Michael Phelps has red circles on his back from cupping therapy – Business Insider

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Will Truman

Will Truman is the Editor-in-Chief of Ordinary Times. He is also on Twitter.

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  1. Avatar Damon
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    says:

    And why is this worthy of commentary? Are we to line up pro / anti cupping?Report

  2. Avatar Kazzy
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    says:

    I actually think this helps illustrate the arbitrariness of rules surrounding “performance enhancement”? Why is a machine that helps you heal faster any different than a drug that helps you heal faster? And, really, this set of drugs that helps you heal faster that are banned and that set of drugs that help you heal faster that are allowed?Report

    • Avatar Dave in reply to Kazzy
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      says:

      Kazzy:
      I actually think this helps illustrate the arbitrariness of rules surrounding “performance enhancement”?Why is a machine that helps you heal faster any different than a drug that helps you heal faster?And, really, this set of drugs that helps you heal faster that are banned and that set of drugs that help you heal faster that are allowed?

      It’s one thing to improve blood flow. It’s another thing to improve healing and gain all sorts of side effects like significantly enhanced strength and/or endurance, something steroids can do.

      This doesn’t look like the kind of thing that takes a mediocre swimmer and turns him/her into a medalist.Report

      • Avatar Kazzy in reply to Dave
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        says:

        @dave

        But why draw the line there?

        Why is cortisone — a steroid — legal in many sports but other steroids are not?

        The fact is we permit certain forms of performance enhancement and not others and often draw arbitrary lines around the two groups.Report

        • Avatar Morat20 in reply to Kazzy
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          says:

          Different type of steroid. Cortical steroids reduce inflammation. Which actually offers the answer to your question.

          In general, drugs that return to to full health are okay, whereas drugs that improve you past full health are not.

          So, bluntly, a drug that reduces swelling so your muscles are working properly is one thing. A drug that gives you bigger muscles is not.

          It’s right in the name — “performance enhancers”.

          A drug that clears up an Opera singer’s sinus infection so she can sing normally isn’t the same as a drug that tightens her vocal cords so she can hit notes higher than her range.Report

          • Avatar Kazzy in reply to Morat20
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            says:

            So an athlete tears a muscle that would normally take 6 weeks to heal. During that time his performance is bunk. He takes a drug that reduces recovery time to 3 weeks. He now has 3 weeks of bunk performance and 3 weeks of normal performance. Hasn’t that drug “enhanced” his performance over that 6 week span from what it would have been absent the drug?

            What about LASIK surgery?

            What about Tommy John surgery, which some players come back throwing harder after? So much so that there are rumors of minor leaguers getting the procedure done voluntarily (i.e., absent an injury)?

            Weight lifting is a performance enhancement. Protein shakes are performance enhancing. That is what athletes do… enhance their performance. But we randomly decide certain things are okay and certain things are not.

            I don’t see any distinction between recovery and non-recovery. In both cases, an outside substance is allowing you to do better than you’d do on your own.Report

            • Avatar Morat20 in reply to Kazzy
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              says:

              Why are we averaging performance? And why are you pretending you can’t tell the difference between “injured” and “not injured”?

              I’m happy to admit there’s edge cases, but when you take clear cut cases and pretend they’re confusing that doesn’t do your case much good.Report

              • Avatar Kazzy in reply to Morat20
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                says:

                Why should the rules be different for injured athletes? I’m not being difficult here… it is a real question.

                Imagine two players… both with level 8 performance. Player A gets hurt. He can still play but now maxes out at level 6. Player B does not. Player A’s new performance level is 6. He takes a drug that gets him back to 8. He’s “improved” 2 performance points. Why is that okay but Player A taking that same drug to get from 8 to 10 isn’t?

                You are the one making the argument that the rules should be conditional… that there should be exceptions for one class of athletes (those who are injured) but not for the rest. I think it fear to put the onus on you to defend that. Not for me to show why whatever rules we do come up with should be applied consistently across all athletes.Report

              • Avatar Morat20 in reply to Kazzy
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                says:

                So you’re arguing to forbid medical treatment from athletes?

                If an athlete breaks his bone, should he be banned from seeing a doctor? Forced to set it himself? Let it heal, no treatment, lest he be ‘performance enhanced’ from his new state of ‘crippled’?Report

              • Avatar Kazzy in reply to Morat20
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                says:

                No. But if a drug is allowable for recovery, why not for enhancement?

