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Be it doping in sport, hot topics like Caster Semenya or Oscar Pistorius, or the dehydration myth, we try to translate the science behind sports and sports performance.

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Tuesday, February 26, 2008

LIfetime bans for drug cheats?

Should dopers be banned for life? Or is two years enough? A debate of crime vs. punishment

Yesterday, we looked at the case of Dwain Chambers, disgraced sprinter from Britain who served a two year suspension for his use of the designer steroid THG and who is now making a bid to run for Britain, first at the World Indoors (which he will run in) and then in the Olympic Games (where he's trying to get to). Even failing this, he's likely to push for the World Champs and other big races in the future. His desire to do so has sparked lively reactions, polarizing opinion among present and former athletes for Britain.

For example, double Olympic Champion Kelly Holmes has said:

"This was an athlete who went to America, knowingly took a drug that was undetectable at the time, got caught, admitted he'd taken drugs, then went on to say that you can't win anything without taking drugs. It doesn't put us in a good light allowing a cheat, who has admitted he's a cheat, to represent us."
She is backed up by Steve Cram, former 1500m champion, and now a commentator and journalist, who suggests that a lifetime ban for any drug cheat should be in order:
"I think a lot of us in the sport feel that a two-year ban is never enough for people committing that type of offence. And I would hope that as the next few months follow on, this isn't really just about Dwain Chambers at all, it's about the sport's attitude towards those who've committed serious drugs offences."
As things stand, Chambers will never take part in the Olympic Games, because the British Olympic Authorities do issue a lifetime ban to all convicted drug cheats. So for now, Cram, Holmes, and others who agree with them, can be satisfied knowing that the Olympics, at least, are out of reach.

However, there are those who support Chambers and are fully behind his efforts to run again. In effect, they are saying that "he has done the time, now let him come back and make a new start". They apply the letter of the law, which says that a convicted doper gets two years, and then is allowed to return to sport.

For example, Kim Collins, former 100m world champion, is quoted as saying:
"If they don't pick him then UK Athletics would be bending their own rules. He should be allowed to run and he should be representing Great Britain because he's the man for the job. He did serve his time and unless they are willing to change the rules and keep it 'once and you're out', he should be able to run."
Now, bear in mind that all this has been said against the backdrop of the issue of Chambers' selection of the British team for the world indoor championships in March, so people are commenting more on that issue than perhaps the issue of what to do with a convicted doper.

Should we be considering a four-year ban for dopers? Or criminal charges?

But it got me thinking about the severity of the punishment for a doping offence. This issue, as you might imagine, is debated extensively, and some have suggested that any positive test should result in a lifetime ban, or at the very least, a four-year ban, as Lord Sebastian Coe and Ed Moses have recently suggested.

Coe, for his part, has been pushing for a four-year ban for drug cheats since last year. If that sounds extreme, others within the IOC have even suggested that doping offences should be criminalized - jail time the result of a positive test.

The problem with increasing the punishment - testing will be even more vulnerable to attack

What interests me about this is that no one is looking at the testing procedure and systems, but rather assuming that testing is capable of reliably catching athletes who do cheat. For the implicit assumption when one calls for increased bans, is that the process that will ultimately give that ban is sound, and not likely to collapse under what would become even more pressure to be correct. If the system for testing and then processing positive tests is even slightly flawed, increasing the bans simply invites even more legal wrangling and controversy.

Now, believe me, I'm the last person to side with those who cheat in sport - I wish we could watch sport knowing that the most any athlete is using is a Vitamin C supplement! But the problem is that the process AFTER A POSITIVE TEST seems to be so flawed that if the punishment was made more severe, the already creaky structures under which athletes are tested would come crashing down under the "burden of proof" that would be required to send a runner to jail!

The "Innocent Man" syndrome

I recently read John Grisham's book "The Innocent Man", which is about a man who is wrongfully sentenced to death as a result of a flawed justice system - he loses 11 years of his life on death row before being exonerated. It would take me pages to run through just how flawed the system was, and besides, this is The Science of Sport, not a Book Club (though I'd highly recommend the book)! But the point is, it would be terrible if someone could write a book in 2015 about an athlete who spends 2 years in jail and/or is banned for life for testing positive for any drug, when he's actually been wrongfully convicted!

