Training Prescription: Placebo

A post on Precision Nutrition got me thinking about a key aspect in the Art of Coaching; the Placebo effect.  As a performance coach you will have to understand this and manage it, and potentially employee it.

During this year's NFL Draft preparation, we had athletes that struggle with the over-reaching phase.  Now understand, most collegiate football players have not gone through an extended over-reaching period that affects them neuromuscularly.  This may sound like a knock on strength programs, but its not.  In a football offseason, they are making steady progression and the emphasis is strength, power and mass in most cases.

Under the stress of the NFL draft process and preparing for the Combine and Pro Days, these athletes struggle with the feeling of over-reaching. We often look to effectively use some methods that may be as much "placebos" as anything else. 

Here's one we see every February. We have the case of an athlete preparing for the NFL Combine. His focus is the 40 and nothing but. Training is going great. Times in the 10 and 20-40 are dropping. He's been training hard and technique is better when we breakdown the video analysis.

The problem, he's 2 weeks out and is coming out of an overreaching phase still. Even though he has shown all those improvements, his NMS is just recovering and supercompensating as evidenced by various jumps we measure.

This concept of overreaching is hard to fully accept for a few. He has to have that current 40 time. When he gets it and doesn't see that all time PR yet, he flips out. Literally. Loses all belief. Wants to throw everything in the training plan out the window. Wants to go find another speed coach to work magic.

So what do we do as coaches? For one we go back and review the plan we set. We remind him how we said this would happen and actually means everything is working. We show him the same progression for guys who have ran great PRs in the 40 in previous years training with us.

Still he's off the reservation.

So, we also breakout PLACEBO.  

Now most people have some idea of the placebo effect.  In a classic pharmaceutical study design, there is the group that gets the drug, the control group who gets nothing, and the group that gets the placebo .  The placebo is something that is inert.  It has no effect.  However, what has been documented for the last half 50 years is that the placebo group will probably show results.

"Whether you believe it will or won't work, you're right" is an old adage that sums it up.  The placebo effect is any phenomenon that occurs from a person’s belief and perceptions, rather than from the actual chemical-physiological effects of a drug.

Placebos can have a huge effect.  It is one of the confounding factors in many areas of medical research.  It's also a confounding factor in performance training.  What is really causing some of the results we see. 

If an athlete uses _____________(fill in the blank with any treatment or modality here) then after 3 weeks receiving it, they feel 90% better.  That's an effective treatment it seems.  Great!

Looks great until you realize that an athlete receiving what looks like the same treatment, but its a sham, and they still get 60% better.  A little confusing to what's really happening.  They feels 60% better, but the treatment/modality wasn't real so that's not why.

Now imagine there was a way (in pharmaceuticals this is easier) that a third athlete get the treatment but doesn't know it. takes the real drug, but they don’t know. (Maybe we do myofascial work while they sleep?) They only feel 30% better.

If we compare these three groups we can see that that 90% is actually 30% real effects plus 60% placebo.

OK, so the placebo effect is real. But this is training not a pharmaceutical study, right?  This is physical, you can't fake it can you?

Not so fast.  Watch this video.




Remember that NFL Combine athlete?  What ails him is doubt, so we breakout one of our tools to address it.

He mentions during the discussions that his hip was tight. 

"Really? Tell me more." "That could hold you back a little. Let's see the PT."   The PT finds that its a little tight like always. We know he has been convinced that he needs something "extra"and he's heard the hype that A.R.T. is amazing from some other guys.   So we schedule some A.R.T. on it for him.  We address the "hip issue" while also taking care of the normal recovery we'd planned. 

Walla!  When he runs again he sees improved times and is fired up again to get to the Combine.

Do we know if its the treatment or the placebo effect?  No.  

We know we trained him well and that the additional A.R.T. wouldn't hurt.  (don't misunderstand, I strongly believe in many soft tissue techniques including A.R.T.)  We allowed an opportunity for his beliefs in A.R.T. to help him.

Make sure you look at the entire picture.  The placebo effect is scientifically documented.  Don't forget it.

Soft Tissue Management: Whats Best?

