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Placebo effect in sports

 Poster: A snowHead
Poster: A snowHead
I think some of you will find this interesting.

https://www.bbc.com/future/article/20200501-the-performance-enhancing-trick-to-being-a-better-athlete
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
The placebo effect is amazing. I saw a programme recently that showed it working for pain relief even when the patient knew they were taking a placebo.

There is so much more to come from these studies.
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
There has been lots of research into the placebo effect. Tablet placebos work better than oral liquids ones, and injected ones are better than both. Colour of tablets work to the point they use the research on actual medicines. The effect extends to who gives it to you too (pharmacist, nurse, doctor, consultant).
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My father in law was a tobacco farmer in (what was then) Rhodesia. He had a big workforce and provided various education and health services. The magic power of "jekshuns" was widely understood. He regularly gave injections of some kind of harmless Vitamin B complex - and the bigger the needle, the better it worked. He once had a major problem with witchcraft - one bewitched worker had already turned his face to the wall and died when another, for whom my father in law had a very soft spot, was affected. In desperation he put out word that there was a mysterious cure which involved electricity. After a few days when this idea gained currency and the afflicted man declared himself desperate, and ready to try anything, some kind of "cure" which involved the terminals on the battery of one of the farm truck was rolled out, with due ceremonial. My husband told the story with absolute horror, but apparently it was a triumph. Those were the old-colonial days!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
So here's the question in cycling, athletics etc - Is taking placebo EPO illegal?

Like the idea of every trailer being full of pros shooting up saline like junkies in a smackden.
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@Dave of the Marmottes, hmm trick cycling in cycling? Don't see any reason why not - it's basically an 'active' form of sports psych. Question though - if an athlete is doing so thinking that they are cheating to get an advantage, is it still cheating?
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Then you can post your own questions or snow reports...
Richard_Sideways wrote:
Question though - if an athlete is doing so thinking that they are cheating to get an advantage, is it still cheating?


Is the converse true, do athletes avoid (or reduce the terms of their sentence) expulsion/suspension if they didn't know something is a drug?
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Perception is reality.
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You'll get to see more forums and be part of the best ski club on the net.
How zen.
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Ski the Net with snowHeads
But then... Reality cannot be defined by perception.
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Whitegold wrote:
Perception is reality.


It really isn't. For most of our senses, there is a huge amount of mental activity interpreting the information and sometimes the brain gets it wrong; the blue and black vs white and gold dress being an obvious example.

When my daughter injured herself skiing last year, she exprienced the same ongoing level of pain as if she had damaged herself, only she hadn't. The physio explained that there is a very low correlation between pain and seriousness of injury which probably explains how Bert Trautmann managed to play an FA cup final with a broken neck. And also explains why taking a pill to make the pain go away could make the pain go away even if you knew it was just a placebo.
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Richard_Sideways wrote:
But then... Reality cannot be defined by perception.


What is reality?
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So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
Depends on your definition of reality. Your brain holds a simulacra of what it perceives reality to be, and this is your normalised real. Everyone else's is slightly different.
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 You know it makes sense.
You know it makes sense.
This is a very exciting subject to come up on Snowheads! Placebos are a favorite subject of mine, and the work referenced in the BBC article that @Orange200 shared is great.

It's helpful to think of the placebo effect as a conditioned response, that is at least one big part of the placebo effect. Think about Pavlov's dogs - when they heard the dinner bell they would salivate, an automatic physical reaction to a conditioned stimulus. Humans salivate automatically when they smell food cooking (and even more interestingly, we start to secrete insulin too). This isn't a "psychological" reaction, it's just stimulus-response pairing.

This is at least part of the placebo effect. Your body associates little white pills with medicine, because that's what medicine has always looked like. So when you get a little white sugar pill, your body reacts as though you've given it medicine - endorphin release, insulin release, any of it can be triggered. It's not a mental thing, it's an automatic conditioned response.

And that's what the scientists saw in the OP's article. Bicyclists with previous experience of real oxygen tanks were given fake oxygen tanks and their breathing improved. At least part of this is Pavlovian, and has nothing to do with belief. There are other components to the placebo effect too - the bicyclists probably felt less anxiety about oxygen deprivation, and this in itself reduced their need for oxygen. The knowledge of an oxygen tank gave them one less variable to worry about, so they were able to focus more on their own performance. But I suspect that this result would have been at least partially replicated even if the scientists told the athletes that the O2 tanks were empty.

