Placebo effects are not only found in medicine: expectations also have a significant impact on motivation and performance, especially in sport. Sports enthusiasts can take advantage of this.

Positive and negative expectations influence athletic performance not only in competitive sports but also in popular sports.

Expectation and placebo effects can have an impact on motivation and performance not only in medicine, but also in other areas such as sports. The carbon fibre of the expensive road bike, the extremely breathable sportswear, and even a teammate's secret tip to try the latest energy drink all fuel our expectations.

The term placebo or expectation effect is rarely used in these contexts. But it is precisely this positive expectation, based on previous experiences and learning processes, that can lead to greater athletic performance. In popular sports, this might simply lead to greater motivation and enjoyment of regular exercise.

Competitive athletes like to talk about the "last few percent" or “incremental gains” that they want to squeeze out of themselves through detailed training plans, dietary changes, sophisticated equipment and, last but not least, mental techniques. There are already several impressive studies that have examined the belief in one's own strength, the effects of “fake doping”, or enhancing performance through positive information.

In 1972, a pioneering study was the first to document a placebo effect in competitive sports: Trained weightlifters were able to significantly increase their maximum strength after a supposed treatment with anabolic steroids. In actual fact, instead of performance-enhancing steroids –artificially produced hormone-like substances – which are known to promote muscle growth, they had exclusively received placebos. But of course, they had the expectation that steroids improve performance, which subsequently led to better results.

It wasn’t until 30 years later and with new advances in research that follow-up studies compellingly documented the impact of the placebo effect on athletic performance.

For example, under the pretext of investigating the effects of caffeine, trained cyclists were given a low-dose or high-dose caffeine supplement or a placebo. At least that's what they were led to believe: In reality, all of the cyclists received a placebo. In subsequent tests, the group that believed they had ingested a high dose of caffeine showed a significant improvement in cycling performance, the group supposedly taking a low dose improved somewhat, and the placebo group actually got worse. Therefore, the cyclists’ expectation was the driving or inhibiting force.

A sophisticated study conducted at Stanford University in the USA sought to determine how simply knowing one's ability affects exercise performance. To do this, each participant underwent a genetic test to reveal their individual predisposition to physical performance. However, the participants were randomly assigned to receive either a “high risk” or a “protected” result from the test. The researchers found that participants with the supposedly best performance profile lasted longer on the treadmill, felt fitter and had the most efficient cardiovascular values. The expectation of being particularly physically efficient even influenced their metabolism.

In popular sport, people draw more psychological and neurophysiological benefit from their training if they are convinced that sport is good for them. In addition to this, positive or negative information influences the training outcomes. This was found in a study conducted at the University of Freiburg with young adults. Before a 30-minute ergometer workout, the participants filled out questionnaires about their attitude to sports and their current mood, and some of the participants were shown films extolling the benefits of cycling. The researchers found that participants who believed in the good effects of exercise or had seen the positive cycling films developed more enjoyment on the ergometer, their mood improved, and they were subsequently more relaxed compared to the participants with a more negative attitude to sports. Having positive expectations might promote motivation to exercise, according to the Freiburg study authors.

You can read more about sports and placebo in the book „Placebo 2.0 – Die Macht der Erwartung“ by Prof. Bingel, Prof. Schedlowski und Helga Kessler, Verlag rüffer & rub, 2019 (only in German)

Tell us your personal story involving the placebo and nocebo effect! Medicine is also shaped by stories. This is why we are gathering patients’ diverse experiences regarding their own expectations for the Collaborative Research Centre "Treatment Expectation". You can find out more here.