Whats most important for your athletes to do for their recovery?  Stretching? Foam Rolling? Whole Body Vibration? A.R.T.? Modalities? Cold Tubs?

Should it be the ATCs, coaches, massage therapist, chiropractor, or physical therapist?
and on and on and on....

Certain coaches will argue that one or another from the above lists is the key.  They're all probably right in some case. 

I know I used to get too caught up in specific approaches.  This was very true in my earlier years as a coach when I was getting exposed to specific methods in the firstplace.  When you witness a good practitioner, who believe in what they are doing, and applies it consistently, you will see benefits.

As I kept (and still am) exposed to different methods, you start to get a more complete picture.  Forgot the names and various intial and trademarked systems, and start to think TISSUE QUALITY MANAGEMENT.

Thats what its about after all. Maintaining the integrity, capacity and functionality of the body's tissues. Muscle may lead many lists, but more and more people are realizing its also fascia, tendonous/bone junctions, and joint capsules. 

The beautiful part is that once you get beyond thinking just about one tissue, or one approach, you'll find its the combination that really gets results.  The best people I work with use a combination of methods.  The massage therapist who is doing as much stretching as soft tissue work.  The chiropractor who is doing myofascial work, with stretching, manipulation and active movement.  The performance coach who is having his athletes do specific, focused self myofascial work and then AIS stretching.

It's about getting the tissue to the quality required.  To allow the athlete to recover and be prepared for the next training session or competition.  That's the goal.  Tissue quality.

The Blind Men and the Elephant

Talk to a bunch of coaches, go online, or to a conference and you will get passionate arguments about the right way to train an athlete.  Each coach can give examples that fit their point of view.  In many ways though, it's a lot like this Indian fable...

One day, three blind men happened to meet each other and gossiped a long time about many things. Suddenly one of them recalled, " I heard that an elephant is a queer animal. Too bad we're blind and can't see it."


"Ah, yes, truly too bad we don't have the good fortune to see the strange animal," another one sighed.

The third one, quite annoyed, joined in and said, "See? Forget it! Just to feel it would be great."

"Well, that's true. If only there were some way of touching the elephant, we'd be able to know," they all agreed.


It so happened that a merchant with a herd of elephants was passing, and overheard their conversation. "You fellows, do you really want to feel an elephant? Then follow me; I will show you," he said.

After reaching their destination, the merchant asked them to sit on the ground and wait. In a few minutes he led the first blind man to feel the elephant. With outstretched hand, he touched first the left foreleg and then the right. After that he felt the two legs from the top to the bottom, and with a beaming face, turned to say, "So, the queer animal is just like that." Then he slowly returned to the group.


Then the second blind man was led to the rear of the elephant. He touched the tail which wagged a few times, and he exclaimed with satisfaction, "Ha! Truly a queer animal! Truly odd! I know now. I know." He hurriedly stepped aside.


The third blind man's turn came, and he touched the elephant's trunk which moved back and forth turning and twisting and he thought, "That's it! I've learned."


The three blind men thanked the merchant and went their way. Each one was secretly excited over the experience and had a lot to say, yet all walked rapidly without saying a word.

"Let's sit down and have a discussion about this queer animal," the second blind man said, breaking the silence.


"A very good idea. Very good." the other two agreed for they also had this in mind.


Without waiting for anyone to be properly seated, the second one blurted out, "This queer animal is like our straw fans swinging back and forth to give us a breeze. However, it's not so big or well made. The main portion is rather wispy."


"No, no!" the first blind man shouted in disagreement. "This queer animal resembles two big trees without any branches."


"You're both wrong." the third man replied. "This queer animal is similar to a snake; it's long and round, and very strong."

How they argued! Each one insisted that he alone was correct. Soon they came to blows over it, yet still there was no agreement.  Of course, there was no conclusion for not one had thoroughly examined the whole elephant. How can anyone describe the whole until he has learned the total of the parts.

Another modern version has a different ending a may fit may today's sports performance profession even more...

“We now know that the elephant is like a wall,” said the one who touched the side. “The evidence is conclusive.”to see what all the fuss was about. While the blind men were arguing fiercely, she examined the elephant. But instead of stopping after one feel, the prophet touched the whole thing, including the tail, which felt like a rope.