It's a fun study and a very cool result, thank you to @Orange200 for sharing it.
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 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Last year my partner went to a doctor's conference on Parkinson's in Birmingham.
When she came should couldn't stop talking about the amazing results of placebo research. I can't remember the figures but a significant percentage of the effects of all drugs is placebo.

The funniest result I heard about were paracetamol tests, depending on where the user thought they were bought and if they were branded. Your headache is twice as likely to subside if you think that your paracetamol comes from Boots, rather than if you if think they are Tesco's own brand paracetamol.
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 Poster: A snowHead
Poster: A snowHead
I am a great believer in hypnotherapy as a way to control your brains perception of pain and to eliminate things which are purely related to the brains interpretation of what it believes and sees.

Essentially it is similar to the placebo effect. There is no actual treatment, other than your brain thinking you are being treated. When you believe in it the results are even more effective.

Training the brain in sport is the main differential in top level sports (given all other things being equal). Believing you will win makes you more likely to win.
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
There is also the Nocebo effect from a link fom same article, which I have not heard of before but is I suppose the effect of negative thoughts
see quote below

Medicine has long known about the placebo effect – the healing power of good expectations. But the nocebo effect, as its evil twin is known, may be more powerful. “It’s easier to do harm than good,” explains Watts. “And this is worrisome, because nocebo’s negative influence can be found lurking in almost every aspect of medical life and beyond.”

https://www.bbc.com/future/article/20150309-the-simple-words-that-make-us-ill
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 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
I'm re-reading Ben Goldacre's Bad Science, 2008 edition I think, and most of what is said above is in there, so has been known for at least 10 years... Placebo is certainly good for pain as pain, as I understand it, is objectively immeasurable, so it's a real mind over matter thing. Easy to trick with a sugar pill. But I found the article interesting as it goes so much further, surely muscles need oxygen to work on a simply chemical/biological basis, so how can they be fooled by placebo? Fascinating. Goldacre similarly comments on the effect of reducing I think it was gastric ulcers, where you simply stick a scope down and measure the diameter, and even a significant number of them got smaller. It really is odd.

My daughter has shown to be a good runner, so once again she was in the annual schools cross country team (she's 11). I train her a bit and make sure I tell her about the mind games; yes you think you're tired but it's just a thought, and all the other runners are tired also. Went to the race in Feb where she was one of the youngest, I was expecting her to come maybe 15th out of 50. She was 3rd up to near end and had to stop 120m (!!!) from the finish - she came 6th. She couldn't walk for an hour after. I was so proud.
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Quote:

She couldn't walk for an hour after. I was so proud.

I'd have been a bit worried!
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 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
She ran her bloody heart out Smile Was sitting there in a deck chair with barely any energy to nibble through fruit... Note for next year - bring something with more sugar and no chewing effort for faster recovery! (She doesn't like coca-cola.)
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Whitegold wrote:
Perception is reality.


No, it's relative.
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 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Wasn't it Brian Clough who, when being told that one of his players who had been knocked unconscious now couldn't remember who he was said "Tell him he's Pele and get him back out there"!
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 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
@Orange200
Quote:

I'm re-reading Ben Goldacre's Bad Science, 2008 edition I think, and most of what is said above is in there, so has been known for at least 10 years... Placebo is certainly good for pain as pain, as I understand it, is objectively immeasurable, so it's a real mind over matter thing. Easy to trick with a sugar pill. But I found the article interesting as it goes so much further, surely muscles need oxygen to work on a simply chemical/biological basis, so how can they be fooled by placebo? Fascinating. Goldacre similarly comments on the effect of reducing I think it was gastric ulcers, where you simply stick a scope down and measure the diameter, and even a significant number of them got smaller. It really is odd.

My daughter has shown to be a good runner, so once again she was in the annual schools cross country team (she's 11). I train her a bit and make sure I tell her about the mind games; yes you think you're tired but it's just a thought, and all the other runners are tired also. Went to the race in Feb where she was one of the youngest, I was expecting her to come maybe 15th out of 50. She was 3rd up to near end and had to stop 120m (!!!) from the finish - she came 6th. She couldn't walk for an hour after. I was so proud.


