Australian Olympic swimmer Kyle Chalmers won a silver medal and the best time in the 2021 Local Freestyle event at the 2021 Local Games. While most of the world was focusing on his exciting performance, others were interested in the noticeable circular bruises on his back and shoulders. Similar marks were seen in Michael Phelps in 2016, when he added six medals to his medal to establish the title of the most successful Olympian in history.

These mistakes were the work of cupping, alternative therapy. Small glass cups are placed on the skin where there is injury or pain, and are used to create an absorption that stimulates “energy flow”. One type of cupping (wet cupping) involves piercing the skin to bleed the area and remove stagnant blood and toxins.

As an exercise physiologist who examines critical thinking, I can’t help but wonder how an athlete’s unwanted protection from alternative therapy can affect the progression of the sport. This is because cupping is quite a feature of alternative therapy, by definition, which is not accepted by conventional science and medicine. When tested in controlled studies, the cup does not work.

In fact, all alternative therapies are on a spectrum, from treatments with certain merits to scientifically denied nonsense. And interventions like cupping, which disguise themselves as science without complying with its robust methodology, are known as pseudo-science.

There are many alternative therapies in the sport

When it comes to unproven alternative therapies, coping is just the tip of the iceberg. Other such practices in sport include chiropractic spinal manipulation, nose strips, hologram bracelets, oxygen drinks, reiki (hand healing), cryotherapy, and kinesiology tape or K tape.

While approximately 40% of Americans have used alternative therapies, approximately 20% have used alternative therapies to improve athletic performance. Studies of amateur and elite athletes show a higher prevalence of between 50% and 80%.

A detailed discussion of the evidence or lack of evidence underlying each practice can be found in books and scientific journals. However, most alternative therapies have three things in common:

1) They are sold according to strong claims and weak evidence.

2) They call scientific terms like “energy,” “metabolites,” and “blood flow” to represent scientific legitimacy.

3) They are based on low quality tests, are poorly controlled and have small sample sizes. This makes it impossible to distinguish the actual benefits of the treatment from those perceived or imagined.

Why do some athletes love alternative therapies?

Despite a scientific consensus on the lack of efficacy, alternative therapies seem to be more popular among the general population than among athletes. So what makes them so popular?

Humans went on to take mental shortcuts called heuristics, which lead to quick but perfect solutions, especially when it comes to health and fitness decisions. Proponents of some alternative therapies exploit the heuristic economy, offering great rewards for low investment. Athletes are always on the lookout for the extra 1% and may be particularly prone to odd claims.

In some cases, the lack of scientific evidence for a particular alternative therapy may be the reason for attracting someone to it. The anti-science movement and unprecedented attacks on scientists around the world have risen in the last decade. The individual may resort to alternative treatments because of dissatisfaction or distrust of conventional science due to the exclusion of social norms or both. Therapy can become popular because it disregards the established order.

Another factor is sponsorship. American athletes earn between $ 15,000 and $ 37,500 for an Olympic medal, and British athletes do not receive any prizes. Many have regular jobs, while some earn with paid advertising. Marketing companies are cautious: they understand our trends better than we do. A company can increase product sales by sponsoring an athlete and linking it to success, fitness and beauty. It’s a win-win, as athletes are able to take advantage of their large social media followers on an advertising base. Apparently harmful Instagram messages should not be taken at face value.

Eventually, some products like K-tape increase sales through visibility. This phenomenon that consumers prefer products they know is called the exposure effect. Increasing visibility increases popularity in a lasting relationship with each other.

It is important that none of these factors speak to the effectiveness of a product.

What benefits do alternative therapies have for athletes?

Not everything is wasted time and money, however, and some alternative therapies have benefits. Meditation has been used to successfully improve anxiety, depression, and psychological well-being, and yoga is a tool for weight loss. In addition, massage and other soft tissue therapies appear to reduce muscle pain and prevent injury.

These data-based alternative therapies can be distinguished from unproven therapies. Care should be taken not to confuse credible claims such as weight loss and relaxation with unbelievable ones such as physical healing and detoxification.

Even without a quantifiable mechanism of action, many other remedies claim efficacy based on placebo effects. The placebo effect occurs when a product improves performance through a positive psychological outcome because individuals believe in the effectiveness of the product. The result can be powerful. For example, a study gave flavored water to competitive cyclists and told them it was a glucose supplement. They saw a 4% improvement in performance compared to a second group, who were told they had received a placebo.

In Olympic sports, where gold and silver can be decided in less than half a second, it’s understandable why sports teams support the use of placebos, especially when athletes believe in strong effects.

Is there a risk of alternative therapies in sport?

The downside, however, is that the risks associated with some alternative therapies are clear. For example, serious injuries and death are also reported, followed by chiropractic spinal manipulation and acupuncture. In addition, skin burns are a common side effect of cupping therapy.

Of course, all medical procedures are at risk. But in conventional medicine, doctors make treatment decisions based on the relationship between risk and benefit. When the benefit of alternative therapy is placebo, the potential risks are difficult to justify, especially because an alternative treatment may result in loss of training time due to injury or other negative outcomes.

The widespread and non-discriminatory use of alternative therapies in sport may have implications for clinical practice. This is because it is impossible to limit the use of placebo to only minor ailments and sports performance. Believing in the effectiveness of alternative therapy that is not supported by science will truly prevent some people from treating a serious illness that can sometimes have dire consequences.

Is there room for alternative therapy?

Can alternative treatments complement what science supports? Maybe. When it comes to safe practice, it is necessary to draw a clear line in the sand to limit alternative therapies to minor ailments and sports performance, not to replace modern medicine.

Pseudoscience is a major barrier to evidence-based practice and science education and literacy. That’s why it’s a potential burden on sport, and why education programs are needed to help differentiate people from pseudo-science. Not just in sports, but in all aspects of society.

Although you can hear it on the cover of the Olympics, lactic acid does not cause fatigue.

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