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Dr M. C. Siff
02-19-1998, 12:41 AM
INTRODUCTORY NOTE

For newcomers, these P&Ps are Propositions, not facts or dogmatic
proclamations. They are intended to stimulate interaction among users working
in different fields, to re-examine traditional concepts, foster distance education,
question our beliefs and suggest new lines of research or approaches to
training. We look forward to responses from anyone who has views or
relevant information on the topics.

PUZZLE & PARADOX 112

Sharing the results of scientific or medical tests with an athlete may be
counterproductive.

This current age of sporting endeavour has in many ways become synonymous
with scientific testing, sports medicine and scientific training. Often this
entails subjecting the athlete to a battery of tests to assess level of 'fitness' and
identify any possible deficiencies. If the athlete is injured, medical assessment
invariably involves preventing the future occurrence of the same or similar
injuries, especially if they appear to be associated with overtraining or
physiological or kinesiological imbalance.

Once these tests have been completed, common practice is to discuss the
results with the athlete and coach, with the objective of improving
performance, facilitating rehabilitation or preventing further injury. The
approach would appear to be that 'knowledge is power' and it undoubtedly
must improve the existing situation. After all, that is what science and
medicine are about: analysis, deduction and imparting information. This
method has led to remarkable advances in science, medicine and technology.
Thus, it would appear to be entirely logical and reasonable to assume that
athletes, teams and coaches must benefit from the results of methodical testing.

However, this approach may in at least one respect have negative effects on the
athlete. While the scientific and medical results collected from any test may
yield objective information on the athlete's condition and what may need to be
done to improve performance, the athlete, on receiving the information, might
interpret them negatively. Whether we like it or not, all 'objective'
information ultimately happens to be interpreted subjectively and ends up
being amplified, attenuated, filtered or distorted by a human receiver.

Thus, when some well-meaning specialist tells the athlete that the isokinetic
tests revealed an imbalance between his two legs, plus an imbalance in the
strength of his knee extensors and flexors, it is quite natural to feel that
'something is wrong' with him. Information that the strength ratio of quadriceps
to hamstrings "should be 60:40", whereas his is 67:33 for the left leg and 70:30
for the right leg, may certainly create the impression that he is abnormal,
deficient or incorrectly trained. In addition, the skinfold tests show that his
bodyfat proportion is 3% too high, his V02 max test shows that it is somewhat
below the 'norm' for successful athletes in the same sport, and so on and so
forth.

It would be naive to assume that the athlete remains emotionally unmoved by
what the scientists have told him so authoritatively. Since they are the
'experts', he has every reason to believe what they say, so it would be unusual
for him to question this information. Outwardly he may appear quite calm, but
inside his perceptions of his current condition may be causing some serious
turmoil and fear. So, every time that he goes to train, he is painfully aware that
his unusual stride pattern or his niggling hamstring soreness may be due to
what the scientists have called an imbalance.

At the same time, his coach, also moved by this information, redesigns the
training program in an attempt to correct the 'faults'. Nobody has pointed out
that these scientific measurements might be perfectly acceptable for this
individual and that some of the world's elite athletes display similar
'imbalances'. But this fact does not matter to all concerned - it is everyone's
perception of the tests which may dictate the outcome far more than any real
imbalances. The athlete perceives that he is less than desirable, the coach is
genuinely worried that he is doing something wrong and the scientists are
subjectively happy that they have set up the circumstances for the athlete to
improve.

If an entire team is tested and 'imbalances' are detected for everyone, the
perceived interpretations may well be magnified by interaction between all
concerned

The circumstances for self-fulfilling prophecy occurring may well be set up by
this testing and information-sharing process. Hamstring injuries may take
longer to resolve, athletes may never realise their full potential, technical errors
might become magnified, unexpected injuries may occur, stagnation in
performance might be reached too readily.... Once again, we may suspect the
insidious detriments of the reverse or negative placebo (nocebo) are at work.

The existence of this phenomenon seems to be well known when medical staff
work with terminal patients, where they are always confronted by the dreadful
question: "Should we tell the patient or not?". Many studies have been
conducted to show that some patients may rapidly give up the will to live, so
the advisability of imparting of this information to the patient and his
immediate family is considered very carefully indeed. The success of voodoo
spells hinges around the intended victim's perception of a given ritual or tale:
the power of the word is well known in all cultures. It has little to do with real
'magic' - only the willingness of someone to believe what he has been told or
shown.

Yet, in the sporting setting, this same question or situation rarely appears to be
worthy of consideration. Scientists, doctors and coaches invariably feel that
the athlete should know the results of all tests. Are we justified in making this
assumption? Should scientists and coaches be considerably more circumspect
in sharing all information with athletes? Is it advisable for the media to
disclose and discuss such results as matter for popular discussion? Would it
not be more sensible for the athlete's personality to be taken carefully into
account before discussing the results of tests? Should the limitations of all
tests be made clear to athletes and coaches, instead of perpetuating the
impression that science is always accurate and correct?
__________________________________________________ ____




Dr Mel C Siff
School of Mechanical Engineering
University of the Witwatersrand
WITS 2050 South Africa
msiff@hertz.mech.wits.ac.za