奧運金牌泳將 菲爾普斯 青睞 cupping (拔罐vacuum pressure)?!

中醫4大神器：刮痧、推拿、拔罐、針灸比一比 華人健康網 2016/08/10巴西里約奧運金牌選手因為愛用拔罐，也連帶使中醫4大神器「針灸、拔罐、推拿及刮痧」成為熱門討論話題。雖然有國外醫師認為拔罐只是「心理作用」；但是，國內中醫師則指出，中醫博大精深，治療是以調整經絡氣血循環為主，但無論使用何種方式，均需「萬病求其因」，才是最好的治療。傳統中醫拔罐，能緩解肌肉痠痛，在巴西里約奧運廣受選手所青睞。新北市中醫師公會常務理事、沙政平中醫師指出，不僅美國奧運金牌泳將菲爾普斯、體操運動員亞歷山大‧納多爾等人，紛紛利用中醫拔罐緩解肌肉痠痛，引起關注。事實上，自從4年前北京奧運開始，就已經有許多西方奧運選手，對傳統中醫有關「針灸、拔罐、推拿及刮痧」深感興趣，且常作為運動傷害的輔助治療之一。而這次中華奧運代表隊，就有不少選手曾有使用拔罐、針灸或推拿來緩解痠痛。

運動常有乳酸推積症候群 易產生痠痛 傳統中醫認為「痛則不通，通則不痛」。針灸主要是刺激人體，調整經絡氣血循環；刮痧、拔罐則是促進局部代謝循環；推拿則可放鬆局部肌肉；上述4種療法，就是要打通經絡氣血，達到緩解肌肉痠痛的目的。中醫針灸，屬侵入性治療，對緩解肌肉痠痛，應用廣效果較好。排解乳酸推積 拔罐立竿見影沙政平中醫師強調，運動選手在挑戰身體極限時，肌肉組織常會出現「乳酸推積症候群」，容易產生痠痛及疲倦感，通常選手多是先用冰敷舒緩肌肉，再作熱敷促進血液循環，希望能排解乳酸堆積，而拔罐則可達到「立竿見影」效果。

進行拔罐、針灸 注意小禁忌 不過，中醫師也提醒，「針灸、拔罐、推拿及刮痧」主要都是在穴道、經絡的部位，一般以治療器官功能性問題為主，如尿失禁、便祕、腸胃不適、疼痛、痠痛等；因為各有其有禁忌，千萬不可小覷。★「刮痧、推拿」：常用在治療中暑，部位以頸部兩側和脊椎兩旁為主。刮痧方向必須由上而下，不要上下來回刮容易受傷，也要避開骨頭的地方。禁忌：1.體質虛弱、疲勞、太餓都暫時不要刮痧，很容易因刮痧而昏倒。2.懷孕的婦女腰腹部也最好不要進行刮痧，避免造成胎兒早產或流產。3.有傷口、皮膚病、腫痛也不適合刮痧，容易造成感染。刮痧常用在治療中暑，但體質虛弱、疲勞者則是不宜。 ★「拔罐」：主要是治療風濕扭傷，多運用在在行氣活血、止痛消腫、拔毒排膿為主。禁忌：1.皮膚易過敏、皮膚發紅、起水泡者不宜。2.精神病發作期也不宜拔罐。3.血小板減少症、出血性疾病禁止拔罐。4.孕婦下腹部及乳房不宜拔罐。5.患者心腎或呼吸功能衰竭者不宜拔罐。皮膚易過敏、皮膚發紅、起水泡者不宜。★「針灸」：屬侵入性治療，應用廣效果較好。可用在治療呼吸系統疾病，或是神經系統疾病，如頭痛、偏頭痛等、遺尿、肋間神經痛，或是肌肉方面疾病，如肩膀痠痛、網球肘、坐骨神經痛、腰痛、關節炎等。禁忌：1.太餓或太飽都不能針灸，吃飽後至少要半小時再針灸，對身體較好。2.近中午時因氣血旺盛，易影響到氣血運作，要避免中午進行針灸治療。3.容易出血或是心臟病者，也不宜進行針灸。

