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Evidence-based treatments exist for many sports injuries; for example, reconstruction of the anterior cruciate ligament (ACL) is clinically effective and has evidence to support it. Other injuries that have a more difficult, recurrent or variable time course to recovery, for example, muscle strains, tendon injuries and bone stress, have more limited evidence.
Although a range of interventions exist for these problematic conditions in ‘conventional’ or ‘mainstream’ medicine, a plethora of gurus offer more exotic interventions and ‘promise’ quicker and better outcomes and return to sport. Gurus are successful in gathering clients for their interventions in a range of ways, but one ingredient is expectation. There is a wealth of information that shows clinical enthusiasm (‘Gee, he’s confident'), novelty (‘No one told me about this!’) and expense (‘The best money can buy’) relate to improved outcomes—usually by increasing expectation1—this is …