                Let’s say an uninjured player thought that putting his wrist in a cast during the offseason would yield better results. In fact, let’s say we knew for a fact that it did. Would we bar him from doing it? No. We’d let him.

                All the treatments you mentioned are available to *all* athletes.

                Drugs for recovery but not for enhancement fails to recognize that improving recovery is itself an enhancement.Report

              • Avatar Morat20 in reply to Kazzy
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                says:

                Do you know what a corticosteroid is? And how it differs from the steroids used by bodybuilders?

                It’s primarily an anti-inflammatory. It doesn’t effect muscle growth, doesn’t decrease healing time. (It has a similar..anti-inflammatory response on the immune system, toning down overreactions — like to allergens, auto-immune disorders, etc. Cortisone cream, for instance).

                In short, it’s basically strong advil. It’s, in athletes, to treat injuries where the inflammation is causing secondary injuries. (For instance, there’s tendons and ligaments in the ankle and foot that, if they tear or strain, cause inflammation — which causes more tearing and straining, preventing the injury from healing.)

                It doesn’t improve healing time in the sense that your “body heals faster”. It reduces inflammation, which can impede healing by causing more damage.

                For your argument to apply to corticosteroids, it’d ALSO apply directly to Advil and Alleve — which are also anti-inflammatories.

                Corticosteroids don’t enhance squat. Not muscles, not healing, not growth, not power, not anything. You can’t compare them to steroids or HGH, because corticosteroids don’t enhance anything.

                It doesn’t even speed up healing! All it does is reduce inflammation which can impede healing, which Advil ALSO does.

                How on earth is it different than Advil? And if you’re claiming Advil is a performance enhancer, then the problem here is you define “performance enhancer” differently than anyone in the world when talking about sports and doping.Report

              • Avatar Kazzy in reply to Morat20
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                says:

                @morat20

                Best I can tell, cortisone is available only when administered by a doctor… that makes it pretty different from Advil.

                My point is that, regardless of how cortisone works (and I’ll cop to not knowing the in’s and out’s of it but ultimately I think they are immaterial), it allows athletes to compete better than they would without it.

                How many football players get out on the field with a cortisone injection who would otherwise be sidelined? How is “playing” not an enhancement over “not playing”?

                Yes, I may be using a different definition than most but that is because I refuse to accept arbitrary distinctions. At least not without an explanation.

                Two athletes with the same performance level. One takes a substance, the other does not. The one who takes the substance performs better than the one who does not. How is that substance not performance enhancing? Even if the one only performs better because he gets out on the field that day while the other is in street clothes?

                I think there are plenty of places you can draw lines that are not arbitrary and which make sense one way or another. I just don’t see a lot of that happening. How many athletes fail tests because a given substance is allowable in one context but not in another?

                I’m all for a “level” playing field insofar as everyone is playing by the same rules. That is actually essential to sports. Whatever the rules are, players should follow them and be held accountable if they do not. But let’s not pretend this is about purity or natural-ness or unenhanced performance. Athletes enhance their performance in myriad ways. That is why they are at the pinnacle of their sport. No one wants to watch random guys plucked from the world and dropped into the Super Bowl. We want to see the best players out there. If the powers-that-be decided that the best version of the game is limited to players whose performance can be influenced by Substances A, B, and C but not Substances X, Y, and Z, so be it. I’m not arguing against that or arguing on behalf of a “wild west” approach to any of this. I’m just pointing out that we allow a bunch of narrative and silliness influence these discussions that muddy the waters and shift the conversation in weird ways.Report

              • Avatar Kazzy in reply to Kazzy
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                says:

                To look at it even more simply…

                I’ve run 4 or 5 half marathons. I’ve gotten faster with each one. Reasons for this include… better/more training, losing weight, better shoes, music that improves my pacing.

                Shaving about 10 minutes off between my first race and my most recent would undoubtedly be considered a better performance, no? I *enhanced* my performance, no? I sure as hell did! And proud of it! Should I be shamed because I did that? I sure as hell don’t think so. And I think most would agree.

                But what if I took advantage of other ways to improve — enhance! — my performance. Training at altitude? Sleeping in those oxygen deprivation tents? Working with a professional trainer? Buying a treadmill so that I can train year round? Cupping? Drugs of one kind or another? Doping? Which of these are legitimate and which of them are not? Why?Report

              • Avatar Morat20 in reply to Kazzy
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                says:

                Best I can tell, cortisone is available only when administered by a doctor… that makes it pretty different from Advil.