「神秘拔罐力量」如同禁藥？　中醫師：兩者功用根本不同 美國游泳好手菲爾普斯（Michael Phelps）於本屆奧運獲得金牌，但他身上的拔罐痕跡意外成為媒體討論焦點。俄羅斯國家電視台更指出，拔罐功效其實與服用禁藥效果差不多，中醫師陳峙嘉表示，禁藥主要是用來提升肌耐力，拔罐則是能緩解肌肉傷害，痠痛時才需要拔罐，兩者並不相同，請勿過度迷信。菲爾普斯曾透露拔罐能舒緩肌肉痠痛，是他最愛的療法之一。陳峙嘉表示，拔罐是古代中、西方常用的一種治療方式，稱為「角法」，是利用獸角吸附在皮膚上達到治療目的，常用來治療「瘀證」，運動後乳酸堆積也是瘀證的一種，所以拔罐可以達到運動緩解效果。奧運體操選手納杜爾（Alex Naddour）也大讚，拔罐是他保持健康的秘方。陳峙嘉說，拔罐對緩解氣滯血瘀特別有效，所以循環系統不好、身體痠痛、運動傷害都可藉由拔罐來舒緩、減少傷害，讓運動生命延長及加強成績表現，但若要維持身體健康，則須多樣方面來配合。英國《衛報》質疑拔罐並無科學療效根據，多是心理作用，陳峙嘉認為，拔罐能緩解運動傷害，就算是心理作用，被治療者「覺得」有緩解、舒服較重要。他更提醒，拔罐時切記力道勿過大、時間別太久，約10～15分鐘就好，否則易吸出水泡。另外頸部、脊椎這些部位不適合拔罐，有凝血障礙、孕婦、急性傳染病、皮膚病的人也不適合。 此外，針對另一民間療法「刮痧」，陳峙嘉表示，其主要功效為緩解「暑熱」，運動員在太陽下運動，如果水份補充不夠、散熱不佳，暑熱在體內鬱積，就會有頭暈、噁心、嘔吐的中暑現象，這時候就可以刮痧。

Does 'cupping' do Olympic athletes any good – and does it matter if it doesn't? The red circular marks decorating many bodies in Rio can be credited to the alternative therapy du jour. Cupping has no scientifically proven benefits – but for many athletes, that winning advantage is in the mind as much as the body US swimmer and multiple medal-winner Michael Phelps covered in the red circles that result from 'cupping' therapy.  US swimmer and multiple medal-winner Michael Phelps covered in the red circles that result from 'cupping' therapy.  Monday 8 August 2016 12.45 BST Last modified on Monday 8 August 2016 22.00 BST Why are so many Olympians – mostly members of Team USA – sporting big red circular marks on their bodies? The simple answer is that they are fans of "cupping" – an alternative health technique that involves pressing hot jars on to the body. This creates suction, which is claimed to increase blood flow to those areas. The swimmers and gymnasts who use it say it helps relieve soreness in their battered bodies. It would certainly help relieve overburdened wallets, but there is no evidence it does anything else. Eating jam out of those jars would probably have a more significant physical impact, though it might not be the most nutritionally savvy strategy. But then again, this is the Olympics. Aside from proving that Olympians are just as credulous as celebrity cupping fans like Jennifer Aniston and Gwyneth Paltrow when it comes to pseudo-science, there's something more interesting at work here. Years and years of relentless, gruelling, exhausting training have brought these bodies to this moment. Now they are at the very culmination of that process. There is no more training they can fit in, nothing left to do but get out there and perform, while the eyes of the world watch them. Suddenly, it's not the body that matters but the mind. The pressure is immense – and unimaginable to most of us.  In that pressure cooker, if you get your head in the right place by some hokey but essentially harmless alternative therapy that your teammate swears works for them, it must be really hard to see the down side. Why wouldn't you give it a try? Even though it's totally unproven as an effective therapy, cupping involves lying down, being forced to relax, while someone does something painless to you that they authoritatively claim will make you feel better. They might as well just rename it the Placebo Treatment – but that's exactly what the circumstances call for. A tiny moment of releasing the pressure of all that expectation and tension. The byword in sport these days is "marginal gains" – tiny, incremental adjustments in kit, technique and training that, when added together, make for big improvements. Think of cupping as the anti-science version. After all, most athletes have their own rituals and superstitions – and if a lifetime of dreaming of gold came down to a few minutes of your life, you would take every edge you can get too, and feel all the better for it.   

