Can the Placebo Effect Influence Enhancement of Athletic Performance?

A placebo substance is a medication containing inactive ingredients that has no direct impact on human health or life and is used as a form of therapy. The patient is unaware that what has been given to them is not a real medicine. A placebo substance is used to improve a person's mental state at a time when the use of a real drug could negatively affect their health. The placebo effect is also utilized in research on the efficacy of a specific drug, medical procedures, or non-conventional treatments. A portion of individuals in the study group receive the placebo substance, while another portion receives the actual medication. A therapeutic agent is considered effective if the percentage of healthy individuals is lower in the placebo group. Nocebo is a term for harmful consequences of the placebo effect resulting from the patient's negative attitude towards therapy. It can exacerbate or even cause symptoms such as nausea, headaches, or penicillin allergy. It is assumed that individuals prone to depression or more susceptible to negative suggestions are at a higher risk for the occurrence of the nocebo effect. Interestingly, there are also indications that voodoo death may be induced by the reverse placebo effect (H. Pilcher 2009).

The placebo effect was commonly believed to have been discovered at the end of World War II. American surgeon H. Beecher, who was to perform surgery on a wounded soldier, discovered that he lacked anesthetic (morphine was the primary painkiller at the time). To avoid a cardiogenic shock, he administered the patient with a physiological saline solution. The reaction to this treatment surprised the surgeon himself - the soldier reacted as if he had just received a dose of morphine. This prompted the doctor to conduct a series of experiments examining this phenomenon. In 1955, he published a review of 15 clinical studies in the American weekly journal „Journal of American Medical Association”. In this manner, H. Beecher initiated research into the placebo effect, despite evidence suggesting that doctors had been utilizing it much earlier.

The functional mechanisms of placebo can primarily be understood in behavioural and cognitive, as well as social, categories. A portion of the effects induced by placebo can be explained by classical conditioning, for instance, if the patient experiences a decrease in pain almost immediately after ingesting the drug (conditional relief). Another functional mechanism of placebo is related to predictions that are formed based on life experiences, pertaining to automatic reactions such as pain and emotions. For example, a patient may predict their health to improve due to taking the drug, while a postoperative patient may anticipate experiencing pain.

C. N. Maganaris, D. Collins, M. Sharp conducted a study in which three trained athletes were administered sucrose before each of them, and they received information that this was a known substance in sports doping. They examined the strength of the exercise, the dead body, and the pressure on the flat bench. The competitors were divided into two groups. In the first group, the participants entered the water test twice, and each was given sugar and water (at the national level). The researchers also examined their strength. The second group also received a higher amount of fat than the sugar, the second group received a lower amount of amino acids than was given to them before the first test. In another experiment conducted by G. Ariel and W. Saville, 15 men participated in exercises such as squats, flat bench press, military press, and leg press. The athletes were given a placebo and informed that they were receiving a substance used in sports doping. It was found that the group taking the placebo had better strength results than the control group. In another study by J. P. Porcari and colleagues, athletes participated in a 5-kilometer run three times. The first run was a test run, before the second run half of the participants were informed that they were drinking oxygenated water, and before the third run the other half of the participants received information about oxygenated water. In addition, before the experiment, the participants watched a film about the positive properties of oxygenated water and its impact on runners' performance. It was observed that the results improved significantly in both groups. Interestingly, the time difference after consuming water was greater in weaker athletes. In another experiment conducted on students, the participants were divided into three groups. Group A was given a placebo consisting of milk and sugar before the first and second tests. They were informed that these were amino acids that increase strength. Group B also received a placebo, but before the second test, they were informed that it was milk and sugar. The participants in Group C did not receive a placebo. During the analysis, it was found that the first group improved their strength results, while the results of the second group worsened after being informed that it was a placebo. Based on scientific research, it can be concluded that the improvement in strength results after consuming substances such as oxygenated water, caffeine, or amino acids was small. However, in experiments where participants believed they were being given substances used in sports doping, the improvement was significant. This may be due to the fact that in the case of using banned substances, expectations regarding their effect are much greater than, for example, in the case of caffeine.

The human mind is capable of exerting an influence on the body in such a manner that it responds even to inappropriate treatments. It can also impact physiological and emotional states, with the efficacy of this intervention primarily depending on the degree of belief of an individual in its effectiveness. Similarly, the occurrence of side effects (nocebo) is a factor. If a patient foresees the appearance of headaches or nausea, the likelihood of their actual occurrence is greater. Adverse treatment outcomes can be caused not only by the drug, but also by psychological aspects. Contemporary scientific data also confirms that the placebo method enables athletes to significantly improve their performance, which sometimes leads to surprising results such as establishing a new personal record. Instead of attributing effectiveness to various drugs and substances, it is worth reconsidering the approach to training, setting goals, and consistently working towards achieving them.