Dwayne “The Rock” Johnson regularly shares updates relating to his workouts and nutrition, and has upped the intensity and rigor in his training and diet recently as he prepares to start filming DC’s Black Adam. In an Instagram photo posted this week, Johnson showed off his back, which was covered in red, sore-looking circular bruises from cupping therapy.

A practice that dates back to ancient China, cupping is a method of treating pain after exercise by placing a glass cup on the skin, creating a vacuum which draws up the tissue. As the glass cools, the skin contracts, encouraging blood flow. Johnson is by no means the first famous figure to try cupping as a form of athletic pain relief; swimmer Michael Phelps famously sported the round bruises from the treatment at the 2016 Olympic Games.

In a recent video on his YouTube channel, cardiologist and doctor of internal medicine Rohin Francis cites numerous scientific studies which have found that there is “no real benefit” or “limited value” to the practice of cupping, with insufficient evidence to support its application in medical situations. “The only trials that showed some benefit in some pain syndromes were not deemed of good enough quality to draw any valid conclusions,” he adds.

Francis acknowledges that Johnson was not recommending that people try cupping at all, and was simply sharing his first experience of the therapy. His concern, though, is that due to Johnson’s vast online following and specific reputation when it comes to his physical fitness, even a brief mention of “quack therapies” like cupping could be seen as a tacit endorsement.

And this is where Francis reaches the crux of his video: he is not especially interested in cupping, but rather the way in which we talk about alternative medicine practices in general.

There is a common way of thinking, he explains, that if a certain tradition has existed for thousands of years, then it must work, because otherwise why would people still be doing it? “Anyone who thinks that just because something has been around for a while, must mean that it’s effective, I’m afraid you just haven’t studied any history,” he says. “This is a naturalistic fallacy, sometimes called the appeal to ancient wisdom.”

Not that Francis wants to disparage the experience of anybody who believes they have benefited from cupping, even if that might simply be due to a placebo effect. “That’s genuinely wonderful, that person’s suffering has improved,” he says. “The effect is real for them. But that’s not evidence that it works.”

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