A Placebo is something of no intrinsic remedial value that is used to appease or reassure another. There is no completely agreed upon definition of what a placebo is, and the scope of therapy can extend from an ingested agent to a physically inert external treatment.7 The concept of the placebo effect can extend to include every conceivable beneficial biological, social, or human interaction that doesn’t involve some drug well-known to the pharmacopoeia.10 Irving Kirsch hypothesised that the self-fulfilling effects of response expectancies, in which the belief that one will feel different, leads a person to actually feel different. This effect is the placebo effect.8
Despite the vast amount of research in the area of placebos, the phenomenon has remained largely unchallenged in the area of sport and performance.12 In high performance it is likely that there are a great number of therapies and ergogenic aids that are used with no real effect of the athlete. Instead, there is the potential for a placebo effect to occur providing a false positive for improved performance. Expectation and conditioning are among the strongest areas for explaining the placebo effect13 and a large component of high performance sport involves mental training of an athlete by their coaches and support staff.
The placebo effect is a psychobiological reaction attributed to numerous mechanisms including expectation of improvement and Pavlovian conditioning.3,4 These psychological reactions can have performance benefits, and when you look at high performance sport the single highest priority is performance outcome. Numerous studies have been completed where athletes falsely believe they have been administered performance enhancing agents, and obtain performance improvements over baselines and controls.1,2,5,6,10,11 These improvements may only be an increase of 1% however at top levels that can be enough to mean the difference between winning and losing. With restrictions on what agents an athlete can use and what equipment and techniques are allowed win each sport it is necessary to look at every possible option for getting the winning edge on the opposition. Some aids that can be used may only provide a placebo effect on the athlete, but this can lead to real performance outcomes.
By working with sports science, psychological benefits can be enhanced for an athlete resulting in further improved results. Items such as compression garments have no proven benefit for their use, however they have shown no negative impact either, and by combining the placebo effect of using such ergogenic aids with the possibility of real physiological benefits could potentially result in an amplified boost for the athlete. Many items such as these become products that are viewed by the general population as necessary for elite athletes. It is unclear with these products if the use at high performance breeds the idea that they have a physical benefit, or if there is a physical benefit that causes the population to believe that high performance athletes need them to compete on an international stage. What is clear however is that some athletes believe that they need them to perform and as such they have a real impact on the athletes performance, whether it is through a placebo effect or physiological or neurobiological mechanism.
It is shown that false belief may enhance performance. This can be achieved through a conscious decision making process as opposed to any direct somatic or psychological mechanism.3 To be able to determine the real benefit of a placebo however, it would be necessary to look deeper into the actual reasoning for the performance enhancements that are achieved. At the moment the only true way of determining whether there is a placebo effect in place is through performance measures and recording athlete results. If there were some neurobiological mechanism that has a physiological effect on the individual causing these changes, it would be necessary to determine what it is and then measure the impact that it has.
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8. Kirsch, I., (1985). Response expectancy as a determinant of experience and behaviour. American Psychologist 40 (11):1189-1202
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11. Sonetti, D.A., Wetter, T.J. Pegelow, D.F., and Dempsey, J A. (2001) Effects of respiratory muscle training versus placebo on endurance exercise performance. Respiration Physiology 127 (2-3), 185-199.
12. Stedge, H. L., Kroskie, R. M., & Docherty, C. L. (2012). Kinesio Taping and the circulation and endurance ratio of the gastrocnemius muscle. J. Ath. Training, 47(6), 635-642.
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