Real Therapy- Beyond Placebo

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I was forwarded and likely baited two links to therapy about how foam rolling and tennis ball rolling of the feet were producing great results and I was taken back how one can not see the problems with the study designs. My belief is that American sport science’s main export to the international community is placebo. Americans are masters of placebo. We are brilliant in snake oil that I think Henk was right in posting how important it is. Placebo is inexpensive (except for erchonia lasers) and not on the banned list. Even some supplements that don’t work have been known to create side effects like acne. Crazy. So my thinking is that we need to look at research better to ensure placebo or motivation is not causing problems. So many times I have changed my program by adopting workouts of others because I felt that something was to it. Early in my career, after visiting a coach I would share the workout purpose and the results of the past with the athletes in advance. I believed in the workout and the athletes could sense my confidence. How could you not when gold medal athletes were doing the same things? Even if the workouts are universal, the sense that we are doing the same thing as the greats gave confidence to the athletes. Placebo is so powerful. Neurochemistry is everything and the mind is a very difficult beast to play with. I try not to get too involved with sports psychology but the problem is most good coaches are good because they are good, and don’t know that sometimes the power of belief is a primary influence. No athlete wants to be part of the control group and miss the latest supplement or advanced therapy.

Back to therapy. I believe that foam rolling has a place. Being in the middle receives very little attention or marketing. You must foam roll before every workout! Or, I never foam roll ever! Amazing. No middle ground or options here. Foam rolling after workouts? Nope. Not much talk there. Being different is great for Apple commercials but few coaches go to this direction. The Winckler mantra of leaving the workout feeling the way you want to start one is something I will never let go of. I am not sorry for that. Therapy now is too much guru nonsense. I am not underestimating therapy as I think REAL therapy is near magic. On the other hand I have seen some stuff online that I must post a tough criticism that we can’t get overly excited about things without looking at the big picture and the full study. For example the study of foam rolling on the quad is riddled with problems.

Look at the subjective way they measured quad range of motion. Goniometer is a start, but how did they determine end range? Also what comparison besides a control was done. I am sorry but a control is starting point and you must include real world coaching options such as things like drills or exercises people will be doing instead of just nothing. Did the range of motion transfer? Did recovery mechanics act differently? Were injuries over a season reduced? Much to think about. I have used the PCA for range of motion because gravity is constant, gravity is free, and gravity has a wonderful inter/intra reliability with therapists and coaches. The study was important though, because we are starting to get closer to the answers because all research will likely stir up good questions. Foam roll has value as it encourages something over the more expensive alternative, but nothing beats the real thing.

Carl Valle

Carl Valle

Track & Field Coach
Carl is an expert coach who has produced champions in swimming, track and numerous other sports. He is one of the foremost experts in the fields of nutrition and restoration.
Carl Valle

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