                There are a number of NSAID that require prescriptions, which work in exactly the same method as Advil. (Which is, you know, a NSAID). In fact, there’s at least one that IS Advil (well, Alleve) at higher dosages with buffers.

                Is that a performance enhancer?

                My point is that, regardless of how cortisone works (and I’ll cop to not knowing the in’s and out’s of it but ultimately I think they are immaterial), it allows athletes to compete better than they would without it.

                Only in the EXACT same sense that “taking advil” or “using RICE on strains” or “heat therapy” does.

                I literally can’t get past you calling an anti-inflammatory a “performance enhancer” and darkly talking about whether it’s fair.

                The only way it “enhances performance” is that it treats injuries. Like a splint, a cast, or an ice pack. It literally does NOT improve performance in any other way.

                Seriously, the logic you’re trying to sell makes a sling a performance enhancer. Two atheletes hurt their arm! One immobilizes it with a sling, the other doesn’t! Three weeks later, athlete A is performing better! because his freaking arm healed, because he had it immobilized.

                Step back a second and realize that you are calling an anti-inflammatory drug, which has no relevant properties to “sports” other than it “reduces swelling” a performance enhancer with a straight face.

                I can’t really have a “where do you draw the line conversation” when you’re trying to say the line is somewhere around anti-inflammatories.

                I think you’ve locked youself into thinking that the “steroid” part of “corticosteroid” means it MUST enhance human performance in some way, because people take steroids to become better athletes. It’s not that kind of steroidReport

              • Avatar Kazzy in reply to Morat20
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                says:

                @morat20

                The narrative and theory behind banning certain drugs* is that they enhance performance. Is this true or not true? If this is true, then we need to define what is an acceptable means of enhancing performance and what is not an acceptable means of enhancing performance. I’m not arguing that this line should be drawn around Advil. In fact, I’d throw the line way out to the other end… let these guys and gals use whatever they want. My argument is that the line is often drawn in an arbitrary way based on narrative or feeling or emotion or whatever.

                I don’t think that injury status should be a factor. Either something is acceptable to use or it isn’t.

                I assume you are okay with “Tommy John” surgery in baseball, wherein a tendon is removed from one part of the body and implanted into another part to repair/replace an injured one. Would you be okay with a player who wasn’t injured getting this surgery done? Because there is talk of that given that some players come back from the surgery throwing harder. Should those players be banned from getting the procedure? Why or why not?

                Maybe the problem is that the powers-that-be decided to make this about “performance enhancement”. As soon as they said, “We don’t want players enhancing their performance,” they had to deal with the pandora’s box that is the myriad ways they enhance their performance, many of which are acceptable.

                Much of the dialogue around this topic is about guys who did it “naturally”. What does that even mean? Is cortisone natural? Tommy John? Glasses?

                Again, we have to make buckets: This stuff is okay to do and that stuff is not okay to do. If you don’t have a principled definition for why something goes in one bucket or the other, than you are deciding arbitrarily. Which is cool if that is what the sports governing bodies want to do… but it doesn’t make it any less arbitrary.

                * And even non-drugs. One form of blood doping involves withdrawing an athlete’s blood, bringing down the temperature, and reinjecting it back into the same athlete. This is illegal in many sports. It is known as “blood doping”, though I imagine most people who talk about it assume “doping” refers necessarily to drugs.Report

            • Avatar Michael Cain in reply to Kazzy
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              says:

              What about LASIK surgery?

              Everyone agreed long, long ago that prostheses to enhance a person’s normal vision (glasses) got a special dispensation from the performance-enhancing ban. The rest — polarized sunglasses, contacts, LASIK — got in on the same dispensation.Report

    • Avatar greginak in reply to Kazzy
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      says:

      For one it depends on whether the enhancement has significant dangers. Cupping may have no actual dangers with its use. ( no idea, haven’t researched it) Many PE drugs have significant dangers with their use. There were a handful of deaths attributed to the EPO cyclists used to use back in the 80’s.

