I started this blog to document my quest for the truth in exercise claims. As I runner, I wanted to know if there was something that would help me run faster, recover quicker, or make my running effort seem easier. Something that was proven, with scientific backing. I’ve been a physician for 25 years and a runner for 36 years. I’ve investigated a lot of claims over the years, but recently, I finally found what I have been looking for!
When athletes use it, they effortlessly outperform their prior efforts. They can run longer, run faster, and recover more quickly. They have a better self image and enjoy their activity more. It can help every type of athletic activity, from weightlifting to endurance cycling. It just makes you feel better!
How much better? Well, when physicians used it for post operative pain after patients had their wisdom teeth removed, they found it made the patients feel as good as 6 to 8 mg of morphine! But there are no adverse side effects, it’s not illegal, and it’s widely available. Many Olympic athletes use it to boost their performance.
Columbia University and University of Michigan scientists have shown how the neurochemistry of it can relieve pain in humans. Neuroimaging studies have shown it activates specific pathways within the brain, causing release of the body’s natural opioids and dopamine. Opioids are pain killers (similar to morphine), and dopamine is a nerve chemical that plays a major role in reward-motivated behavior, and motor control.
In the experiment, scientists applied it as a cream to the volunteer’s forearms. Next, a control cream (subjects were told it had no effect) was applied to a nearby area. Researchers then placed a painfully hot stimulus (similar to a very hot cup of coffee) to both forearm areas and used positron emission tomography (PET) scans to measure and compare brain activity during each application. They found that the cream treatment caused the brain to release more opioids, which relieved the pain. (7)
The amazing thing is how it can be utilized: it can be a cream, a drink, a food, a pill, tape, clothing, or object. It can be made into anything you want, and will work just as well, as long as you believe it will work. What is it? It’s a placebo.
A placebo is a substance or procedure that is objectively without specific activity for the condition being treated. (9) Although it is inert, it can have a positive affect on how you feel. The opposite is called a Nocebo Effect, which causes unpleasant symptoms. Both the positive placebo effect and the negative nocebo effect are subsets of Expectation Effects. You apply Kinesio Tape because you think it will help, and it does. You think you’ll have a bad race on a hilly course and you do. If you believe it, it will come true.
A good example is ankle taping. Recurrent ankle sprains are common among athletes, and ankle taping reduces the risk of injury. Yet, many studies have shown the tape does not provide structural support. The tape itself or how it is applied has no effect on ankle stability. But it is effective because athletes believe it will protect them from injury. Therefore, it works because taping may have a placebo effect. One small study looked at whether there was a placebo effect with ankle taping in individuals with ankle instability. The researchers tested the subjects under three conditions: (i) real tape, (ii) placebo tape, and (iii) control (no tape). They found no significant difference in performance among the three conditions, BUT the participants’ perceptions of stability, confidence, and reassurance increased with both real and placebo ankle taping when performing the tasks. They concluded the effect of ankle taping on participants’ perceptions may contribute to its effectiveness in preventing injury. (10)
“In recent decades, reports have confirmed the efficacy of various sham treatments in nearly all areas of medicine. Placebos have helped alleviate pain, depression, anxiety, Parkinson’s disease, inflammatory disorders and even cancer”. (6) There seems to be two intertwined psychological mechanisms which underlie the placebo effects—expectancy and conditioning. If you expect something to give you a positive result (such as consuming an energy drink before a race) and you then happen to have a good race, you have created positive reinforcement. This positive belief about future outcomes can trigger those outcomes the next time you engage them in the same activity. (3)
I think this is the psychological basis for superstitions. For example, Sanya Richards-Ross, an American sprinter, wears arm sleeves. Initially worn due to her Behcet’s disease, she now wears them because she associates them with running her fastest times. Whether it is superstition or the power of a placebo, the sleeves “help” her win.
