How cupping affects recovery and performance for running, OCR, and endurance sports
Thomas Solomon, PhD.
Updated onReading time approx 3 minutes (750 words).
What you’ll learn:
Cupping is a hands-on technique from alternative medicine where a therapist places cups on your skin and uses suction to pull the tissue upward.
When it comes to exercise recovery and endurance performance, the research is thin so we honestly don’t know yet if cupping helps, does nothing, or quietly gets in the way.
Curious about the how and why? Scroll down for the details, the nuances, and the nerdy bits.
The information I provide is not medical advice. Before making any changes to your habits of daily living based on any information I provide, always ensure it is safe for you to do so and consult your doctor if you are unsure.
What is cupping?
Cupping comes from alternative medicine. A therapist places a glass (or bamboo) cup on the skin over the body part they’re targeting, then creates suction so the skin and tissue get pulled up into the cup. There are 2 main styles: “Dry cupping” creates suction but doesn’t break the skin. “Wet cupping” involves small cuts so blood is drawn into the cup. Either way, you usually end up with a bruise because blood pools under the skin—this is called a hematoma, which is just a fancy word for “blood pocket under the surface”.
People most often use cupping to try to reduce pain. Several meta-analysesA meta-analysis quantifies the overall effect size of a treatment by compiling effect sizes from all known studies of that treatment. suggest cupping might help with chronic (long-lasting) pain — things like low back pain or neck pain — but the big problem is that cupping protocols vary a lot from study to study and there is generally a low quality of evidenceA low quality of evidence means that, in general, studies in this field have several limitations. This could be due to inconsistency in effects between studies, a large range of effect sizes between studies, and/or a high risk of bias (caused by inappropriate controls, a small number of studies, small numbers of participants, poor/absent randomisation processes, missing data, inappropriate methods/statistics). When the quality of evidence is low, there is more doubt and less confidence in the overall effect of an intervention, and future studies could easily change overall conclusions. The best way to improve the quality of evidence is for scientists to conduct large, well-controlled, high-quality randomised controlled trials. (see Shen et al. 2022, Wood et al. 2020, Cramer et al. 2020, & Kim et al. 2011). That’s why we still need more high-quality randomised controlled trialsThe “gold standard” approach for determining whether a treatment has a causal effect on an outcome of interest. In such a study, a sample of people representing the population of interest is randomised to receive the treatment or a no-treatment placebo (control), and the outcome of interest is measured before and after exposure to the treatment and control. before anyone can say “Yep, this definitely works” with a straight face.
You’ve probably seen famous athletes wearing those circular cup marks — cupping really hit the mainstream at the 2016 Olympics, when swimmers came to the pool looking like they’d been hugged by a very committed octopus. Anecdotally, I’ve heard a couple of people say they “feel” more recovered after cupping. But feelings are tricky beasts. If you already believe the marks mean “elite recovery mode,” your brain may happily do the rest of the work. (Brains are helpful like that. Also occasionally unhelpful.) So...
What is the scientific evidence on the effect of cupping on recovery and athletic performance?
There is currently no systematic reviewA systematic review answers a specific research question by systematically collating all known experimental evidence, which is collected according to pre-specified eligibility criteria. A systematic review helps inform decisions, guidelines, and policy. or meta-analysisA meta-analysis quantifies the overall effect size of a treatment by compiling effect sizes from all known studies of that treatment. that directly tests whether cupping improves recovery from exercise or endurance performance. What we do have is a small collection of experimental trials:
— Hamstring flexibility: Some studies report improved flexibility after cupping, but the “benefit” shows up mainly when there is no control group (Warren et al. 2020 
). When cupping is compared against a control or sham condition, the advantage disappears (Williams et al. 2019 & Schafer et al. 2020). Another study (Hammons et al. 2022) found improved calf range of motion after muscle-damaging exercise, but no improvement in delayed onset muscle soreness (DOMS), which is the “why do stairs exist?” soreness that peaks a day or 2 after a hard session.
— Muscle stiffness: One study (Li et al. 2022) reported that cupping might reduce ultrasound-measured muscle stiffness, but this was measured at rest, not after exercise, so we can’t assume it translates to recovery.
— Inflammation markers: Another study (Ekrami et al. 2021) found that cupping before exercise might slightly blunt exercise-related rises in circulating cytokines (markers of inflammation). Whether that matters for recovery or long-term training adaptations still needs to be tested.
So, at the moment, there isn’t enough evidence to make a firm call on cupping for recovery. That means we can’t honestly say whether it’s helpful or harmful overall.
What we do know is that each cup site causes bruising (a hematoma), which is literally tissue damage that your body has to spend time and energy repairing — energy that could otherwise go toward recovering from training. In theory, that could slow recovery rather than boost it. Less common side effects include pain and burns (see Mohamed et al. 2023).
Yes, cup marks can look kind of cool, but there are too many unknowns to make this worth gambling your recovery or performance on — at least for now. If your goal is better recovery, you’ll almost certainly get more return from the boring stuff: sleep, food, hydration, and actual rest. (Science-based recovery is boring sometimes.)
Even though there’s no systematic review or meta-analysis focused on exercise recovery or performance, there is a systematic review on cupping for musculoskeletal rehab (see Mohamed et al. 2023). The authors concluded that “the evidence of cupping on increasing soft tissue flexibility is moderate, decreasing low back pain or cervical pain is low to moderate, and treating other musculoskeletal conditions is very low to low” and that cupping “might be used as a useful intervention because it decreases the pain level and improves blood flow to the affected area”. Overall, they also noted that the evidence base is small and often messy—some studies have no control group, others use sham (fake) controls, and control group comparisons vary widely (heat, physiotherapy, electrical stimulation, stretching, or paracetamol/acetaminophen).