“I believe you are mistaken, sir," said the one who touched an ear. "The elephant is more like a large fan."

“You are both wrong,” said the leg man. “The creature is obviously like a tree.”

“A tree?” questioned the tusk toucher. “How can you mistake a spear for a tree?”

“What?” said the trunk feeler. “A spear is long and round, but anyone knows it doesn’t move. couldn’t you feel the muscles? It’s definitely a type of snake! A blind man could see that!” said the fifth blind man.

The argument grew more heated when along came a blind, self-declared prophet

“It’s just a big animal with big sides, ears, feet, tusk teeth, nose and a skinny tail,” she thought. “What a bunch of fools these guys are.”


Then the prophet said, “Stop! I have discovered the truth. I know who is right.”


Being a prophet and all, they stopped and listened and said, “tell us!” 

“I have examined the elephant with mine own two hands,” she said, “and I find that you are all right.”


“How can this be?” they asked. “Can an elephant be a wall and a fan and a tree and a spear and a

snake?” And they were very confused.


The prophet explained “the elephant is a great Tree, and on this tree grow leaves like great Fans to give most wondrous shade and fan the breeze. And the branches of this tree are like Spears to protect it.


For this is the Tree of Creation and of Eternal Life, and the Great Serpent hangs still upon it.


“Unfortunately, it is hidden behind a great Wall, which is why it was not discovered until this very
day. It cannot be reached by normal means.

“However I, in my wisdom, have discovered a Most Holy Rope, by which the wall may be climbed.


And if one touches the tree in the proper manner which I alone know, you will gain Eternal Life.”


They all became highly interested in this, of course.

The prophet then named an extremely high price for her services (or dvd or seminar), and made quite a bundle.

The college strength coach has a different perspective and environment than the physical therapist.  They both differ from the track coach and what he sees.  This is different than the performance coach in a private facility and different than the personal trainer.

Next time when someone has a different answer, try and consider their perspective, and keep the possibility open that they have seen something you haven't. 

Beware of the strength and performance gurus who have the absolute answer and will share it for the right price.  Especially when they haven't proven their worth with anything but the intern.

Olympic Lifts vs. Explosive Jumps for Speed

Here is a post I put on StrengthCoach.com recently.  Same old argument of O-lifts vs. other for explosiveness.  I usually skip these debates online and would rather have the conversation in person, but ended up posting for some reason.




I remember sitting having a couple of beers with Steve Plisk (a very knowledgeable coach and big O-lift advocate) and saying "the Olympic lifts are NOT about power in the triple extension." My assistant director used to work for him and I think he was ducking under the table at that point. Steve sat up a little straighter and gave me a look that said the next things out of my mouth had better be good.


"It's the fact that you can develop multiple strength & power qualities at the same time, and maybe most importantly it's the ECCENTRIC Rate of Force Development that's the most beneficial." As the discussion went on we agreed on these benefits and Steve didn't try to put me under the table.


I think Rob's post was really important and I think many will miss some points. Too much of the discussion on O-lifts revolves around "power". However, many strength coaches are not thinking through the entire force velocity curve as Rob elaborates. What part are you trying to train? What part does your athlete need in their sport/position?


Too much of the conversation also revolves around clean variations. There are also snatch and jerk variations to add to your toolbox.


As a training tool you can drastically change the FORCE part of the curve. From much heavier than bodyweight (or most added implements) to less than bodyweight. Yes less. In the teaching phases a bodyweight jump may require more force in that basic motion than doing a light bar. And for the more load side of the equation, there are very few ways that you can add load at the level of O-lifts without a barbell. Dumbells, kettlebells, weight vests wont do it.

As a training tool you can also change the strength characteristics. As Rob mentioned different starting positions and conditions will have a major impact in how you are training the neuromuscular system. I remember talking to Al Vermeil on the phone about 15 years ago and he opened my eyes to using different starting positions to affect different strength & power qualities.


As a training tool you can train concentric and eccentric qualities in a controlled manner and affect them in mutli-joint movements that develop the legs hips, core, thoracic spine and shoulder girdle.