But the even bigger problem - dopers will get away with more under the increased burden of proof

Now, if you're thinking I'm going soft of dopers, let me address the balance. Because while the chance of "false positive" is a real one, what concerns me more is that dopers who test positive will have even more chance of getting away with it, because the entire process that ultimately delivers their sentence would now be under even more pressure to avoid a false conviction.

What we have seen in recent years is a dramatic change in how doping cases are managed. In the past, it was a case that an athlete would test positive, receive their ban, and disappear for four years - think Ben Johnson in 1988. He got caught, took his punishment, and we didn't hear from him again, until the ban was served.

But these days, "positive" doesn't mean positive, it means start the legal fight

But what is happening more and more today is that athletes are wising up to the "grey areas" in the system. There is almost a "guide book" on how to respond when you test positive. You begin by attacking the personality and integrity of your accusers, you go after the credibility of the laboratory testing you, you cry out that people are out to get you and that you're being discriminated against. Then you take your defence into the media and put all kinds of articles on Wikipedia to claim your innocence. You might even consider writing a book about it, and you definitely hire an expensive legal team who help you concoct defences like the "vanishing twin theory" which is more at home on an episode of "House" than in a sports tribunal, or you simply bombard the system with so much doubt that you escape punishment because no one can prove the use amidst all that uncertainty. And all the while, you deny, deny, deny, because actually proving that you used drugs is no longer as simple as testing your blood or urine and finding the presence of drugs in it! (and this doesn't even take into account the fact that a lot of drugs can't even be detected!)

The positive drugs test, formerly definitive proof that an athlete has doped, is now nothing more than the start of a usually messy, drawn out fight that is played out in the media and undermines the sport more than even the drugs use does. The problem is that sometimes the athlete has a case, because there are flaws and mistakes, and the system is not beyond reproach, which it needs to be in order to issue life bans. The result of this is that I honestly believe that we are headed for the day where an athlete who tests positive will face a trial consisting of a judge and a jury of their peers, who will have to assess their guilt based on days of testimony and evidence...think "Boston Legal" and "The Practice" for sport.

So my concern with increasing the length of a doping ban, and possibly criminalizing the use of drugs in sport is that the testing procedures, which are already "losing their teeth" in terms of actually following through with a positive test will become completely toothless as a result of increased bans --- taking a decision to ban an athlete for two years can be done a little more lightly than sending that same athlete to prison and preventing them from ever competing again!

So while in theory and principle, I'm all for a lifetime ban or even criminal charges, actually proving it poses a problem and until WADA and the federations figure out how to regain the upper hand in the "post-positive test" battle, increasing the ban will do little more than intensify the pressure they are under.

Back to Dwain Chambers - what should be done?

But let's get back to Dwain Chambers, for as Cram points out, the issue is not solely about one athlete, but about the attitude of the system towards its "cheats". And I'd love to hear from any of our readers who have some sports law experience, or even some experience in employment law on this one, because the issue here is bordering on that of "restraint of trade", where someone is prevented from earning a living unfairly.

Do you believe that a lifetime ban can be enforced for something like drug use? Or does this amount to restraint of trade, unfairly preventing the athlete from earning a living or surviving? Is it possible to block an athlete's participation based on one "mistake", willful or not?

I tried to think of the analogy from the world of business - if a businessman was caught defrauding his company, he'd without doubt be fired, and probably face criminal charges. But would he ever be able to work in the same industry again? Would the business world consider issuing a lifetime ban on a corrupt businessman? Well, rhetorical question, because there's no "system" to ban him from. But there's a good chance he'd be labeled and unable to find work, at least in the same area. Is that the same situation as Chambers and the Olympic Games?

All questions for which I don't have an answer - if you do, or have an opinion, please do let us know!


