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Aug 07 2012

Olympic Placebos

The reality’s hard to escape:
It’s just sticky and bright-colored crepe.
It’s absurd, or it’s funny;
It’s made lots of money—
The placebo, Kinesio Tape

Just a few observations, prompted by a post on NPR’s Health Blog and by my observations of the US Olympic trials.

That brightly colored tape adorning the shoulders, legs, and abs of so many Olympians… oh, hell, I’ll say it–it’s a placebo. The NPR piece implies it, but won’t go out on that limb. There is plenty of profit motive behind the tape–which, of course, means that there would be all the more reason for them to highly publicize the research that proves it is more than placebo… and what we get instead are endorsements by athletes.

We’ve seen this before, of course, with various bracelets, with copper, or holograms, or magnets (actually, only click on those if you really doubt that they exist–these snake-oil sales-weasels don’t need you to give them hits. Search for the terms instead, and add “double-blind” to your search terms, and a vastly different story emerges). At the US trials, I saw another placebo, the “cold laser“, which also has tons of accolades and endorsements, but no double-blind experimental support. At the US trials, a behind-the-scenes peek showed us a “laser”(to my eye, it looked like a set of LEDs) being used while the athlete’s warmup suit was still on–I want to see the data on how much light penetrated the suit, let alone any significant layers of skin. The claims, though, were far-reaching, in terms of how much this treatment could balance the athlete’s energies, etc. etc. etc.

Thing is… The better an athlete is, the more chance they have to superstitiously associate some arbitrary event or object with competitive success. The thing about Olympians is, they tend to win (at least in the qualifying meets–otherwise they would not be Olympians). If every member of the trial squad was wearing their secret super-spy decoder ring, the winner is the one who gets to say it contributed to her or his success. (For one of the best presentations of the science here, see Stuart Vyse’s book “Believing in Magic: the Psychology of Superstition”)

Ah,but… the other thing is… even when some pre-performance ritual is superstitious, it can have very real effects on performance. “Placebo” is not at all the same as “no effect”. I would rather my favorite athletes be aware that their success is their own, and not the result of some bracelet, light, tape, or intercessory prayer. But I know my favorite athletes are human, and, as humans, are apt to be influenced by superstitious conditioning. It’s not foolish, it’s perfectly understandable… it’s just wrong.

18 comments

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  1. 1
    timdiaz

    Is it necessarily wrong? Placebos have a measurable positive effect on performance. So assuming the placebo is harmless, I would say that one way to ensure that you reach your absolute peak performance is to make sure you have a good placebo. :D

    The problem is ensuring you have a good one without realizing that it is in fact a placebo, which would screw up the effect.

  2. 2
    Cuttlefish

    I’m definitely in the “it’s not wrong” school, but I make a distinction between “pre-performance ritual” and “superstition”. Long story, but… pragmatically, I want an athlete in 100% control of the things that she or he can control. If the tape is something that someone–anyone–else can mess with, my athlete can suffer. If my athlete knows it is superstition, and can apply her own tape (currently, the company wants specific experts to tape athletes up), she has one fewer possible distraction. A behavioral pre-performance ritual (think Jason Kidd, and his pre foul shot routine) is something that cannot be interfered with, whereas Roger Clemons’s pre-game chicken dinner depends on a cook. A lucky coin can be (and has been) stolen; a lucky bracelet as well.

    Knowing what works and what doesn’t, knowing what is in your head and what is in the world around you…matters. Come to think of it, Karen Pryor, in “Don’t Shoot The Dog” (if memory serves), mentions that her son is an athlete, and tried to be sure that no other person had any control over the stimuli that influenced his performance. To me, that is the bottom line.

  3. 3
    MaryL

    Many athletes are highly superstitous so let them have their harmless placebos.

  4. 4
    rdmcpeek43

    Steve Novella has a pretty good
    take down of this expensive
    colored duct tape over at James
    Randi’s site (8/4). Works a lot like
    those designer “arm huggies”
    (e.g. U.S. sprinter Sanya Richards-Ross). They give her a more
    powerful arm swing. Yeah, right.

  5. 5
    Cuttlefish

    MaryL–

    My own students are influenced by these athletes. Some are good enough that the holographic bracelets are provided free of cost. Others have to pay, from tens to hundreds of dollars, for bracelets that cost, at most, a couple of bucks to produce (and I am being generous). The profits from these placebos are enough to finance the powerbalance pavillion. People are making millions of dollars by lying to athletes.

    For the Olympians, you are absolutely right–for the most part, the placebos are harmless.

    For millions of athletes across the world, looking for that slightest edge, these are ripoff artists seeking the much larger jackpot in those lower tiers.

    It is particularly galling to me that these charlatans are taking an evidence-free shortcut to success, by exploiting athletes, who cannot progress without demonstrated success. In the vast majority of sports, data rule. Method A works better than method B. Strategy X works better than strategy Y. The proof is in the results. Scores are better; times are better. The scientific equivalent is the double-blind, placebo-controlled experiment. Which these placebos cannot overcome.

    Athletes at these lofty levels are rarely assured of victory. They want any edge they can get. They are vulnerable.

    Athletes at lower levels are even more vulnerable, and even more desperate. This is where the profit is. At this level, the placebos are not harmless.

    They are profit.

    And I am opposed to it.

  6. 6
    Cuttlefish

    rdmcpeek43–I had not seen that–thanks for the reference!

