THE PLACEBO EFFECT

one of these treatments began to relieve symptoms. Despite this haphazard and arguably unscientific approach, players still returned to fitness within expected time scales. Therefore it was argued by Howe that because the players believed that the treat- ments they were being given, by qualified medical staff, were effective in relief of their pain and inflammation, recovery was assisted. This belief in the ritual of care and healing is lent sup- port by a comment from an ex-professional rugby player in a recent research study, who when asked whether he believed the placebo effect may be a factor in recovery from injury, responded ‘how else do rugby players dramatical- ly recover when a wet sponge is applied’ (22).

Therapy, Health and Fitness degree at the University of Kent. He also runs a successful Sports Injury and Rehabilitation Clinic at the University and provides training and injury prevention consultancy for athletes, sports teams and organisations.

References 1. Evans D. Placebo: The Belief Effect. Harper Collins 2003. ISBN 0007126123 2. Iverson L. Drugs: a very short introduction. Oxford University Press 2001. ISBN 0192854313 3. Shapiro A and Shapiro E. The Placebo: Is it much ado about nothing? In: Harrington, A. (Ed.) The Placebo Effect. Harvard University Press 2000. ISBN 067466986X 4. Kirsch I and Sapirstein G. Listening to Prozac but Hearing Placebo. A Meta-Analysis of Antidepressent Medication. Prevention and Treatment 1998;1(2):1-15 5. Hrobjartsson A, Gotzsche P. Is the Placebo Powerless? The New England Journal of Medicine 2001;344(21):1594-1602 6. Dimond E, Kittle C, Crockett J. Comparison of internal mammary artery ligation and sham operation for angina pectoris. American Journal of Cardiology 1960;5:483-486 7. Benedetti F, Amanzio M et al. The spe- cific effects of prior opioid exposure on placebo analgesia and placebo respira- tory depression. Pain 1998;75:313- 319 8. Hashish I, Harvey W et al. Anti- inflammatory effects of ultrasound therapy: evidence for a major placebo effect. British Journal of Rheumatology 1986;25:77-81 9. Van Der Windt D, Van Der Heijden et al. Ultrasound therapy

for acute ankle sprains (Abstract). Cochrane Database of Systematic

Reviews 2002;(1):CD001250. 10. Voudouris N, Peck C, Coleman G.

Conditioned response models of placebo phenomena: further support. Pain 1989;38(1):109-116

11. Ogden J. Health Psychology: A text- book. Open University Press 2000. ISBN 0335214711

12. Adams N, Field L. Pain, the tissues and the nervous system: a conceptual model. Physiotherapy 2001;84: 27–36

Part two of this paper will be published in the next issue and will detail how the placebo effect may be used to enhance or augment existing therapies.

THE AUTHORS ■ Dr Chris Beedie is a member of the British Psychological Society and the British Association of Sport and Exercise Sciences. He is cur- rently senior lecturer in sport and exercise psychology, and pro- gramme director for the BA/BSc programme in Sport and Exercise Psychology, at Canterbury Christ Church University College, Kent. His academic interest and peer-reviewed publications focus on the effects of emotion, mood, and mind-body interactions on human performance. His consultancy work focuses on training practitioners in the field of health, fitness and sport, to better utilise psycholog- ical principles in their professional practice.

■ James Hopker is a member of the British Association of Sports Rehabilitators and Athletic Trainers. He graduated from St. Mary’s, Twickenham in 1998 and is now a lecturer on the BSc. Sports

www.sportex.net

13. Jeffels K, Foster N. Can aspects of physiothera- pists communication influence patients’ pain experi-

ences? A systematic review. Physical Therapy Reviews 2003;8:197-210

14. DiBlasi Z, Harkness E et al. Influence of context effects on health outcomes: a systematic review. The Lancet 2001;357:757-762 15. Gracely R, Dubner R et al. Clinicians’ expectations influence placebo analgesia. The Lancet 1985;325:43 16. Staats P, Helmat H, Staats A. Suggestion/placebo effects on pain: Negative as well as Positive. Journal of Pain and Symptom Management 1998;15(4):235-243 17. French S. Pain: some psychological and sociological aspects. Physiotherapy 1989;75:255-260 18. Charman R. Pain theory and physiotherapy. Physiotherapy 1989;75:247-254 19. Benedetti F. How the doctor’s words affect the patient’s brain. Evaluation and the Health Professions 2002;25:369 -386 20. Thomas K. General Practice consultations: is there any point in being positive? British Medical Journal 1987;294:1200-1202 21. Howe D. An ethnography of pain and injury in professional rugby union: The case of Pontypridd RFC. International Review of Sport Sociology 2001;35(3):289-303 22. Beedie CJ. Athletes perceptions and experiences of the placebo effect: A pilot study. Journal of Sports Sciences 2005:23(2);168-169

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