Monday, February 25, 2008

Dwain Chambers is back

Hopefully, you've noticed the newly added Tabs at the top of the page - we've added this to make it a little easier to navigate your way around our archives and to find articles. Thanks to Vanilla from Half-fast for steering me in the right direction to figure out how to add the tabs. While we're in the process of fixing them up and adding and rearranging our content, our email subscribers might get the occasional arbitrary email post which is actually just a page we're inserting to make use of the tabs, so please bear with us! We hope the tabs work well and they make the site a little easier to get around!

But for today, we thought we'd look at a story that has been around in the news for a while now, but one that we missed while I was in the USA - the story of Dwain Chambers.

Dwain Chambers: A headache for sports authorities, but a case control study on the state of doping

Dwain Chambers of Britain was one of the world's most promising sprinters - in 1999, at the age of 21, he claimed bronze at the World Athletics Championships in Spain.

He went on to win the European Championships in 2002, but never really made the big breakthrough, living in the shadow of the dominant sprinter of the early 2000's, Maurice Greene.

Then, in 2003, the wheels came off for Chambers, when his performances were poor, and he failed a drugs test in August. It was subsequently revealed that he had tested positive for THG, the designer steroid made famous by the BALCO scandal. It was Chamber's use of THG that landed him with a 2-year ban from the sport. He later admitted to having used THG since 2002, which would cost him (and team-mates) medals from the 2002 European Championships.

During his ban, Chambers dabbled in American Football, including a failed tryout with the San Francisco 49ers. He eventually returned to competitive athletics in 2006, and even won a medal as part of the British relay team at the 2006 European Championships. It was after this race that one of his team-mates from the 2002 European Championships, Darren Campbell, refused to join the team on the victory lap, in protest against Chamber's drug past. Campbell, along with 2 other team-mates, had been stripped of their own gold medals in 2002 thanks to Chambers' confessed use of THG.

The headache grows - Chambers finds form indoors

But the looming problem for the British Athletic authorities was only going to get bigger. Chambers has returned to form in 2008, and won the British Indoor Championships, having expressed his intention of qualifying for the World Indoor Championships.

The problem for the authorities is that Chambers had effectively retired from athletics in 2006, after the European Champs, when he had again attempted to start a career in American Football with the NFL Europa league. This was mixed in with a stint on a reality TV show, but the net result was that British authorities took Chambers off their list of athletes who would be tested out of competition.

However, on his return, Chambers did everything required of an athlete to qualify for the British team, even winning the indoor 60m title which SHOULD have guaranteed him his place.

But the situation is not so simple - understandably, the British athletics authorities do not want Chambers in their team. In their words:

"The committee was unanimous in its desire not to select Dwain".
And this was AFTER he'd been selected for the team, amid threats of lawsuits and counter-threats should he be omitted.

However, the fact was that there was no law in place to exclude Chambers and so the only basis for leaving him out would be an "exceptional circumstances" clause. This "exceptional circumstance" might have been that Chambers CANNOT run in the Beijing Olympics, thanks to a British Olympic law that gives a life-time ban to any athlete failing a dope test.

They chose not to make use of that law, possibly fearing reprisal from Chambers' lawyers, and so now we will see Chambers competing in a British vest come the World Indoor Championships in March.

But there's more to Chambers than this

So having said just this, Chambers' story is not exceptional. But then you begin to consider some of the things he has said since he was caught and banned. For example, in an interview with Matthew Pinsent in mid-2007, Chambers had the following to say about doping in sport:

"It's simple, science always moves faster than the testers. Some people take chances, some don't, and I was willing to take that chance. I was under the assumption that I wouldn't get caught."

In one sense, one has to applaud Chambers' honesty, as it makes a change from the usual conspiracy theories and denial that characterizes most positive tests these days - the usual tactic is to attack the testers, cry smear campaign, and deny every accusation. Chambers chose instead to speak his mind, revealing what most athletes probably think before they too use drugs.

But then later on, Chambers was asked whether a clean athlete could possibly beat a doped ru
nner, his reply was:
"It's possible, but the person that's taken drugs has to be having a real bad day. That's what I believe."
This was seen to be a 'confession' that most of the top, successful athletes were using drugs and that success was not possible without the use of drugs. This common interpretation of Chambers' comments is probably taken a little out of context, but it earned Chambers almost universal condemnation from former and present British athletes. Now that Chambers is part of the British athletics scene once again, the viewpoints have been expressed from all corners.

