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Why Are Athletes Sporting Circular Bruises?

Cupping may have gained notoriety during the recent Summer Olympics, but it has been around for thousands of years.

Cupping has gained publicity due to its use by American sport celebrities including Olympians Alexander Naddour, Natalie Coughlin, and Michael Phelps. While cupping therapy might be trendy now, it’s certainly not new, with its roots dating back to ancient Egyptian, Chinese, and Middle Eastern cultures. It is a fascinating alternative form of medicine that has received mention in historical accounts dating as far back as 5,000 years ago.

So why are our athletes choosing to sport these bruises?

The basic idea behind cupping therapy is to create a vacuum just above the skin, so that blood is drawn to the surface in specific parts of the body that need healing. In today’s times, there is a range of materials that can be used to craft the cups that therapists use to create suction. While ancient healers used materials like animal horns, seashells, and bamboo, healers today use medical standard silicone cups, rubber cups, and glass cups to achieve the same results. These new materials allow therapists to watch the effect on the skin during treatment, while silicone cups also allow the therapist to move the cup while under suction for a massage-like effect similar to deep tissue massages.

How is cupping performed?

Cupping therapy involves applying cups to the patient’s skin in a series of positions through the use of suction. This suction effect allows the therapist to target areas just below the skin, as well as deeper tissue within the body, which is beneficial for dulling pain, breaking up deep scar tissue, and relaxing tender muscles or connective tissue. In this way, cupping is almost like the opposite of getting a massage, since instead of applying pressure to swollen areas, it draws pressure outward and off of these areas. For this reason, cupping is often done in patients who experience chronic lower back pain, muscle knots, tightness due to anxiety, swelling, or stiffness.

While there are several variations to cupping therapy, the type most widely used in Western cultures is referred to as “dry” cupping. In the traditional application of dry cupping, glass cups are warmed using a cotton ball or other flammable substances soaked in alcohol. The material is lit on fire and placed inside the cup, before being quickly removed. By burning a substance inside the cup, oxygen is removed from inside the cup. As the air inside the cup cools, a slight vacuum effect takes place. This vacuum anchors the cup to the skin and pulls it slightly upward on the inside of the glass.

While this traditional approach is still used, a more modern version was created for those squeamish about using fire near their body. “Air” cupping uses a suction pump placed at the bottom of the cup to create a vacuum inside the cup. This is the more popular alternative and is the version most widely used by athletes today.

Depending on your comfort and your practitioner's assessment of the problem, cups may be moved around or left in place during your treatment. They may remain on your body briefly or for longer amounts of time. Each treatment is unique to the patient on that particular day, and your therapist will communicate with you about the duration of the treatment for that particular day. What are the benefits gained from cupping?

Cupping targets soft tissue by applying local pressure to pain points and areas of swelling. As blood flow increases within vessels and capillaries, tissues receive much-needed nutrients and oxygen. Cupping is thought to release tissues deep inside the body, relax tense muscles and ease stiffness associated with chronic back and neck pains, migraines, rheumatism, and fatigue. Some athletes have been known to use cupping therapy to naturally improve performance and reduce stiffness, muscle cramps, joint pains, and scar tissue caused by injuries, much like the use of deep tissue massage.

What does cupping feel like?

Most patients experience a relaxing sensation coupled with relief when cupping therapy is performed. They might also experience a slight twinge when the skin is pulled up by suction. Because the skin is tugged upwards, tiny capillaries under the surface of the skin may expand. This can result in a circular pattern forming on the treated area with a small amount of swelling. However, these dark circles are not the same as bruising caused by blunt-force trauma – they are generally not painful and cupping therapists can perform light massage to the area in order to assist in the healing of these marks.

Can anyone receive treatment?

Although cupping therapy is a non-invasive form of treatment, it is not recommended for pregnant or menstruating women. Patients that have bone fractures or muscle spasms also cannot be given treatments. Further, in the case of patients that have a form of cancer that is spreading from one part of the body to the other, cupping is not advised. If the patient suffers from a condition because of which they bleed easily or if they have a high fever with convulsions, the therapist may refrain from providing treatment. There are certain areas of the body where cupping must not be used such as an artery, ulcer, pulse points, or any part where there is evidence of deep vein thrombosis.

What are the side effects?

Cupping might sound a bit scary to someone who’s new to the practice, but rest assured that cupping is generally painless. During a cupping session, it’s common to feel some heat and tightness around the cup, but many people find this to actually be relaxing and soothing. Cupping causes the skin to temporarily turn red, blue, or purple, especially if there is an injury or blockage under the area that was cupped. The skin discoloration can last anywhere from a few days to a couple of weeks but is rarely painful. Once the marks have cleared, the procedure can be repeated until the condition or ailment is resolved.

Just how effective cupping therapy is is still being debated, but many patients have found that it has helped them immensely. Modern medicine, however, recommends that patients not rely completely on this form of healing but only use it to supplement other conventional forms of treatment such as medication, massage, and physical therapy.

For those seeking treatment through cupping therapy, we invite you to call us at 703.349.5100 to schedule an appointment with our Certified Massage Therapist, Lori Murphy, or click here to request an appointment. To stay up-to-date on the latest news and tips from us, be sure to follow us on Facebook and Instagram, and sign up for our monthly newsletter for even more information sent straight to your inbox!



Arthritis & Sports is the premier orthopaedics practice in Northern Virginia. Our team of specialty-trained physicians offers the latest treatment options for the full spectrum of orthopaedic sub-specialties - all under one roof.


From nonsurgical treatments like orthobiologics and physical therapy, to massage therapy and  nutrition counseling, we are dedicated to providing you with exceptional care from injury through rehabilitation.

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