How Placebos Can Help You Run Faster

Runners may benefit from the power of placebos -- even after they know they've been duped.

Just believing that you're blood doping is enough to help you run faster, recent research found.

When the runners found out that they'd been given nothing more powerful than an injection of salt water, many were red-faced and a little embarrassed, lead author Ramzy Ross said. While the subjects may have felt duped, however, it's actually another testament to the power of expectation on our health, placebo experts said. Other work has shown that placebos can soothe a baby's cough, relieve migraine pain, and even produce the same outcomes as actual knee surgery.

One of the key issues in placebo research is parsing out what makes them work, said John Kelley, deputy director of the Program in Placebo Studies at Harvard Medical School and an associate professor of psychology at Endicott College.

The two most common components, he said, are conscious expectations and classical conditioning. Think of the first as what you could verbalize: In the case of the runners, for example, most would say that taking erythropoietin (EPO) would improve their aerobic capacity and delay fatigue. As for classical conditioning, just as Pavlov's dogs started salivating when the physiologist entered the room in anticipation of being fed, people experience physical responses to certain associations.

In fact, even when researchers tell subjects they're taking a placebo, so-called open label studies still show a positive placebo effect.

Researchers attribute it to the conditioning response, Kelley said. It works best in people who have been treated previously for a condition. People with migraine headaches who experienced pain relief by taking a certain drug in the past also felt better when taking a pill that looked similar -- even when they knew it was not the actual drug.

By that rationale, athletes who have previously blood doped for real might fare even better on sham EPO, Kelley said. Previous research on cyclists showed that the benefits of taking morphine during workouts were maximized when the cyclists were preconditioned to using it first. Ramzy's team also delivered the placebo to the runners via injections instead of pills, knowing that most people have a stronger reaction to more invasive procedures.

The runners who were "really into what we were doing and understood how EPO could work" had the best results, Ramzy said. The average improvement over the 3,000-meter races was 1.2 percent, or about 10 seconds. The study will be published in Medicine & Science in Sports & Exercise.

Because placebos tend to work best in situations that contain some type of psychological component, such as pain, the results of the running study make sense, Kelley said.

There could be a bonus after-effect, too: After the subjects in the running study recovered from the initial shock of realizing they had not taken a performance enhancement, most took it as a confidence boost.

"They said, I know that I can do it now," Ramzy said. "There's this belief system that wasn't there before."

On Monday, the World Anti-Doping Association released a report describing a pervasive doping culture among Russia's athletic programs. The agency alleges that doping cover ups are so widespread in Russia that Russian athletes should be banned from competition — possibly even next year's Olympics -- until the country cleans up its act, according to a report in the

New York Times

. Liliya Shobukhova, shown here crossing the finish line to come in second in the women's London marathon April 17, 2011, said she paid the Russian Athletics Federation 450,000 euros to cover up a positive doping test. Part of the new report describes the possibility that Russia uses a laboratory on the outskirts of Moscow to help cover up widespread doping by pre-screening athletes' doping samples and ditching those that test positive. Such widespread, state-sponsored doping hark back to the notorious days when East Germany oversaw a decades-long program to funnel performance-enhancing drugs to their athletes, known officially as State Plan 14.25. Doping among individual athletes, however, has long been reported across many nationalities and sports. Given how prevalent cheating is these days, it can be difficult to sort out the range of substances that athletes abuse to get ahead. And although different sporting disciplines have their own regulations in terms of regulations and controls, the same drugs seem to keep coming back.

Does Athletic Doping Even Work?

Erythropoietin (EPO) is a banned substance that didn't get a lot of attention before the scandal over disgraced cyclist Lance Armstrong. EPO is naturally produced in the body and stimulates the production of red blood cells in bone marrow.

Although it's typically used in patients who are severely anemic, athletes competing in endurance events like cycling can receive injections to boost their performance. The elevated levels of red blood cells deliver more oxygen to the muscles, which allows them to do more work.

EPO is one of the substances Armstrong admitted to using.

Tour de France Doping: Should It Be legal?

Human-growth hormone, among the most popular steroid used by cheating professional athletes, including Armstrong, does exactly what its name would imply: promotes muscle growth. The steroid has the added benefit of strengthening bones and tendons, which is why its often administered to patients coping with range of conditions from children with growth hormone deficieny to adults dealing with muscle atrophy as a result of aging or disease.

Profesional athletes use it to boost their strength and muscle mass. Baseball players, including Jason Giambi (pictured here), who later apologized in a press conference for steroid use, were among the most frequent users of HGH.

Using Tetrahydrogestrinone, also known as "THG" or "the Clear," didn't make Barry Bonds the most hated player in baseball of his time. He managed to do that all by himself.

It did, however, help to fuel a wildly successful baseball career that included 14 All Star appearances, four MVP titles and several home run records. By lying to a grand jury about his use, he also winded up before a judge and almost in jail.

THG was a synthetic steroid designed by Bay Area Laboratory Co-Operative (BALCO), the California-based company that provided a number of athletes with a once undetectable performance-enhancing drug.

Human Chorionic Gonadotropin, or "HCG," was another steroid that proved popular among baseball players, most notably Jose Canseco, who was caught by authorities trying to smuggle the hormone across the border from Mexico.

HCG isn't used by itself, but rather after a steroid cycle. Steroids can shut down the bodies natural testosterone production, and HCG is a drug that helps men produce testosterone and sperm. HCG is also used medically to help women get pregnant.

A steroid popular among bodybuilders (almost guaranteeing athletes will abuse it as well), Winstrol is a steroid much like HCG in that athletes typically don't use it by itself.

Winstrol is another hormone athletes might take when off-cycle from another steroid. The purpose of the drug among athletes and bodybuilders isn't so much to build muscle, but retain it after a "bulking cycle" and cut fat.

Ben Johnson, the Canadian sprinter who beat Carl Lewis at the 1988 Olympics, might be the most famous user of Winstrol, and had his gold medal stripped as a result of testing positive for the compound. Johnson never denied using, and alleged that other athletes in the competition had all been cheating with performance-enhancing drugs.

How Do Olympians Keep Getting Better?

Although banned today, amphetamines, also known as speed, were once common in sports, ranging from baseball and football to gymnastics and wrestling.

These potentially addictive performance enhancers give a boost with heightened alertness and increased confidence, and can reduce perception of pain. These drugs also comes with a wide range of negative potential side effects from increased blood pressure to hallucinations to heart attack.

Last November, Baltimore Orioles shortstop Ryan Adams was suspended after he tested positive for amphetamines.

Ephedrine is a stimulant used by athletes to give themselves an energy boost.

Not only is ephedrine a banned substance by multiple sporting organizations, but it's also illegal to sell the herb from which it is derived, ephedra. Ephedra is potentially dangerous and has been implicated in the deaths of athletes both amateur and professional.

One of the earliest famous cases of ephedrine use in professional sports was Diego Maradona, who was booted from the 1994 World Cup after he tested positive for it. He later claimed that the compound was present in a sports drink and he had only ingested the drug inadvertently.