Trick or Placebo? Does it Matter?

by Mitch Hauschildt, MA, ATC, CSCS

When I teach my classes, I like to demonstrate a lot of techniques that get quick results with relatively little effort.  In seminars, I use them to illustrate and prove points related to our discussion in that moment.  Because I usually teach about the nervous system and it’s pliability, I have a lot of different ways that I can make immediate changes in the body.

Some call these techniques “tricks” with a rather negative tone in their voice.  It’s as if doing something quickly that improves a squat, toe touch or other movement pattern is a bad thing.  Their reason for the negative tone is that a “trick” may not actually be changing things long term.  Some have even called short term solutions a “placebo” and writing them off all together.

I see it differently.  My first job as a clinician is to get people feeling better one way or another.  My thought process on this has really evolved in recent years to view “tricks”, “placebos” and other short term solutions as windows of trainability.  As long as they are safe, I don’t really care why or how they work.  They are giving me an environment of relatively little pain and improved movement that helps me train everything else.

Pain is largely a nervous system issue in response to a perceived threat.  There is very little correlation between pain and tissue damage in the literature.  That is illustrated by the fact that we know that approximately 70% of the population has a lumbar disc pathology but absolutely no pain.  If pain is only generated by tissue damage, then those people would always have pain.  Pain is a generated by the brain feeling threatened by its environment.

The same brain that gives us a pain signal in response to threat will also decrease range of motion in response to a threat.  There may be good reason for the response and there may not be.  Either way, feeding the brain a novel stimulus to either reduce pain or improve movement capacity is a good thing.

Now, let’s be clear on what HAS to follow any of these short term interventions.  As Dr Spina says, “no single input can cause a lasting change.”  I agree completely and it holds true for any and all inputs.  We have to have multiple inputs to make a change long term.

Performing any intervention on it’s own will not have long lasting effects.  Let’s get over this idea that we are simply “tricking” the system or giving someone a “placebo.”  What we’re actually doing is opening an window to train within.  As long as we explore the new, pain free range of motion with meaningful movements, then they can be a great intervention that lasts long term and ultimately leads to a better outcome in the end.

Use whatever skills, modalities and novel stimuli that we have access to and then train through it.  Its a recipe for success.