      If a dangerous substance is legal then it will become the norm in a highly competitive field. This raises the danger for everyone since to have a chance at winning they have to try to do what everyone else is doing. There are lines in every sport about what is legal and what isn’t based on safety.Report

      • Avatar Kazzy in reply to greginak
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        says:

        @greginak

        Many of the drugs now banned pose little threat.

        I’m not necessarily taking an “anything goes” approach… only pointing out that the lines that are currently drawn are pretty arbitrary.Report

        • Avatar greginak in reply to Kazzy
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          says:

          Yeah the lines are arbitrary but lines usually are, especially in sporting rules. If they don’t’ pose a threat than there is less reason to ban them. However if they are completely legal than athletes will use them. That does raise the specter of athletes chugging asthma inhalers or 20 other legal meds before or during every event. That could have unforeseen consequences and could also turn each sport into more of a medical contest than athletic contest. Certainly tech and medicine matters now, so much so that money often rules in many sports but i’m all for some limits.Report

          • Avatar Will Truman in reply to greginak
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            says:

            Right. If you let one person, you have to let anybody. If anybody can, than everybody who wants to compete has to. So everybody will.

            So when looking at various performance enhancers, whether diet and exercise or drugs or bionic implants… we have to ask the question of how comfortable we are saying “If you want to compete at the highest levels, you have to be willing to do this.”

            If there is an arbitrariness or hypocrisy, it’s that as we know what the highest level of football does to athletes, we are comfortable saying “You have to do that to yourself if you want to play professional football.”

            (I wouldn’t be opposed to a heavily regulated steroid regimen for healing, if I could be convinced that it could be reasonably regulated and a net positive or at least neutral to the health of the athletes.)Report

            • Avatar greginak in reply to Will Truman
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              says:

              Yeah the key problem is that playing many sports at the highest level is brutal on the body, football being the best, or worst, example. So PE’s may be just adding another level of harm. I’d be fine with allowing more healing focused meds but i’m not sure how to regulate that either.Report

              • Avatar El Muneco in reply to greginak
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                says:

                It’s not just at the highest absolute level – being anything like competitive at anything like the highest level your body is capable of is brutal. Just throwing 150 fastballs, even if they max out at 65, is going to hurt. Pro footballers are expected to do 11-12km over 90 minutes, but even the 1/2-2/3 of that that a hardcore weekend warrior does can take days to recover from.
                Competitive sport is hard. Not least because if it isn’t, your talent causes you to bubble up until it is. Kind of a hell race version of the Peter Principle or Civil War Union General Selection Criteria.Report

              • Avatar greginak in reply to El Muneco
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                says:

                True. Lots of age group distance runners have to cope with injuries. Training is hard if you put effort into it and try to be better. A lot of that is sport dependent though when you get away from the pro level. Cycling 6 days a week is much easier than running. As a pro, though, cycling can be hard on a body although quite a bit of that is the inevitable falls. At the pro or highly competitive amateur level pretty much all sport is really hard on a body. Take it down a peg away from the really successful amateurs and sport can be done with much less injury and stress often.Report

            • Avatar Kazzy in reply to Will Truman
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              says:

              I don’t know if that is necessarily true. Do you think Bartolo Colon is doing all the same stuff that Bryce Harper is?Report

  3. Avatar Mike Schilling
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    says:

    Tom Wolfe fans: Is this “The thing with the cup”?Report

  4. fillyjonk fillyjonk
    Ignored
    says:

    I’m just sort of amazed this is still a thing. I only knew it from “Zorba the Greek,” where Zorba tried to cure the old French prostitute (? I presume she was) by doing cupping on her. As I remember it, you light a match inside the glass globe to heat it up, so it will create like a small vacuum (?) and you stick it on the skin. It looks painful.

    Again, I might be misremembering (it’s been a while since I saw the movie, don’t remember if the scene was in the book) but I think he was trying to treat her for TB? Not very effective, she died.Report

  5. Avatar DensityDuck
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    says:

    The funny part is that, if the placebo effect actually exists, then maybe this “do-nothing” therapy actually does have a beneficial effect. If you believe that something useful has happened, you’ll exert yourself to a greater extent than you might otherwise choose to do.Report

  6. Avatar El Muneco
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    says:

    Not convinced. In a world with hyperbaric chambers, “increases blood flow and promotes healing” isn’t a killer app. Maybe it’s easier. So it’s halfway between that and massage therapy. It’s still a point on a continuum that already exists.Report

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