Summary
Dr. Stephen Cabral, a board-certified doctor of naturopathy who trained at a traditional Chinese medicine hospital in China, breaks down a recent study published in the Public Library of Sciences on cupping and athletic recovery. The study found that while cupping did not improve muscular strength, power, or VO2 max directly, it improved heart rate variability (HRV) by 37% and significantly enhanced sleep quality and recovery in athletes. Cabral emphasizes key details from the research: high-suction cups (400 mmHg) were required for results, while weak hand-pump devices (100 mmHg) showed no benefit. The protocol involved 15-minute sessions twice per week. He explains the mechanisms behind cupping, including improved circulation, lymphatic movement, parasympathetic nervous system activation, and faster post-workout recovery. Notably, the sleep benefits were lost once the competitive season started due to travel and stress, while the HRV and recovery benefits persisted. Cabral advises that cupping should be part of a broader recovery strategy alongside sleep optimization, hydration, progressive overload, and soft tissue work.
Key Points
- A recent study showed cupping improved HRV and recovery by 37% in athletes, though it did not increase strength, power, or VO2 max
- High-suction cups (400 mmHg) were required for results; weak hand-pump devices (100 mmHg) were ineffective
- The effective protocol was 15 minutes of cupping, twice per week
- Cupping improves circulation, moves the lymphatic system, and shifts the body into parasympathetic nervous system dominance
- Sleep benefits from cupping were significant in the preseason but diminished during the competitive season due to travel stress
- HRV and recovery benefits persisted throughout the season even after sleep benefits faded
- Traditional glass cups with fire cupping provide the strongest suction compared to plastic pump cups
- Cupping should complement other recovery strategies including sleep optimization, hydration, and soft tissue work
Key Moments
Cupping improved HRV and recovery by 37% in athletes
Dr. Cabral cites a recent study showing that cupping improved HRV and recovery by 37% in athletes, though it did not directly improve strength, power, or VO2 max.
"How would you like to improve your HRV and recovery by 37%?"
High suction cups required for results - low suction devices don't work
Dr. Cabral explains that the study found weak hand-pump cups at 100 mmHg did not improve recovery or HRV, while high-suction cups at 400 mmHg were effective. He recommends glass fire cups or high-suction devices for meaningful results.
"The researchers were amazed that the cupping did that. And so they started to look into more of the physiology as to why it works. So although it doesn't make you stronger or faster, it appears to improve your autonomic nervous system and recovery. And the way that it really does that, and I'm just going to share with you what I've seen in my own experience as well, is that the suction, and let me give you actually a really important note on this. They found that the weak devices, which you like hand pump, those ones that only created 100 millimeters of mercury, a lower suction did not work to improve recovering HRV. It had to be the high suction cups, which led themselves to 400 millimeters of mercury. And again, you don't really need to know what all of this means, but I'll tell you for sure: a lot of like the smaller plastic cups."
Optimal cupping protocol is 15 minutes twice a week
Dr. Cabral outlines the optimal cupping protocol from the study: 15 minutes, twice a week with high-suction cups. He explains the mechanisms including improved circulation, lymphatic movement, and shifting the nervous system toward parasympathetic dominance.
"In China and in my practice in Boston, we always used glass cups and we did it with fire. I know that not everybody's going to do that, but basically the fire inside with alcohol, just on a, on a basically a cotton ball, took away the oxygen. And when you placed it on the person's back, it just immediately sucked up. That's the traditional way of doing it. I know not everyone's gonna do it. But if you're working and you're having cupping done, it should at least be done with a high suction methodology, or you'll get no results really at all. Okay, so that was important. Now, the second part is that it should be done twice a week. If you want these same exact results, which is improved recovery, which is again, it's so important. I'm going to talk about the microcirculation, et cetera, in just a moment. But 15 minutes, twice a week, and the 400 millimeters of mercury, higher suction cups. That's all that you need to know. Twice a week, 15 minutes, high suction. That's it. Okay. So now here's why it works: it improves the, well, once you get the suction of the skin in the blood, it's improving overall circulation. It is helping move the lymphatic system. That does help with detoxification and move stagnant blood as well as anything accumulated during the workout out. So it helps facilitate that recovery faster. It literally helps you recover faster. The second thing it does."
Cupping improved sleep in preseason but not during competitive season
The study found that cupping significantly improved athletes' sleep during the preseason, but once competition and travel started, the sleep benefits disappeared while recovery and HRV benefits remained.
"So here's what I want to share with you though, is that it worked exceptionally well preseason before games started. The problem is that the sleep benefits, so athletes were getting so much better sleep while doing cupping twice a week, 15 minutes."
