I’m reading the article on PainScience about the well-established non-efficacy of stretching and I just made it to the section on stretching’s effects (or non-effects) on DOMS. Since pain is highly psychosocial, I would imagine that someone could make stretching into a sort of placebo. That is, because she is so convinced that stretching helps with soreness, she develops the expectation that, if she stretches, she will not be sore, or at least less sore, the next day; and that expectation in turn improves her pain outcome, not because of any physical link between stretching and DOMS, but because of the psychosocial aspect of pain. The converse is also true of course, regarding the nocebo effect. That is, now that she has developed this correlation between stretching and no pain or less pain, whenever she doesn’t stretch, she develops the expectation that she’ll be super sore the next day; and lo and behold, she is more sore–again, not because of any direct causation between stretching and DOMS, but because of the psychosocial nature of pain itself.
My question is, how do scientists go about studying, say, whether stretching has any effects on DOMS as independent from, i.e. how do they control for, the subjects’ psychosocial milieu? If a stretch group reports back less pain than a control, couldn’t we just attribute that to the expectations of the subjects, and the same for any outcome? This, in my mind, would seem to be a general problem with studying the correlation between pain and anything about which expectations can be had about the pain itself (e.g. Epsom salt baths and pain, massages and pain).
This is the problem with trials in which subjects aren’t (or perhaps can’t be) blinded, or when subjects are aware of whether or not they are being “treated”. Of course, one strategy to deal with this would be to assess the subjects’ baseline knowledge and expectations prior the intervention (similar to what we do in a real clinical setting), and outcomes can then be compared to these baseline data.
Right… So, you could have one group who thought stretching helps with DOMS and a control (a group that’s agnostic, presumably) to determine whether expectations have any influence on outcomes. And/or you could study just one group who’s agnostic to see if there’s any underlying expectation-independent cause. Correct?
Pyschosocial? Do you mean psychosomatic, or am I missing something? Because the first is a great song, but the latter seems to make more sense in this context.
That is only a tiny piece of the biopsychosocial model of pain. Tons of other things influence the pain experience from a psychosocial standpoint. I’d suggest looking into work by Lorimer Moseley and Adriaan Louw, etc. for more on this.