  7. 7
    ischemgeek

    When I was competing at high level (I didn’t go to Olympics, only nationals and a few low-level international competitions), we were told if you have, say, a favorite hat to wear, wear it because it makes you comfortable and gives you a psychological boost – but that’s all it is, a mind trick to play on yourself. I knew a guy who went so far as to have a competition outfit down to the pair of underpants he wore. I never wanted to know that about him, but he bragged openly about how if he had his competition outfit down to his underpants, he felt better.

    IOW, we were told that we could feel free to use a ritual or placebo, so long as we knew it was a ritual or placebo. If you have five hats that are the exact same except that one’s your favorite, there’s really no difference between any of them. If you like wearing arm warmers, wear arm warmers, but they’re not going to improve your performance on their own (because if they did, they’d be banned or regulated). On the hats, one’s your favorite because it’s your favorite, and that’s fine, but don’t assign any special qualities to it in your head: a hat is just a hat, even if it’s your favourite and has sentimental value.

    I still think that’s a good way to look at it. It lets you have your psychological equivalent to a comfort blankie when you’re in a super stressful situation, but if something happens to your comfort blankie, you know that’s all it is and you don’t take as long to bounce back from the change as you would if you thought that your blankie was a special magic blankie that could, through some mystical qualities, improve your performance. It’s a blankie. There’s nothing special to it except that it’s your favorite blankie. Have your favorites, by all means, and certainly try to keep things as consistent as possible, but don’t think there’s anything magical to any of it.

  8. 8
    machintelligence

    The level of superstition also varies (inversely) with the odds of success. Baseball players have few superstitions about fielding, which they do almost perfectly, but lots for batting, where the success ratio is at best around 33%.

    Even NASA/JPL have their peanuts.

  9. 9
    Tony Pingree

    Hi Cuttlefish,

    What we are talking about here is a placebo affect.

    Placebo’s affect us all, whether we like it or not.

    Any item or ritual that gives us a perceived beneficial affect is generally a good thing.

    Its not just in sport that you find people using these affects.

    This illusion affects us all either directly or indirectly.

    Keeping the positive placebo’s can benefit us all.
    .

  10. 10
    Die Anyway

    I saw all of that tape and assumed it had some sort of supportive value… prevent muscle or tendon tearing, or reduce swelling, or something. I didn’t realize it had magic properties. Sigh.

  11. 11
    JustaTech

    Considering some of the frankly disgusting rituals athletes go through, well, at least the tape is pretty. (There was a guy from the US in the 1500m who kept licking his hands and then rubbing it on various spots of his arms, legs and chest. Even the commentators thought it was weird.)

    @rdmcpeek43: I have a friend who swears by her “sleeves” but mostly because they keep her warm and are easily shed, unlike a shirt. Might be different arm-warmers.

  12. 12
    MaryL

    Cuttlefish – You make good, thought out points. I was thinking of my brother’s tape rituals (a particular brand and size, ONLY, for starters), and some of the things I’ve read and heard from professional athletes. That’s what I’m familiar with. You’re right about rip-off artists. Exploitation has many ways to disguise the snake oil.

  13. 13
    qwerty

    Aren’t these things kind of like the “lucky socks” of yesteryear? The only difference is that there is someone making a profit out of these worthless charms.

  14. 14
    starskeptic

    If placebos had an effect, they wouldn’t be of any use in controlled studies…

  15. 15
    Tony Pingree

    Sorry but placebos do have an effect.

    In controlled studies for new medicines they have to double blind results to rule out the placebo effect.

    Its about the same affect as homeopathy strangely.

  16. 16
    dvizard

    If placebos had an effect, they wouldn’t be of any use in controlled studies…

    Sorry but placebos do have an effect.

    In controlled studies for new medicines they have to double blind results to rule out the placebo effect.

    Please do not confuse the effect of the placebo itself with the effects seen in a placebo group in a controlled trial. This confusion is made far too often.

    The effects seen in a placebo group in a randomized controlled trial are a combination of natural recovery, regression to the mean, changes in the patient’s behaviour, and then additionally the actual effect of taking a placebo (which might be minor compared to the other effects). The effects seen in the verum (non-placebo) group must then be compared to the effects in the placebo group to find the effect of the real medicine over placebo.

    To measure the effect of the placebo itself in a strict sense, one has to compare a placebo group with an entirely untreated group – something which is done in studies about the placebo effect, but usually not in clinical trial for new medicines.

  17. 17
    carlie

    Athletes at lower levels are even more vulnerable, and even more desperate. This is where the profit is. At this level, the placebos are not harmless.

    They are profit.

    And I am opposed to it.

    Exactly. And to take it down another level for an example, kids all over little league are wearing necklaces with titanium in it, because some pro baseball players do and it supposedly enhances performance. These things cost upwards of $30, for an ugly necklace with a little metal in it (they are made of braided fabric).

    Now picture being the only kid on your little league team who can’t afford to get one, because your parents have already scrimped and tapped themselves out to get all the other stuff you need to play. Picture feeling left out because you’re the only one without one. And maybe your performance suffers because of the anti-placebo effect, or maybe it doesn’t.

    Now picture you getting blamed for a game loss by the other players because they think you weren’t playing quite up to par, and they say it’s because you aren’t wearing one.

  18. 18
    Blondin

    Oh, that little mouse who gave Dumbo a feather has a lot to answer for.

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