed off the effectiveness of cupping as a placebo only. Few English language studies had reached the healthcare masses in the U.S., so accessible research was limited. Now, cupping therapy is found in most professional sports organizations and SOF human performance programs.

How it works

It’s no secret that years of wear and tear can take a toll on the body’s soft tissues. A complex network of blood vessels, nerves, and connecting tissue chains is just below the skin’s surface, all saturated by a slippery ocean of lymphatic fluids. Trauma, inflammation, dehydration, overuse, or inappropriate use create breakdown and binding.

The places where tissues get stuck together are collectively known as “adhesions.” These adhesions now create a new problem: restricted structures pull and snag on their neighbors. As the tissue gets knotted up and moves less, blood flow to and from the area is compromised, creating malnutrition and more stiffness in the surrounding regions. In addition, tiny spots of tightness can develop into tension felt throughout whole body parts, seemingly far away from the original problem.

IT band adhesions cause skin “puckering” under the cup. The band is stuck to the underlying quad muscle and contributes to knee pain with running.
Altered blood flow (darkened skin response) over the lower ribs. Years of combative training and a nasty fall into a ravine lead to scarring.
Adhesions in the left upper trap creating an “orange peel” appearance in a person with a history of cervical spine fusion surgery and left shoulder pain with lifting.

How to Try It

Several professionals who treat pain and injuries use cupping therapy, such as physical therapists, athletic trainers, chiropractors, and massage specialists. Like with any treatment, success with cupping relies on it being applied to the right person, for the right problem, at the right time. Cupping can be surprisingly effective when other methods have failed. Examples include nagging shoulder AC joint sprains, arthritic low back pain, chronic shin splints, and pain after bone bruises or poorly healed trauma scars. However, cupping isn’t appropriate for fresh injuries, varicose veins, certain cancers, or skin conditions.

When applied correctly, most people notice improvements in pain or stiffness within the first 4-6 sessions, delivered over a few weeks. Healthy skin will turn light red for an hour or so after treatment, then return to normal. Unhealthy or scarred tissue will develop mild soreness and a round, hickey-like mark, gradually fading over subsequent days and additional sessions as the tissue repairs. Cupping paired with a corrective exercise program can accelerate recovery and prevent recurrent pain flares. At the 6-treatment mark, a degree of permanent change is usually observed, and sessions taper down from weekly to monthly. Clients can often purchase cups and apply them for maintenance or self-treat minor flare-ups. 

If you’re dealing with chronic soft tissue problems and haven’t found lasting benefits with other methods, you might want to try cupping. It’s a low-cost, low-risk, rapid-response technique that can give great results – just prepare for weird looks if you take your shirt off in public!


Gilmartin S. The Guide to Modern Cupping Therapy. Robert Rose, Inc. 2017.

Why Michael Phelps, other Olympic atheletes use cupping therapy for recovery. Sports Illustrated Magazine. https://www.si.com/edge/2016/08/10/rio-2016-olympics-cupping-therapy-benefits-michael-phelps. Published August 10, 2016.

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