The Effects of Cupping

Treatment on Delayed
Onset Muscle Soreness
Lawrence Totaro, Andy Bradford, Leo
Radziwon, Clayton Metz
Background
● Delayed Onset Muscle Soreness (DOMS): Soreness due to physical exertion of a muscle

beyond what it is accustomed to.

● Cupping Therapy: A form of alternative medicine in which special cups are placed on the skin

to create suction.

● Prior research conducted on cupping therapy and its effects on flexibility.

● Shown to have an effect on soft tissue with an increase in blood circulation and muscle

elongation, while decreasing muscle tension.

● Importance of our study: To determine if cupping is a reliable treatment to relieve the

symptoms of DOMS
Purpose
● There have been many studies regarding ways to reduce pain from delayed onset

muscle soreness. From acupuncture to massage therapy, many alternative methods

have been performed, but cupping has yet to be one of them. This study is designed to

test whether cupping will help to reduce the symptoms of pain and soreness
Hypothesis
Null Hypothesis
● Cupping will not show an effect on the pain levels of delayed onset muscle
soreness
Research Hypothesis
● Cupping will show an effect on the pain levels of delayed onset muscle
soreness
Methods
● We will have 2 groups matched by gender, age group, level of sport, and
sport played.
○ Women, 18-22, D2 soccer players
○ Group 1: (N = 15) soccer players who received cupping therapy once
during the testing period (time = 48 hours)
○ Group 2: (N = 15) soccer players who did not receive cupping therapy
during the testing period (time = 48 hours)
● The soccer players will undergo a rigorous condition program that consists
of running 4 miles, along with an hour of drilling. All soccer players will
undergo the same condition program.
Methods Cont.
● Immediately after completion of the conditioning program, we will collect pain ratings
via the Likert Scale (1-10); 1 representing the least amount of pain, and 10
representing the most amount of pain. The pain ratings will be focused specifically
on the lower extremities, due our focus of utilizing cupping in that region.

● 24 hours after completion of the condition program, players in group 1 will come in
one at a time to avoid bias and for privacy to receive cupping on the rectus femoris,
vastus lateralis, vastus medialis and vastus intermedius regions of the thigh. The
cupping will be superior, lateral, and medially to the insertion point of the quadriceps.
Methods Cont.
● Once treatment is completed, the players in group 1 and 2 will return 24 hours later
with to give their pain rating via the Likert scale regarding the conditioning program
that they had completed 48 hours prior to their second readings and their current
pain levels.

● The Likert scale will be printed out on a large poster board, to aid in some players not
being familiar with how the scale works in the explanation of pain management. The
player will either point, verbally announce, or a combination of both, their level of pain
that they are experiencing at their initial read. This same protocol will be continued
throughout the second readings as well.
Statistics R O1 T O2
R O3 O4
One-Way Between Groups ANOVA
● Determines whether there is a statistically significant difference between the two
post-groups
● One-Way
○ One independent variable
● Between Groups
○ Each participant is only in one sample
 Received Cupping No Treatment

Participant Pre-Treatment Post-Treatment Participant Pre-Treatment Post-Treatment

1 7 4 16 8 6

2 6 5 17 8 7

3 7 4 18 7 6

4 8 4 19 6 5

5 6 2 20 9 6

6 9 5 21 8 5

7 10 6 22 6 4

8 9 4 23 8 6

9 8 5 24 7 7

10 8 3 25 6 8

11 6 4 26 7 7

12 6 2 27 9 7

13 7 3 28 10 8

14 9 2 29 9 8

15 10 4 30 8 8
Results
Results
Conclusions
- According to our findings, cupping does decrease DOMS, and we can reject the null
hypothesis of there being no effect
- Since we have found that cupping is indeed effective, it should be studied more
extensively to find what other benefits it can offer aside from what we already know
Limitations
- The Likert Scale is a significant limitation due its subjective nature
- Unknown level of pain each person is experiencing prior to the training
- Not being able to control activity levels after training is also significant
- Type and condition of footwear can also be a factor in terms of force
distribution and pain
- Skin sensitivity must be accounted for as well, being that some may not
be able to tolerate the suction of the cupping treatment
Limitations Cont.
● Internal Validity
○ This is dealing with having "randomization" instead of choosing our participants for our study,
thus protecting our internal validity. From there, having a population size greater than 30 will
also aid in protecting our internal validity.
● External Validity
○ Repeating this study with other sports players, ages, and genders are needed to accurately
represent all populations and validates cupping as a recovery mechanism
● Confounding Variables
○ Supplementation is something that is also unable to be controlled during this testing. While it
can be discouraged, we can't stop this 100%
○ There is a possibility that medications may also play a role in the level of soreness/doms a
player may experience after the conditioning program
○ Injury history is another factor out of our control
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