In this article, you will find all of the key information that you should take away from this week's podcast with David Nolan. If you are interested in field sports, or work with those who are, then this is for you.

Here is an excerpt from the article:

 

"There are many claims made about massage, and some are wilder than others. For example, here are 50 ridiculous quotes from massage therapists. However, as I have alluded to already, I find it incredibly boring when people just ridicule the low hanging fruit of pseudoscientific treatments, so let’s focus on the more mainstream claims that are often accepted.

It is often stated that massage is a useful treatment because it improves blood flow to the muscle, or that it enhances the removal of lactate / “acidic” byproducts from the muscles. Both of these claims are, in fact, false. Wiltshire et al. (2011) investigated the hypothesis that “one of the ways sports massage aids muscle recovery from exercise is by increasing muscle blood flow to improve “lactic acid” removal”. The opposite was found, as massage actually mechanically impeded blood flow and slowed down clearance of lactate and hydrogen ions from the muscles. This isn’t necessarily relevant to claims made about injury rehabilitation, but it does give some insight into the erroneous claims about massage as it relates to recovery mechanisms. Along with this, Shoemaker et al. (1997) sought to assess the effect of common massage techniques on muscle blood flow using Doppler Ultrasound. Three massage techniques were used, in both the forearms and quadriceps, but none had any effect on muscle blood flow, whereas light exercise did. If improved blood flow to the muscle is the goal, massage does not seem to be a great call."

 

Here is an excerpt from the article:

 

"There are a lot of variables like these to which we are often blind. We assume that the improvement in a symptom/condition must be specific to the treatment, but this is far from true. When painkillers are administered covertly, the effects are significantly diminished. Likewise, when painkillers are stopped (e.g. morphine) but the patient is told they are still being delivered the medication, they continue to have reduced pain, despite the fact they are no longer receiving any medication (Benedetti 2014).

This extends even further to surgery, where there is a large theatrical component that is part of the ritual, and often a very large expectation of improvement. We have seen this in multiple surgeries that have been demonstrated to be no better than “sham” surgeries, where the surgeon makes a cut but doesn’t actually perform the surgery. In a cohort of patients with knee osteoarthritis, this was tested by the subjects being randomised into one of two groups (Sihvonen et al. 2013):

Arthroscopic Partial Meniscectomy – A surgical procedure where an incision is made into the knee and part of the degenerated, torn meniscus is removed.

Sham Surgery – Replication of the surgical procedure (e.g. still bringing the patient to the operating room, getting all of the instruments, turning on all of the surgical equipment throughout to replicate the noise and environment).

Both groups improved, but there was no difference between them. This sounds far fetched, but if you think it through, there are multiple placebo effects at play, from the expectation to the suggestions to the environment, all the way to the post-surgical care and rehabilitation. It’s certainly something we should pay attention to, especially when we consider how biologically plausible the surgical procedure would seem to be, with most other treatments (including those discussed) seeming far less plausible in comparison."

 

Danny competed in his first physique competition this weekend (awaiting stage photos). We are incredibly proud of the effort and discipline he has displayed throughout his preparation.

 

Throughout the coaching process, he has continuously ticked every box required to make progress. He put his goal above his desires, which can be difficult to do in the modern food environment. Losing 17kg is not an easy task, but with Danny's discipline, he made the process look easy. 

 

Well done, Danny.

 

 

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The resources listed are simply resources that are likely to be educational and thought-provoking. It does not mean that we endorse every point made by any of the authors listed in either this newsletter or any of those to follow.

 

Book: Placebo Effects - Fabrizio Benedetti