Can cupping enhance recovery and athletic performance?
Cupping might help reduce chronic (long-lasting) pain, but that conclusion is based on low quality of evidenceA low quality of evidence means that, in general, studies in this field have several limitations. This could be due to inconsistency in effects between studies, a large range of effect sizes between studies, and/or a high risk of bias (caused by inappropriate controls, a small number of studies, small numbers of participants, poor/absent randomisation processes, missing data, inappropriate methods/statistics). When the quality of evidence is low, there is more doubt and less confidence in the overall effect of an intervention, and future studies could easily change overall conclusions. The best way to improve the quality of evidence is for scientists to conduct large, well-controlled, high-quality randomised controlled trials. and a lot of between-study variation (heterogeneityHeterogeneity shows how much the results in different studies in a meta-analysis vary from each other. It is measured as the percentage of variation (the I2 value). A rule of thumb: if I2 is roughly 25%, that indicates low heterogeneity (good), 50% is moderate, and 75% indicates high heterogeneity (bad). High heterogeneity means there’s more variability in effects between studies and, therefore, a less precise overall effect estimate.) and a high risk of biasRisk of bias in a meta-analysis refers to the potential for systematic errors in the studies included in the analysis. Such errors can lead to misleading/invalid results, and unreliable conclusions. This can arise because of issues with the way participants are selected (randomisation), how data is collected and analysed, and how the results are reported..
For exercise recovery and athletic performance, the evidence is currently too limited to draw a confident conclusion.
We also don’t have solid data comparing trained athletes with untrained people, or comparing males with females. So, any confident “it works for everyone” claim is gonna be premature.
High-quality randomised controlled trialsThe “gold standard” approach for determining whether a treatment has a causal effect on an outcome of interest. In such a study, a sample of people representing the population of interest is randomised to receive the treatment or a no-treatment placebo (control), and the outcome of interest is measured before and after the exposure to treatment/control. are urgently needed before we can have real certainty about the claimed benefits.
It’s also unknown whether cupping could harm recovery. But we do know it can cause pain and burns, and it reliably causes bruising—damage that needs time to repair. So, at least in theory, it could delay recovery rather than help it. And time (and money) spent doing a “maybe” recovery method might be better spent doing the basics well: sleep, eat, hydrate, and chill out. Boring? Yes. Effective? Also yes.
How to use this: If you enjoy cupping for pain relief and it doesn’t interfere with training, that’s your call—but for recovery and performance, don’t rely on it as your main tool. Prioritise sleep, nutrition, hydration, and smart training load first; if you still want to experiment, treat cupping as “optional garnish,” not the meal.
Information you can trust. All content on Veohtu is meticulously researched and written by Thomas Solomon, PhD. He does not sell supplements, recovery products, or ad space, and he has no sponsorships, brand affiliations, or ambassador roles. Everything you read reflects his independent views, shaped solely by peer-reviewed scientific evidence — and that will never change.
Full list of meta-analyses examining cupping for recovery
Here are the meta-analyses I've summarised above:
Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation: A systematic and evidence-based review. Mohamed et al. (2023) J Back Musculoskelet Rehabil.
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Who is Thomas Solomon?
My knowledge has been honed following 20+ years of running, cycling, hiking, cross-country skiing, lifting, and climbing, 15+ years of academic research at world-leading universities and hospitals, and 10+ years advising and coaching in athletic performance and lifestyle change.
I have a BSc in Biochemistry, a PhD in Exercise Science, and over 90 peer-reviewed publications in medical journals.
I'm also an ACSM-certified Exercise Physiologist (ACSM-EP), an ACSM-certified Personal Trainer (ACSM-CPT), a VDOT-certified Distance Running Coach, and a UKVRN Registered Nutritionist (RNutr).
Since 2002, I’ve conducted biomedical research in exercise and nutrition and have taught and led university courses in exercise physiology, active recovery, biochemistry, and molecular medicine.
And, with my personal experience of competing on the track (800m to 10,000m), the road (5 k to marathon), on the trails, and in the mountains, by foot, bicycle, cross-country ski, and during obstacle course races (OCR), I deeply understand what it's like to train and compete — I've been there, done it, and gotten sweat, mud, and tears on my t-shirt.
Disclaimer: I occasionally mention brands and products, but it is important to know that I don't sell recovery products, supplements, or ad space, and I'm not affiliated with / sponsored by / an ambassador for / receiving advertisement royalties from any brands. I have conducted biomedical research for which I’ve received research money from publicly-funded national research councils and medical charities, and also from private companies, including Novo Nordisk Foundation, AstraZeneca, Amylin, the A.P. Møller Foundation, and the Augustinus Foundation. I’ve also consulted for Boost Treadmills and Gu Energy on R&D grant applications, and I provide research and scientific writing services for Examine.com. Some of my articles contain links to information provided by Examine.com but I do not receive any royalties or bonuses from those links. Importantly, none of the companies described above have had any control over the research design, data analysis, or publication outcomes of my work. I research and write my content using state-of-the-art, consensus, peer reviewed, and published scientific evidence combined with my empirical evidence observed in practice and feedback from athletes. My advice is, and always will be, based on my own views and opinions shaped by the scientific evidence available. The information I provide is not medical advice. Before making any changes to your habits of daily living based on any information I provide, always ensure it is safe for you to do so and consult your doctor if you are unsure.