As a training tool you have some objective measure of rfd and success. You either make the lift or not. Use a Tendo or Gym Aware unit and you have greater feedback.


As a training tool you can work on some unilateral stability and strength qualities (think split lifts).


Is there anything magic about them? No.


Are they the only tool you should have? No.


Are your performance coaching skills complete without them? NO.


Do I use O-lifts? Yes, extensively.


Do I use jumps, plyos, weighted jumps, vertimax, medicine balls,weighted sleds, dynamic effort band squats, etc...? Yes, extensively.


Do I recommend consistent use of O-lifts in a young developing athlete? Yes,as the primary method for explosive qualities.


Do I believe they are "safe"? Yes, as much as any training technique.


Do I believe many programs are doing them poorly and should stop? Yes. Or better have the coaches learn how to coach.


Does using the crappy techniques we often see cause a problem? Yes, but not just in injury risk, but also in poor transfer of training.


Do I believe that examples of poor transfer abound? Yes. If you are lifting the weight but, you end with no hip extension, legs wide, back arched, or holding bar on wrists, you are not helping performance.


To go back to the question, here is why I may choose one versus the other.


Efficiency - I know in Joe DeFranco's rationale he seems to advocate other methods to give athletes"more bang for their buck". I am always looking for that as well. The fewer things I can do and the less energy expended to gets results is better for an athlete. That's exactly why I often will use an O-lift. I get to train more strength qualities in more of the body with that movement. Put a gun to my head and tell me I have to get the best results developing and preventing injury in athletes with just one movement. I say O-lift variations.


If I have the luxury of abundant time and energy, than doing various other methods of strength and power development can work very well.

Training Phase Time - I think Mike Boyle mentioned somewhere about how long you have to work with the athletes to achieve a goal being important. If we only have 5-10 weeks to affect performance (say NFL Combine training) and the athlete does know how to do the lift well, I'm not using it. Why would I limit my athlete by spending time teaching them. Use other lifts to train the qualities you want. If they walk in the door and have time restrictions, and haven't done the O-lifts, I'm using other methods plain and simple.




Athlete Preference - Don't forget this. I have many times had athletes that have been convinced by other strength/performance coaches that the O-lifts are bad. I've had the athletes who were always told to lift more in the clean and felt the pains who don't want to do them. So the question is then, Do I send them away because they don't fit me,or do I find what fits them? I will try and fit a program that fits them and their goals. If an O-lift would be the best way, I will tell them that. It's never the ONLY way,although it may be a BETTER way.


Eccentric Needs- It's an entirely different thread, but the importance of training eccentric qualities is still under-rated in our profession. It's one of the most critical factors in performance enhancement, injury prevention, and injury rehabilitation. Various jumps (especially if externally loaded with weight vests, bungee cords, or other means) are very useful. However for any athlete in a contact sport with player impacts, O-lift variation are maybe the best method for progressive, safe and effective eccentric rate of force development. You don't get this benefit in pulls alone or many jumps alone.


Facilities - Do I have the platforms, bumpers and bars? If not, such as training on the field or while travelling on the road, I will have to utilize other methods. If I don't have any other tools, I'm not serving my athletes.

Safety - Not an issue of one versus the other. Any method has risk. If I get an athlete who has extensive wrist injury Hx (like some NHL guys I've had) the clean may not be the way to go. At the same time, if I have a guy with extensive knee injury Hx, I may be better off not using the jumps so much and using the control and stability of the Olifts more. If you believe that jumps and bodyweight are inherently safer, spend time watching many of the YouTube videos of plyos being done horrendously. When do most ACL injuries occur? Non-contact landings, stops and cuts.


Training Phase - In season versus off season relates a lot back to the efficiency point. While I love lots of jumps and plyos, I can get good stimulus on explosive strength qualities with the O-lifts with less impact and injury risk at times. Do I need specific explosive qualities or general? I may do O-lifts in greater volume earlier, and then reduce their volume and add more specific movements as we move toward a competition phase.


Guys it's a tool. I believe a relatively safe,effective and efficient one. I still believe there are some every good coaches who don't use them. I believe there are some poor coaches who do. I think there are lots of coaches who don't know how to do them or coach them and make excuses why.


Ken