There is a story about the famous Brazilian soccer player Pelé, who gave his soccer shirt to a fan. When his performance began to suffer, he sent an assistant to retrieve the shirt. His expectations that the shirt helped him perform at his best had positive reinforcement, because when he was able to wear it again, his performance improved. The funny thing is, what Pelé thought was his lucky shirt was actually a replica, passed off by his assistant as the original.
Newer research is revealing how knowing you are receiving a treatment or medication increases its effectiveness. From a biological or physiology perspective, you would think a substance would exert its effect in a very specific way, at a very specific level, affecting specific receptors, changing hormones or influencing the body’s biochemistry. Yet recent studies involving covert administration of treatment (hiding the treatment from the subject) has found “that when the patient is completely unaware that a treatment is being given, the treatment is less effective than when it is given overtly (openly) in accordance with routine medical practice.” The difference between open and hidden administrations is thought to represent the placebo component of the treatment. The decreased effectiveness of hidden treatments indicates that knowledge about a treatment affects outcome. (4)
You can harness the power of the placebo effect simply through words. Having an esteemed athlete or coach tell you how incredible your performance will be, will improve your performance. Studies have shown how patients can have the placebo effect without getting a pill, shot, or procedure, and feel better simply from visiting the doctor. Sitting in an exam room, seeing the white coat, or a supportive word from the doctor can change your physiology. This type of placebo effect seems related to the degree of confidence and faith the patient has in the doctor or activity. So, having a stranger tell you how fast you’ll run a race won’t be as effective as Lolo Jones encouraging you.
Sport success is often dependent on a person’s belief in their ability to be successful, which is reinforced through hard work and perseverance.
An excellent example of how the placebo effect can influence runners can be found in this short, easy to read article “Mind over Body” by John Porcari, Ph.D., and Carl Foster, Ph.D.
Here is how you can harness this powerful performance enhancement:
Follow a routine.
Have a lucky object.
Repeat a mantra.
Avoid negative thoughts.
Find something that makes you feel or perform better and use it! (Maybe Sanya Richards-Ross can send you her sleeves).
1) Acute psychological benefits of exercise: Reconsideration of the placebo effect. Szabo A. J Ment Health. 2013 Jan 16.
2) The placebo effect: powerful, powerless or redundant? Kamper SJ, Williams CM. Br J Sports Med. 2013 Jan;47(1):6-9. doi: 10.1136/bjsports-2012-091472. Epub 2012 Aug 14.
3) Lessons From Recent Research About the Placebo Effect—From Art to Science. Howard Brody, MD, PhD; Franklin G. Miller, PhD.JAMA. 2011;306(23):2612-2613. http://jama.jamanetwork.com/article.aspx?articleid=1104739#ref-jco15154-4
(4) Overt versus covert treatment for pain, anxiety, and Parkinson’s disease. Colloca L, Lopiano L, Lanotte M, Benedetti F.
(5) Placebo effects in competitive sport: Qualitative data. Christopher J. Beedie. Journal of Sports Science and Medicine (2007) 6, 21-28. http://www.jssm.org
(6) Placebo Effect: A Cure in the Mind By Maj-Britt Niemi Scientific American. http://www.scientificamerican.com/article.cfm?id=placebo-effect-a-cure-in-the-mind
(7) Researchers Demonstrate How Placebo Effect Works in the Brain. http://phys.org/news105029324.html
(8) Amino Acids. 2012 May;42(5):1803-8. Effects of red bull energy drink on repeated sprint performance in women athletes. Astorino TA, Matera AJ, Basinger J, Evans M, Schurman T, Marquez R.
(9) Deconstructing the Placebo Effect and Finding the Meaning Response. Daniel E. Moerman, PhD; and Wayne B. Jonas, MD. Ann Intern Med. 2002;136(6):471-476.
(10) The placebo effect of ankle taping in ankle instability. Sawkins K, Refshauge K, Kilbreath S, Raymond J. Med Sci Sports Exerc. 2007 May;39(5):781-7.
11) Placebo effect in sports. Mark Berdi, Doctoral (PhD.) thesis booklet. http://pszichologia.phd.elte.hu/vedesek/Brdi_Thesisbooklet.pdf