PLACEBO EFFECT SUMMARY
- The placebo effect has real-world performance-enhancing effects.
- Examples of the placebo effect were that weightlifters who thought they were getting anabolic steroids increased their total strength on the bench, squat, and deadlift by 100 pounds.
- Runners who thought they were receiving EPO but in reality was just a saline solution completed the 3 km distance 1.2% faster than when they received nothing
THE PLACEBO EFFECT IS REAL
How many times have you bought a supplement and “felt” it was putting on muscle, only to find out it was all in your head? The most striking examples of the placebo effect is a study in which subjects were told they were getting “steroids” in a weightlifting study. The “steroids” were nothing more than a placebo, but the lifters increased their total strength on the bench, squat, and deadlift by 100 pounds!(1)
A Pill That Immediately Increases Strength
There should be some positive expectations in your training that you will put on new muscle while you are training; if you think you will not gain muscle, then more than likely, you won’t. In a study titled “The top-down influence of ergogenic placebos on muscle work and fatigue,” published in the European Journal of Neuroscience, researchers reported a 22% increase in strength in trained athletes who were told they were given high dose caffeine but received a placebo.(2)
In another example of the placebo effect, individuals were given a placebo comprising two milk-sugar tablets, 8–10 minutes before testing. They were told that the substance comprised a “strong combination of amino acids and that the strength effects were immediate!” The placebo group increased strength in the bench press and seated leg press. In contrast, when the subjects were told they were given a placebo in the previous experimental bout and re-tested, their strength declined to the same as the control group.(3) This suggests that if you believe something is working, it will!
THE MIND CAN HAVE A POWERFUL EFFECT ON PERFORMANCE
Scientists are seeing how powerful the mind is for enhancing strength and possibly even muscle growth. A 2017 study found that when kickboxers used mental imagery in their routine resulted in greater strength increases.
The group that performed mental imagery had increased testosterone and reduced cortisol and heart rate, resulting in lower training stress and promoting a more favorable hormonal response to training.(4) This suggests the mind has a powerful outcome in eliciting favorable effects on performance and muscle growth.
IS YOUR PRE WORKOUT LEGIT OR IS IT ALL IN YOUR HEAD
“You have to try this new pre-workout…I swear it works!! I feel like all my lifts have been going up since I started using this supplement.” We have all bought a product or supplement that a friend recommended, and many times just by believing something will work…it does. The placebo effect is a powerful performance-enhancing belief that taking something will improve performance.
ATHLETES TOLD THEY WERE GETTING EPO PERFORMED BETTER
Orally administered placebos have been typically shown to improve endurance performance by ~2% in participants who are at least moderately well-trained.(5, 6) Produced naturally by the kidneys, EPO is also available as a pharmaceutical performance-enhancing drug.
What is EPO?
EPO stimulates the production of red blood cells in the bone marrow and increases the concentration of red blood cells and hemoglobin in the blood. More red blood cells shuttle oxygen to the cells, including muscle cells, enabling them to operate more effectively. Studies have shown that EPO administration increases hematocrit (Hct), which can lead to an increase in the oxygen-carrying capacity of between 7% and 13%.(7, 8) Such an increase in oxygen-carrying capacity can cause an improvement in endurance performance.
The Study
Researchers told endurance runners that they were doing a study on human erythropoietin or EPO. Participants were initially provided with a detailed information sheet about the study (Described as ‘‘A study to assess the effects of OxyRBX on sporting performance in well-trained individuals’’) and a ‘‘drug information sheet’’ on OxyRBX describing its purported effects, dosage, and safety information.
The runners were told they were a new EPO drug called OxyRBX, but it was just a saline solution. They told the runners about all the side effects of using the EPO drug and told the runners to ask questions. This was all done to reinforce the belief that they were receiving the real drug despite receiving a placebo. The subjects received the placebo every day for seven days via subcutaneous injections. There was also a washout period in with they received no injections, which served as a control. The runners then completed a 3 K race with blood sampling.

Results
At the end of the study, runners who thought they were receiving EPO but in reality was just a saline solution completed the 3 km distance 1.2% faster than when they received nothing. (9) They also performed 1.5% faster compared to their race times before they enrolled in the study. 1.2% may not seem like much, but this is physiologically relevant and could mean the difference between winning and losing at the elite level.
To put these results into context, in the 2012 Olympics, the difference between the gold medal and the fourth place was less than 1% in all track events from 1500 to 10,000 m.
The interviews with the subjects were really interesting about how powerful the placebo effect can be for performance.
Athletes Perceptions
“Run today outdoors about 3 miles easy run in approximately 30 min, last 10 min more difficult, however much better than normal. This was a repeated route. Breathing was easier during running, noticeably different.”
“Thinks best run was today. Doesn’t know why and says the only thing that’s different is the drug, so the drug potentially had an effect. Breathing was better, utilizing oxygen really well. Muscles more efficient, good push off every step.”
‘‘I when I started taking the drug, particularly noticed in the gym that I was doing a lot more in my sets than normal, and also running I did feel less tired even when I was on the treadmill. I don’t like running inside, but I felt I could run longer than normal. Even in training sessions, I felt I was running better, felt less out of breath, and enjoyed the sessions more. One session, it was windy, but I was still running well, coach said I was running faster.’’
Believing A Supplement Works Causes Real Performance Enhancement
All the runners found the placebo increased motivation, improved recovery, and reduced perception of effort during exercise. This small improvement is nowhere near the performance-enhancing effects of EPO, which improved performance by 6%.(7)
The next time you spend money on a new supplement, is it increasing performance, or is it all in your head that you expect the supplement to work? The placebo effect is truly powerful, and we have only begun to unravel how powerful the mind is for improving performance. This article listed several examples of the placebo effect and how powerful it is for increasing performance.
Here are some specific examples of the placebo effect during exercise:
- One study found that cyclists who believed they were taking a caffeine supplement were able to ride for longer and at a higher intensity than those who knew they were taking a placebo.
- Another study found that athletes who believed they were wearing compression stockings experienced less muscle fatigue and soreness after a workout than those who knew they were wearing placebo stockings.
- A third study found that people who believed they were taking a supplement that would improve their blood flow were able to walk for longer distances on a treadmill than those who knew they were taking a placebo.