When Michael Phelps showed up to Rio with his back covered in large, purple, hickey-looking dots, it reignited the buzz around the acupuncture-like therapy treatment called cupping, in which small glass orbs are heated on the body, creating a vacuum that sucks the skin away from the muscles. Alex Naddour, Natalie Coughlin, and Chris Brooks have also relied on cupping during training; if the world's best athletes are doing it, it must be legit. 

As if that weren't enough evidence of cupping's efficacy, Gwyneth Paltrow, the queen bee of all that is healthy and weird (preferably both), was ahead of the trend when she showed off the signature marks during a 2004 movie premiere. Goop swears by cupping, along with other Chinese medicine practices that "help the body heal itself," and her word is as good as gold... in certain circles, anyway. 

It's one thing for Gwyneth to parade around with glass hickeys all over her body. But with Olympic athletes getting in on the action to help with muscle soreness and recovery during the Games, everyone's wondering: does it really work?

What the science says

Professional athletes may use cupping to help with muscle tension and to increase range of motion, but normals might just get something out of it, too. A review of more than 50 years of studies of cupping in China showed it could be beneficial for pain relief, although the review also determined further testing is needed to back up that theory in practice. Cupping may also help with carpal tunnel syndrome, back pain, shingles, and other acute and chronic pain conditions, but more randomized trials are needed to really determine the health benefits either way.

As is often the case with many alternative healing practices, there are a bunch of studies on it, but they aren't really up to scientific snuff to definitively say how cupping actually works, or whether the improvements seen are from the therapy or just a placebo effect. Larger sample sizes, rigorous controlling, and standardized clinical settings are needed to give cupping the official seal of approval. For the most part, though, existing studies haven't found any negative side effects, so despite how it looks, cupping is pretty safe. 

What the experts say

"It increases blood flow, can reduce muscle tension, and allows athletes or patients to feel improvements in their range of motion," physical therapist Marcus Williams, who uses cupping in practice at Ohio State University Medical Center, says. He adds that while cupping lacks clinical evidence, there are basically three theories to explain why athletes and other people seek it as a form of treatment: it increases blood flow to a local area; the tensile force of stretching the skin helps dull pain signals being sent to the brain; and hormones, like endorphins, are released to help heal the area.

The scientific explanation ultimately doesn't matter much to Williams; patients he's treated say it works. "Just from a subjective standpoint... the patient or the athlete will tell you that they feel better, they feel like they have more range of motion, and less pain, and nine times out of 10 that’s an immediate impact."

Plus, since cupping is non-invasive, it's a pretty cheap and inexpensive treatment that allows them to continue training. "Athletes find that the anti-inflammatory response created by cupping allows them to recover faster," adds Dr. Michael Y. Mizhiritsky, a board-certified physiatrist and specialist of physical medicine and rehabilitation at New York Bone and Joint Specialists. "So, in the case of Olympic athletes who are competing several times per day, cupping is used as both a prevention and recovery mechanism." 

The scientific evidence for cupping may still be up in the air, but athletes typically have nothing to lose when they give it a try. "Even though there have not been any randomized trials, cupping has been used for thousands of years," Dr. Mizhiritsky says. "Olympic athletes will do anything to their bodies to improve performance. Cupping is a natural method that has no illegal implication.

And if it's good enough for Michael Phelps, it's probably good enough for you, right? 

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Christina Stiehl is a health & fitness staff writer for Thrillist who doesn't plan on trying cupping, mostly because her mom wouldn't appreciate dozens of red marks all over her neck. Follow her: @ChristinaStiehl.

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