For example, in response to Chambers' selection for the World Indoor team for 2008, Dame Kelly Holmes, double Olympic Champion from Athens, was quoted as saying that:
"This was an athlete who went to America, knowingly took a drug that was undetectable at the time, got caught, admitted he'd taken drugs, then went on to say that you can't win anything without taking drugs. It doesn't put us in a good light allowing a cheat, who has admitted he's a cheat, to represent us."
Harsh words, which encapsulate just how strongly some feel about Chambers' inclusion and the possibility that he will be fighting for an Olympic berth later this year. For more quotes and reaction to the story, check out this article.

The interesting possibility of a case control comparison of past vs. present

But apart from all the ethical and legal arguments that this issue has raised, there is also an interesting possible "case-control" study that may arise as a result. I for one, will be very interested to see just how Chambers fares this season.

Because what we have here is an athlete who admitted to using a steroid over a very clearly defined time-period, who is now competing, supposedly drug free.

So lets' say that Chambers comes back and runs the same times as he did during his drug-use days. If this happens, it invites three interesting possible conclusions, the first two of which are:
    • Either he is still using drugs, and they are providing the same effect as before
    • The drugs he used did not work to begin with
The second option seems unlikely, so it will be very interesting to see how the athletics world responds to Chambers should he be successful in 2008. He is already viewed with suspicion and that will only grow if he is successful this year. Perhaps the only way he will be able to avoid all suspicion and fulfill the role of "anti-doping ambassador" (a role he himself has spoken of) is if he is unsuccessful on the track!

That's a tricky situation to be in -
success means suspicion, while avoiding suspicion requires mediocre performances! Of course, there is the third possibility which is that he is now drug-free and still performs at the same levels thanks to his training and dedication, but then being the cynics we are, that's a far less likely scenario!

So it will be very interesting to see how Chambers fares in the coming months. The possible legal wranglings on the horizon will also make for interesting discussion, should Chambers go after the Olympic Games as he's threatened to do. But for now, we'll keep an eye on his performances and see just how he performs!


Thursday, February 21, 2008

Oscar Pistorius: A case where the science does not matter

Latest news on Pistorius - the appeal that will focus on "non-science" matters - why science appears irrelevant to Pistorius

Well, it's been a prolonged absence, but I'm now back in SA having had a great time of it travelling through the USA and Egypt. And so we'll get right into some of the meaty issues that have developed in the last week. And what a week it's been - Roger Clemens and McNamee taking their case to Congress, Dwain Chambers and a brewing storm over his participation, and breakthroughs in the study of fatigue. Those issues to come in more detail...

Pistorius to appeal ban at CAS

But for today, a brief update of the ongoing story of Oscar Pistorius, the South African Paralympic runner who is vying to compete in the able-bodied Olympic Games.

The story is now into its second year, after first hitting the major headlines last year. And we've tried as much as possible to cover the developments with a more critical eye. Indeed, part of the reason for steering the blog in the direction we did (a news site) was to report on scientific issues in a little more detail than the mainstream media.

So this particular issue is a fascinating one, and in a series of posts on it, we've looked at the realm of theoretical evidence that suggests that Pistorius does have a large advantage as a result of his high-tech carbon fibre blades. We then added to this by analysing his debut performances in Europe last year, where all that theory was proven correct and he ran a race that is physiologically impossible. That alone should have been enough to issue a ban ON SCIENTIFIC grounds, but the IAAF, to their credit, performed very extensive testing on the limbs.

Their result? They showed conclusively that Pistorius has a LARGE ADVANTAGE over able-bodies athletes. What was most amazing about this finding, is that that there was an advantage, but just HOW BIG IT WAS - we're talking 30% differences in economy and mechanical efficiency. Difficult to know how that translates to performance, but it's clear it's seconds, not milliseconds. This has not discouraged Pistorius from taking the case to the Court of Arbitration for Sport, citing "new evidence" and challenges to the IAAF result.

