Skip to main content

Placebo's evil twin....in the gym

Today I came across this new and very interesting study: Preventing motor training through nocebo suggestions

Here is the abstract:

Although placebos have repeatedly been shown to increase physical performance and endurance, much less is known about the effect of their negative counterpart, nocebos. Here, we employ negative suggestions and a sham electrical stimulation as a nocebo conditioning procedure in healthy subjects performing a leg extension exercise to total exhaustion. Using two different protocols, we analyze the contribution of expectation alone or the combination of conditioning and expectation to the nocebo effect evaluated as the change of work performed and rate of perceived exertion. We find that it is possible to negatively modulate the physical performance in both cases, and we argue that this effect can effectively offset the outcome of training programs.


The discussion in the paper is instructive:


The main finding of this study is that it is possible to negatively modulate the performance of subjects carrying out a muscle exercise to volitional maximum effort by employing discouraging suggestions and negative conditioning.


I do find this study absolutely fascinating.  The whole idea of the power of belief in health and healing is realitively well known - we have all heard of the placebo.  But what is less well known is the nocebo - the idea that rather than positive benefits, there can be negative impacts from certain contexts and expectations: you can get worse.

What is interesting here is how nocebo effects extend to exercise performance - hearing negative suggestions can impact how well you perform.

All this stuff about the impact of the mind is so important and could potentially trump all other effects - diet, exercise whatever.  If you think it is doing you good it will.  If you think it is harmful, then it will be.    It is like Samuele Marcora's work on the psychobiological model of fatigue - the impact of perception is so important.

By the way, coincidentally, Chris Kresser had a great podcast on this this week with a full transcript here: The Placebo Effect and The Power of Belief in Healing

In some ways this is all like epigenetics - the impact of environment, in this case perceptions and expectations, outweigh what seem to be the bigger more obvious factors.

The search for the perfect diet or exercise routine may be pointless.....the most important element to either is what you believe  about the diet or training regime.

Dr Kurt Harris has a good post on placebo here.

Comments

FeelGoodEating said…
Chris,

I saw this show recently about a Doctor from Harvard University, whos turning major heads and pissing off some big boys at the pharma companies. He found that the placebo sugar pills work better antidepressants. The results of his studies were so convincing that he took it one step further and looked at knee surgeries. People that needed it either got a knee replacement or fix, and others just got their opened up and sown back up. Guess what, after 1 year the fake treatment patients were doing better then the true surgery patients and after 2 years they were equal.
This is the future of our medicine, we are going to figure out how to reproduce the signals our body sends and what these signals produce physiologically..... wildly fascinating. Here's the link to the show
http://www.cbsnews.com/8301-505269_162-57380096/inside-60-minutes-placebo-story/

Cheers
Marc
Mark Tyrrell said…
Hi Chris and thanks Marc for the link to the show. I recall reading research years ago showing that the single biggest factor in how long someone lived was not (up to a point obvioulsy) objectively how healthy they were but how healthy they believed themselves to be! And whilst belief might not literally move mountains it might help move that barbell : )
Cheers
Mark

Popular posts from this blog

Dry January

I mentioned a few weeks ago that I was taking part in "Dry January".  I didn't make a big song and dance about it, but I decided to go for a calendar month or so with no alcohol.  A few people have asked me about my experience, so here are a few points. Why take a break from drinking? Alcohol is an interesting topic.  As a drug it is widely accepted in society, central to so much of our socialising and leisure.  There seem to be lots of health benefits - so we are told - yet there are also a lot of problems in terms of health, relationships and lifestyle that come from drinking. Over a few years I'd begun to become aware and then concerned that I was drinking too much and too regularly.  I am in a busy and stressful job and sometimes a glass of wine after work to relax is really helpful.  But over time, one glass became two.  Two glasses became ....I might as well finish the bottle.  A habit got established....and was starting to get too e...

So where have I been?

You will have noticed that this blog has been quiet for a while....  There are a few reasons for that, reasons that I thought I'd list here: WORK -  my day job has been incredibly busy and stressful this year. Working 10-14 hour days the last thing on my mind when I got home was putting something on here.  FACEBOOK/TWITTER - I suppose I've been using other channels to do some of what I used to do here. Quick fire posts pointing to interesting studies or news etc tend to get posted to Twitter (@chrishighcock) or to the Facebook Hillfit group http://www.facebook.com/groups/263083947097000/  REASSESSMENT - I've found myself less comfortable with some of the positions I've taken in the past. Sometimes I'm embarrassed by some of the things I've promoted. I'm not Paleo or low carb. I think Tabata and intervals are misunderstood and misapplied. I cannot really claim to be HIT.   I find myselfunable  honestly to post things on here and pretend that I am some sort o...

Taking up space for a brief update

I've a couple of posts in draft that I will get up soon -  an update / reflection on Dry January and some thoughts on the scheduling benefits of short workouts if your life is busy.  Before that though, I am pointing to something else. However, I wanted to highlight something that is coming this weekend that I've been involved in.   Amber Rogers (Gokaleo and author of Taking Up Space ) has been pulling together a bundle of books from various authors with a common theme, one that I've been pushing here recently.   Keep it simple, avoid the hype, be patient, be consistent and flee the gurus.   I've talked before about how we get obsessed with pushing for more and more, when enough is OK.  I've given my view that so much of the health and fitness internet world is more like a gnostic religion than something that will benefit your life. There are other voices out there saying similar things and I'll be pointing to a bundle of books later this week ...