Dry Cupping Attenuates Inflammation Markers and Rated Perceived Exertion in Table Tennis Players after Intensive Training

J Physiol Investig. 2025 Sep 1;68(5):266-273. doi: 10.4103/ejpi.EJPI-D-25-00017. Epub 2025 Aug 29.

Abstract

High-intensity training induces inflammation, fatigue, and muscle damage in athletes. Cupping is popular for managing muscle stiffness and fatigue. This study investigated dry cupping's effects on training intensity perception, blood cell populations, and inflammatory markers in table tennis players after intensive training. Ten skilled players were randomly assigned to cupping (C) and noncupping (NC) groups, with a 14-day washout between treatments. The rated perceived exertion (RPE) scale evaluated training intensity perception at three points: before training (PRE), after training (POST), and 30 min postcupping (POST30). Blood samples determined white blood cells (WBCs), neutrophils, platelets, lymphocytes, and muscle damage markers such as blood urea nitrogen (BUN), creatine kinase (CK), and lactic acid (Lac). The results indicated that both groups experienced similar training intensity. At POST30, Group C had significantly lower RPE, WBC, neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) compared to Group NC (Group C: RPE: 1.91, WBC: 7.39 × 10 3 /μL, NLR: 2.93, SII: 526.62 vs. Group NC: RPE: 2.85, WBC: 9.45 × 10 3 /μL, NLR: 3.35, SII: 619.14; P < 0.05). Group C also significantly reduced BUN (POST: 15.57 mg/dL vs. POST30: 14.56 mg/dL) but did not affect CK and Lac changes at POST30. In conclusion, dry cupping significantly reduced RPE, WBC, NLR, SII, and BUN levels, suggesting it mitigates exercise-induced fatigue by modulating systemic inflammation.

Keywords: Blood urea nitrogen; Chinese medicine; fatigue; systemic inflammation index.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Athletes
  • Biomarkers / blood
  • Humans
  • Inflammation* / blood
  • Inflammation* / prevention & control
  • Male
  • Physical Exertion* / physiology
  • Tennis* / physiology
  • Young Adult

Substances

  • Biomarkers