The only answer that Pistorius will accept

The IAAF testing really should have been the end of the debate, especially considering that Pistorius has opportunities BEFORE the testing to consult his own experts and contribute to the research process. To say after the fact, once the result is announced, that the testing was faulty is either an admission of incompetence to begin with, or simply a plea to keep this issue in the media for a little longer.

Point is, the IAAF tested everything, in duplicate, comprehensively. The theory pointed to an advantage back in June last year, the results from his races suggest that he has the advantage by confirming those theories, and the IAAF testing proved it, beyond all measure of SCIENTIFIC doubt, in my opinion.

But the science is not the issue for Pistorius, the media is

But this is clearly not about the science to Pistorius. Rather, it is obvious that the only answer they will accept is the one that allows him to run. To date, 9 months into this debate, and the Pistorius group has not produced a single shred of valid scientific evidence. In fact, everything scientific they have claimed has been downright laughable. Last year, there were claims that lactate production caused Pistorius' back pains, they have also "proven" that he has no advantage by pointing out that his strides are normal in length.

And now, in the latest of the "scientific barrage" being generated, we have been told that Pistorius clearly has no advantage because another runner, who lost his leg in an accident, has not run faster on the blades than before.

The extent of Pistorius' science

In the latest retort, Pistorius has decided to appeal the IAAF ban to the Court of Arbitration for Sport in Switzerland. He does this "for all disabled athletes", despite the fact that the Paralympic community are largely silent on this issue. I know personally of at least five Paralympic athletes who are OPPOSED to his campaign (that is 100% of my own sample), but I guess they are not part of the "athlete group" he refers to?

In his latest scientific angle, he draws on the story of a fellow South African, Joseph van der Linde, who was a good, promising sprinter, before a farming accident forced the amputation of his right foot.

He duly continued running, wearing a SINGLE carbon fibre blade. His times, however, were never able to reach those his "pre-accident days". In Pistorius' words:

"If my artificial limbs gave me an advantage, as alleged by the IAAF, Joseph should run faster, not slower," he said.

Never mind the fact that:

  • Once an athlete (like van der Linde) loses the limb later in life, they must relearn all the motor control patterns, which means the chances of running properly again are very minimal. Pistorius learned to walk and run on prostheses, so he is an entirely different class of athlete. There is therefore no comparison between the two.
  • Pistorius runs on two blades, van der Linde only runs on one. The result is that Linde is unbalanced, and this costs MASSIVE energy as he runs, because one leg is highly variable in length, while the other is relatively fixed. This is in fact something we've discussed in detail in the past. In fact, I would go so far as to say that Pistorius should be banned from competing against single-leg amputees, because his advantage of them is even bigger than the advantage over able-bodied athletes. Again, the point is, van der Linde is a completely different case and the comparison is worthless.
The truth of the matter - not even van der Linde agrees with Pistorius' argument

So what we have here is Pistorius bringing another athlete into the debate, entirely unwittingly. And what is more, his comparison is not even valid. Now, the only thing that could possible make more of a mockery of this "evidence" is if that athlete himself doesn't agree with Pistorius! And that is exactly what happened!

Joseph van der Linde himself disagrees with Pistorius. Yet somehow, he finds himself in the category of "evidence supporing the defence"! A truly bizarre twist in this story...

But, don't take my word for it. Joseph van der Linde has himself ridiculed Pistorius' comparison, saying that "you cannot compare him to Oscar", and that "Pistorius enjoys advantages over other athletes". You can read his summary and reasons here.

van der Linde actually cuts right to the facts, which is surprising, since he's not a scientist. Yet he displays a better appreciation and capacity to grasp the science than Pistorius. Why is that surprising? Because ever since this story broke, it was always going to be a question of science - Pistorius and his team had to have known that ultimately, they would need to win the argument on scientific grounds. Yet they have been completely ignorant, their science has been laughable and they have nothing but hollow claims to show for their efforts.

To date, that is the only science that has come out of the news of Pistorius' appeal. There is talk, admittedly, of "experts" who have seen flaws in the IAAF testing. But then there are also rumours that Pistorius is consulting with local scientists in an attempt to help his case. These "local experts" do not have the necessary expertise to challenge a world leading German lab on this topic, pure and simple.

