ARI SHAPIRO, HOST:
The most-decorated Olympian of all time won his 19th gold medal last night, and that wasn't the only circle on his body. Swimmer Michael Phelps had a bunch of reddish-purple marks almost like bruises or hickies. They are the result of cupping, an ancient Chinese healing practice that has recently become popular with athletes. Jie Jin is a second-generation acupuncturist in the Washington, D.C., area.
JIE JIN: Today we usually use glass or plastic cupping. In the old days, it would be ceramic, bamboo. It can be made of different materials.
SHAPIRO: The cups are placed on the skin, and then the air inside of them is removed to create a suction effect, leaving behind those round marks. Some techniques use a tube almost like a vacuum cleaner. Others use fire to burn up the oxygen. People use it on their back or their legs. Jie Jin says Michael Phelps uses it where you would expect given his sport.
JIN: I see cupping marks on his shoulder, on his upper back. So he's a swimmer, and that has to do with the style of swimming he does. The practitioner needs to look at the condition and to palpate where the tenderness of the muscle and diagnose it correctly and then find out where to put the cups.
SHAPIRO: In Eastern medicine, people use cupping for all kinds of ailments. Sports therapists have started picking up the technique in just the last five to 10 years. They use it for a narrower set of problems like sore muscles and stiff joints. Dr. Karyn Farrar has a sports therapy clinic called Rehab 2 Perform.
KARYN FARRAR: Just like a soft tissue massage can apply pressure directly to the tissue in order to bring blood flow to the area, the same is used with the cupping. So negative pressure is actually pulling tissues apart.
SHAPIRO: There is not scientific evidence showing that this actually has a physiological impact. Do you think this is anything more than just a placebo?
FARRAR: I think that the research just hasn't been fully completed. But based on what I see in my clinic every day, it absolutely has a physiological impact.
SHAPIRO: Placebo or not, Olympians are always looking for anything that will give them a competitive edge. Dr. Bill Mallon is an Olympic historian and editor in chief of the Journal of Shoulder and Elbow Injury. We called him in Rio via Skype, and he said he only recently started spotting those telltale round hickies on Olympic swimmers.
BILL MALLON: I did see it during the U.S. Olympic trials, and I know myself, I was kind of dubious a little bit because I just hadn't seen much literature on it yet.
SHAPIRO: And now...
MALLON: I still have not seen much literature.
SHAPIRO: This is just the latest - I don't know whether you want to call it a fad or a trend - in trying to get optimal performance. What have we seen before cupping?
MALLON: Well, the biggest one for the last probably 10 years now has been kinesio taping.
SHAPIRO: Explain what kinesio taping is for people who aren't familiar.
MALLON: It's the taping you see the athletes putting on their skin in certain areas of their body where there's some sort of injury or dysfunction. Especially around shoulders you see it a lot. And what it's supposed to do is kind of give a sort of a kinesthetic feedback to the muscles to kind of keep them functioning more properly whenever you have something out of a little bit of alignment.
SHAPIRO: Does it seem at all odd to you that at the highest levels of athletic performance and competition, people are using techniques, whether it's K-tape or cupping, that really are not proven in the medical literature to do all that much?
MALLON: No. Actually it doesn't seem odd to me at all just because the margins between first and second, second and third or being on the podium or not - I mean it's so small that they're looking for any edge they can get, and that's what's led to doping of course.
But you know, in these cases, they're looking for a legal edge. So if it's something that doesn't impede their performance or doesn't make it worse, you know, they try it. It may just give them that little hundredth of a second edge that may lead to a gold medal instead of a silver.
SHAPIRO: Dr. Bill Mallon, thanks a lot for your time.
MALLON: No problem. Thank you very much. Transcript provided by NPR, Copyright NPR.