The Placebo Effect in Sports Training

and Medicine
Mai Le
ID: 7928981
STATS 2300 F22 | Dr. J. Tichon
Due November 7, 2022
 The Placebo Effect in Sports Training and Medicine
Mai Le

Whether deception is ethical or not has always been debatable, but some deception
might do more good than harm in the very special case of placebos. A placebo is an
ineffectual treatment designed to work by deceiving the users into thinking that a
good outcome is guaranteed. A phenomenal and rather neat twist to this method is
how users can observe actual beneficial changes in their physical or mental state
despite consuming a fake treatment, this psychological effect is named “the
placebo effect.” Along with its uses mainly in pharmacological research, the effect
has recently taken up a prominent role in the study of sports and exercise, as
placebos are commonly paired with supplements and sports medicine to improve
athletic performance (Bérdi et al., 2015). In an episode of the podcast series
KoopCast, coach Jason Koop and Dr. Nick Tiller, PhD (2020) discuss the benefits of
the placebo effect in training while also addressing the boundaries of its usage in a
clinical setting.

Tiller suggests that it is appropriate to implement placebo in training to assess the

relationship between an athlete and ergogenic aids, which are products that help
enhance performance. When used with the purpose of reducing the use of
substances, the placebo effect has consistently shown successes in amplifying
athletic potential (Koop & Tiller, 2020). Despite being a new topic in this area, several
observations and experiments have been conducted on the mechanism of this
effect in various contexts. In 2009, Beedie and Foad reviewed 12 past studies on
the placebo effect in the training of different sports and how it might influence
multiple aspects of athletic abilities, such as strength, endurance, and pain
tolerance. All experiments reported positive changes of varying magnitudes in
groups provided with placebos that are used in place of an ergogenic aid or pain
reliever depending on the study’s subject (Table 1). Additionally, a study by
Saunders et al. (2016) investigated whether a placebo ingestion of caffeine affects
performance through an experiment where a caffeinated or non-caffeinated product
was given to 42 cyclists. The researchers noted that athletes who believed that they
had ingested caffeine prior to the physical test are more likely to perform better. It is
clear that not only was the application of placebo in training fruitful in past works,
the effect continues to show good results in evaluations of a supplement’s effects
on an athlete in recent years as well.

The downside of its increasing popularity is that the placebo effect, like any other
method that can yield positive results with a minimal cost, is highly likely to be
subjected to exploitation. In the podcast, Koop and Tiller argue that, for taking care
of athletes’ wellbeing is a vital part of training, it is frankly inappropriate and
negligent to use the placebo effect as a replacement for necessary medical
prescriptions and procedures (2020). In the same vein, multiple published
researchers in the study of placebo effect in sports have made clear how they
strongly discourage using the successes of placebos to promote complementary
and alternative medicines (CAM), a form of treatment that is designed to yield
results entirely by the placebo effect instead of evidence from extensive research
and standard clinical trials (Beedie et al., 2017). The authors reason that, because
each individual responds to placebos differently (Beedie & Foad, 2009), the
probability of an athlete receiving positive outcomes from treatment is highly
variable and unpredictable. Along with the fact that its long-term effects still require
further investigation, placebos do not have the consistency in effectiveness to be
the sole foundation for a type of medical treatment. Furthermore, by citing
Franklyn-Miller et al. (2009), Beedie et al. (2017) explain in the same article that
opting out of legitimate practices for placebo-based treatment in hope of a faster
healing process can worsen the athlete’s condition, and stress that such cases can
happen as an unfavourable consequence of uninformed medical decisions by
athletes because of their eagerness to return to training and competition.

To sum up, the relatively novel understanding of the placebo effect and its
mechanism remains a double-edged sword to sports training and sports medicine.
As discussed in the podcast episode by Koop et al. (2020), when it is used with a
good purpose like reducing the use of supplements in a controlled and consensual
setting, placebos can produce satisfactory results for athletes in training and
competition. On the other hand, if used irresponsibly in a context like medicine
where the application of the placebo effect is still understudied for short-term
benefits, athletes can face serious physiological harm. Nonetheless, the possibility
of placebos being misused should not limit their potential in many other cases. In
my opinion, as long as athletes have a thorough understanding of what they’re
being administered and there are established guidelines on ethical use implemented
in place, athletes should be able to make full use of the placebo effect in training to
maximize their capabilities and practitioners of sports medicine should use it to
improve the quality of treatment for their patients.
 References

Beedie, C. J., & Foad, A. J. (2009). The placebo effect in sports performance: A brief
review. Sports Medicine, 39(4), 313–329.
https://doi.org/10.2165/00007256-200939040-00004

Beedie, C., Whyte, G., Lane, A. M., Cohen, E., Raglin, J., Hurst, P., Coleman, D., &
Foad, A. (2017). ‘Caution, this treatment is a placebo. It might work, but it
might not’: why emerging mechanistic evidence for placebo effects does not
legitimise complementary and alternative medicines in sport. British Journal
of Sports Medicine, 52(13), 817–818.
https://doi.org/10.1136/bjsports-2017-097747

Bérdi, M., Köteles, F., Hevesi, K., Bárdos, G., & Szabo, A. (2014). Elite athletes’
attitudes towards the use of placebo-induced performance enhancement in
sports. European Journal of Sport Science, 15(4), 315–321.
https://doi.org/10.1080/17461391.2014.955126

Franklyn-Miller, A., Etherington, J., & McCrory, P. (2009). Sports and exercise
medicine--specialists or snake oil salesmen? British Journal of Sports
Medicine, 45(2), 83–84. https://doi.org/10.1136/bjsm.2009.068999

Hurst, P., Schipof-Godart, L., Szabo, A., Raglin, J., Hettinga, F., Roelands, B., Lane,
A., Foad, A., Coleman, D., & Beedie, C. (2019). The placebo and nocebo
effect on sports performance: A systematic review. European Journal of
Sport Science, 20(3), 279–292.
https://doi.org/10.1080/17461391.2019.1655098

Koop, J. & Tiller, N. (Hosts). (2020, Sep 03). How to be a skeptic in sports science
with Nick Tiller, PhD (Ep. 47) [Audio podcast episode]. In KoopCast: Ultra
Training Banter.
https://www.jasonkoop.com/podcast/how-to-be-a-skeptic-in-sports-science
-with-nick-tiller-phd

Saunders, B., de Oliveira, L. F., da Silva, R. P., de Salles Painelli, V., Gonçalves, L.
S., Yamaguchi, G., Mutti, T., Maciel, E., Roschel, H., Artioli, G. G., & Gualano,
B. (2016). Placebo in sports nutrition: A proof-of-principle study involving
caffeine supplementation. Scandinavian Journal of Medicine & Science in
Sports, 27(11), 1240–1247. https://doi.org/10.1111/sms.12793