The science does not matter to Pistorius - only the exposure and media attention

To me, it is clear that the science is the furthest thing from the agenda. Indeed, Pistorius' agent, Peet van Zyl, was quoted as saying that the case is not going to argued "on technical matters only". So instead of focusing on the facts, we are going to be treated to smokescreens and mirrors, with the bizarre notion that banning an athlete with an ADVANTAGE is discriminatory! In otherwords, the science says he has an advantage, but that is insufficient to prevent him from competing!

Can I suggest that the next step is that a drug cheat will have to be allowed to compete against other athletes because he is simply not as naturally talented as the other athletes and so the drugs are NECESSARY even though they give him an advantage! Too small at birth? No problem, use steroids and growth hormone to bulk up, and if they ban you, just point out that it's not your fault you are not a natural power sprinter. That seems to be where the argument is going.

Unless, that is, Pistorius can prove that the legs don't provide an advantage...but then, that would require scientific testing and evidence, which seems to be in short supply. The reason for that, incidentally, is because the only science that does exist says the advantage is enormous, but selective hearing is fully in play on this one.

Quite frankly, the process is ludicrous, and the cards need to be placed on the table - there is no science to support that there is no advantage, only talk. And unfortunately, the media has willingly gone along with this "truth". There is only the desire to keep this story in the public eye for as long as possible, because the longer it stays there, the longer the cheques are written and the balance climbs. At the risk of sounding cynical, this is not an issue of courage and human spirit any longer, it's financial, and marketing and endorsement related.

So unfortunately, this issue will only end for Pistorius when the auhorities say that "There is NO advantage". This is of course untrue, so I suspect we have much longer to travel on this issue. But don't expect valid scientific facts in defence of Pistorius any time soon.


Thursday, February 14, 2008

Fatigue: A mechanistic breakthrough

Columbia researchers shed light on mechanism of muscle fatigue

First, thanks to many of you who sent us the article by Gina Kolata from the New York Times. It is a hot news week, first with this story breaking on Tuesday and also with Roger Clemens and Brian McNamee testifying before a congressional panel on Wednesday. This kind of story on fatigue is right up our alley here at The Science of Sport, and so let's take a look at this and see what it is all about before we get to the Clemens/McNamee hearings.

Why study fatigue?

Since its inception the profession of Exercise Physiology has focused on "fatigue." This is a broad term, and fatigue has many manifestations. We can fatigue during dynamic maximal exercise such as a peak power output test, and we can fatigue during sub-maximal (endurance) exercise. We can also produce muscle fatigue in the lab while contracting a single limb and muscle group, either repeatedly or continuously. So it has many faces, and exercise scientists have been interested in all of these areas for decades. In fact one of the first exercise labs in North America was the Havard Fatigue Lab, and one of their most famous investigations of fatigue involved two dogs, Joe and Sally, who were fed glucose or nothing while running on a treadmill. The scientists were the first to demonstrate in the lab that carbohydrate ingestion during this type of exercise enhances performance.

Great discoveries occur by accident

While a large number of scientists today are interested in what causes fatigue during endurance exercise, the more mechanistic studies focus on actual muscle fatigue---that is, what is actually happening inside the muscle and how that may or may not cause the muscle to stop working as well.

The clinicians at Columbia University were actually interested in congestive heart failure patients. The problem in these patients is that the heart begins to fail as a pump, and the consequence is that things get a bit backed up. The heart becomes more and more filled with blood, thus losing its ability to actually contract and to pump blood, and it was this weakening of the heart that interested Dr. Andrew Marks at Columbia University.

In their quest to understand their heart failure data, they came to realize that certain events at the molecular level contributed to the cardiac fatigue. The problem is that for muscle, either cardiac or skeletal, to contract, we must produce a successful chain of events. In short, a nerve signal reaches the muscle and stimulates the release of calcium (Ca2+). The calcium is what is actually causing the process of muscle contraction. A special part of the muscle called the sarcoplasmic reticulum, or SR for short, releases calcium, flooding the muscle cells with it. The calcium causes muscle contraction to happen, and when we want to relax the muscle the calcium is then pumped back into the SR, thus causing relaxation of the muscle.