A number of these things aren't quite purely biological in the sense you're referring to. For example, ulcers are multifactorial in cause. It can be due to excessive acid secretion because of bacteria, genetic susceptibility to high acid secretion, genetic susceptibility of stomach lining to damage at acid levels lower than would normally cause damage, cortisol/adrenaline levels in response to stress or many other reasons, some medications eg. NSAIDs.

By performing an "intervention" one can plausibly except a number of people to undergo a placebo-like effect, feel better, with a subsequent reduction in cortisol/stress hormones, thereby removing that aetiological factor from the equation. For a group of people for whom that was a factor, you can expect some improvement.


Similarly with the "surely muscles require oxygen and the mind can't override that", well actually it can. For the vast vast vast majority of people, when you stop doing exercise because your muscles are on fire, it's not actually because your muscles literally can't take in any more oxygen/do any more work. It's because they're running low, and your brain is receiving the warning signs to this, and because we're not conditioned like elite athletes, we stop when our brain thinks the body can physically do no more. Obviously it can. One of the reasons athletes are successful is because not only are they physically conditioned much better than we are (muscles physically can utilise more oxygen before producing lactate etc) but they are mentally conditioned to be able to push themselves through that brain barrier telling them they're hurting, and their muscles warning them of "low oxygen" levels (note: NOT no oxygen levels).

Give even an elite athlete a sugar pill designed to "improve their aerobic/lactic threshold" and even they can squeeze out a little more performance than normal if they truly believe it, because you're not changing their physical conditions, simply their mental conditioning/willpower/whatever you want to call it.

@snowxxx
Quote:

There is also the Nocebo effect from a link fom same article, which I have not heard of before but is I suppose the effect of negative thoughts
see quote below

Medicine has long known about the placebo effect – the healing power of good expectations. But the nocebo effect, as its evil twin is known, may be more powerful. “It’s easier to do harm than good,” explains Watts. “And this is worrisome, because nocebo’s negative influence can be found lurking in almost every aspect of medical life and beyond.”

https://www.bbc.com/future/article/20150309-the-simple-words-that-make-us-ill


Nocebo effect doesn't get talked about but is seen absolutely everywhere. One interesting example is this craze (moreso in the US because they have the industry and fad embracing society like no other) regarding gluten "sensitivity". Now gluten intolerance is something used to describe people with coeliac disease. Their bowels can't process it, it causes inflammation, physical symptoms of illness, and with long term exposure, bowel cancer. There are millions of people around the world who state they get the same symptoms that coeliac people do when they eat gluten (bloating, lethargy, constitutional symptoms, diarrhoea, inability to concentrate etc etc). However when you test them they clearly don't have coeliac.

Now there are likely multifactorial reasons for this, but one very important one, as shown in RCTs is the nocebo effect. Ie. you take a bunch of these people and do the following experiments:

- give them gluten but tell them it's NOT gluten
- give them gluten but tell them it IS gluten
- give them non-gluten but tell them it IS gluten
- give them non-gluten but tell them it's NOT gluten

Many of these people with "gluten sensitivity" will feel their symptoms ONLY when they believe they're eating gluten (even if they're NOT eating gluten). If you give them gluten but tell them it's not (by making it look like a non grain product) then they don't have symptoms. Very interesting and the effect is seen in many other areas!
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 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
Also, how do I @ people here?

You guys @ other users and their names come up in bold, but I can't seem to do it (I've done it manually above)

And when quoting, getting the person's username to come up with the quote?
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Click on the name on the left to get:
@karansaraf,


to get the message quoted as well click on the speech bubble on the right:

karansaraf wrote:
Also, how do I @ people here?

You guys @ other users and their names come up in bold, but I can't seem to do it (I've done it manually above)

And when quoting, getting the person's username to come up with the quote?
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Quote:

She couldn't walk for an hour after. I was so proud.


Quote:
I'd have been a bit worried!



Running a child to the brink of death to win a piece of shiny metal and oneup the other parents in a pointless race.

Makes sense wink
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 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
@Whitegold, introducing a child to the idea that she’s more capable than she thinks is surely good? It works in many areas eg standing at the top of a difficult run, taking a deep breath and smiling before you launch makes it much easier!
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welshskier wrote:
Wasn't it Brian Clough who, when being told that one of his players who had been knocked unconscious now couldn't remember who he was said "Tell him he's Pele and get him back out there"!


John Lambie, Partick Thistle manager at the time.
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