Michael Phelps uses cupping to ease his muscle pain. What does science say? Updated by Brian Resnick on August 8, 2016,  When Michael Phelps took to the water to swim in the 4x100-meter relay Sunday, many noticed weird purple circles covering his right shoulder. The dots are the result of cupping, the latest alternative therapy elite athletes are using to try to recover faster and perform better. But as with a lot of alternative therapies, the science on these medicinal hickeys is pretty inconclusive, suggesting you may not need to sprint off to a cupping practitioner to try it out on your sore muscles. Michael Phelps of the USA competes in the men's 200m butterfly heats on day 3 of the Rio 2016 Olympic Games at the Olympic Aquatics Stadium on August 8, 2016, in Rio de Janeiro, Brazil. Cupping comes from traditional Eastern medicine Phelps got those marks from glass or plastic vacuum cups that were placed on his skin by his personal trainer. The practice involves very simple tools: plastic or glass cups and a vacuum pump. The process is very simple as well: The cups are placed over muscles, and then, using the pump, you create an area of vacuum pressure that draws blood to the surface, breaks capillaries, and forms the perfect purple circle on the skin. A mechanical vacuum isn't always needed; sometimes the cups are heated and then placed on the skin. As the cups cool, the air inside them contracts, forming the negative pressure needed to bring blood to the surface. Cupping has been around for centuries in traditional Chinese medicine; it's also used in the Middle East. Chinese medicine practitioners would say it helps open up channels of qi, or the body's life force. Athletes claim it aids healing, recovery, and blood flow and reduces pain. Phelps has apparently been cupping for some time. This photo on his Instagram page was taken about a year ago.  Phelps isn't the only American athlete adorned with the spots — Alexander Naddour, an American gymnast, has been seen with the purple blotches too.

Cupping seems to be safe. But does it work? Unlike many alternative therapies, cupping has been studied enough for meta-researchers to do several systematic reviews of the scientific evidence. Individual studies can exaggerate effects or suffer from design flaws, so researchers use systematic reviews to cut through hype and understand where, on the whole, the bulk of the evidence lies. For cupping, the systematic reviews I read all suggested the practice isn't harmful — but the studies on it are too weak to come to solid conclusions about whether it really works. "We included 550 clinical studies in this review ... 78.1% of these [randomized clinical trials] were with high risk of bias," read one such review, published in a 2010 edition of BMC Complementary and Alternative Medicine. Papers with high risk of bias either don't blind the researchers to the treatment groups or have their methods compromised in another way. The review also noted a big limitation to evaluating cupping: There's no standard method to measure its effectiveness.

The review concluded: The current evidence is not sufficient to allow recommendation for clinical use of cupping therapy for the treatment of above diseases of any etiology in people of any age group. The long-term effect of cupping therapy is not known, but use of cupping is generally safe based on long term clinical use and reports from the reviewed clinical studies. Another 2012 review in PLOS One looked at 135 studies and also found "a lack of well-designed investigations." The PLOS One review did find some evidence that cupping works, but it was for specific applications like "herpes zoster [a.k.a. shingles], acne, facial paralysis, and cervical spondylosis [an age-related degradation of spinal disks in the neck]." Not exactly conditions that affect an athlete's performance. A red flag for a treatment like cupping should be that no one can explain exactly how it is supposed to aid athletic performance. "The mechanism of cupping for pain remains largely unclear," a 2015 systematic review of systematic reviews on cupping reports in the Journal of Traditional Chinese Medical Sciences. (A review of reviews is as meta as science gets.) If you can't explain what's going on, it's hard to know what variables need to be closely studied. It could be that cupping brings more blood to an area and this promotes healing. But that's just a guess. Some say it helps relieve stress in the muscles by pulling them upward. Overall, "larger well-designed trials are needed to validate the therapeutic efficacy of cupping therapy," the 2015 review reads. This is the space where a lot of fad health trends thrive: There's no good data to prove cupping helps, but, likewise, there isn't data to disprove it either. Meanwhile, you have celebrity endorsements to propel the fad forward. There's one way it could help, however: the placebo effect. Athletes are superstitious folk. If they try something once — like cupping, or wearing an "energy" bracelet, or what have you — and perform well, they may get scared about what will happen if they stop. Studies suggest that caving in to these superstitions can ease athletes' minds and help them maintain confidence in their abilities. And since cupping is probably harmless, that would not be the worst thing.