The key to Marks' findings is that his group showed the calcium channels were "leaky," and so the calcium was not reaching its target of the muscle cells. The result was that the muscle could not produce the required amount of force, and in the case of the congestive heart failure patients the consequence of this is that the heart begins to fail in its job as a pump.

Translation - from the lab to the "field"

Calcium blocking drugs were originally developed to lower blood pressure, but Marks' lab altered a calcium-blocking drug so that it was a bit less effective. The result appeared to be a drug that shores up the "leaky" channels. Then they exercised mice for 21 days, with one group receiving the drug and one group a placebo. Both groups showed fatigue over the 21 days, which was measured with a continual treadmill run. However the mice that received the drug ran 13 min longer on the 21st day---77 vs. 64 min for the placebo mice.

To help support this finding, Marks' then collaborated with Dr. David Nieman at Appalachian State University in Boone, NC. The drug cannot be administered to human subjects as it has not yet been approved by the FDA, and so Nieman and Marks instead demonstrated that after cycling three days in row for three hours at 70% VO2max, the cyclists had leaky calcium channels. This suggests that, just like the mice during their 21 day training program, the cyclists were becoming fatigued.

The full pdf file is available to everyone and can be downloaded here. Be warned, however. . .even for scientists it is highly specific, and with all of the special abbreviations and acronyms it might take a while to sift thru!

What on earth does this mean???

So will athletes be taking an "anti-fatigue" drug in the near future? Not likely. . .it will take time before Marks' new drug will become available for use in humans. Clinical trails take years to complete, but more telling is the quote by Dr. W. Robb McClellan from UCLA: "In heart failure, there are three medications that improve mortality, but there have probably been 10 times that many tested." So the odds are against a new drug for this condition, and even if it is approved, WADA and other anti-doping organizations would likely include it on their list of banned substances.

For now what we all must do is follow the development of this drug and see how the clinical trials play out. The problem is that fatigue is such a complex event. . .even if the drug prevents the calcium channels from leaking, that is no guarantee that it will enhance performance during self-paced exercise such as road racing and cycling.

Come back tomorrow for our analysis of Clemens' and McNamee's testimony!

Friday, February 08, 2008

A drug conspiracy? Growth Hormone test

Drug conspiracy? Or administrative bungling? How a potential test for growth hormone slipped through the cracks (and it's possible rescue)

Well, first off, apologies again for the long absence between posts - it's been a frantic period of travel and work (and nothing in particular) and as a result, we've slowed right down in our posting sequence!

I (Ross) spent a large part of the last week and a half working my way steadily across the USA, beginning in Boulder where I was lucky enough to meet some of the local running community and was also blown away by some of the ideas and technology emerging from what must be one of THE meccas for endurance sport - but more on that in a future post. Then I moved progressively along the Grand Canyon, down to Phoenix for the Superbowl (condolences to Pats fans) and ended up in Vegas (which is just untrue - could have sworn I was in a theme park).

In any event, the result of the travels is that we've beena bit slow off the mark on a couple of really interesting stories, but as they say, better late than never! And one of the most interesting ones was this report from last weekend's Telegraph, in which a possible improved test for Growth Hormone is discussed.

The test - 8 years in waiting, while drug cheats prospered

The story concerns Professor Peter Sonksen, an endocrinologist (an expert in hormones) from London's St Thomas hospital, who was working to develop a reliable test for growth hormone prior to the Sydney Olympics in 2000.

As regular readers and any other followers of sport will know, growth hormone is a huge problem among elite atheltes, precisely because it has never really been possible to test for it! The confirmed or alleged use of growth hormone has some high-profile athletes linked to it...think of growth hormone, and you may think of the following athletes:

  • Marion Jones - it was one of the drugs in her "cocktail" at BALCO
  • Lance Armstrong - never "proven", but it was testified at a court case that he'd admitted to its use (among other substances) when questioned by doctors during his treatment for cancer
  • Willy Voet and the Festina cycling team - in 1998, the first of the current series of drugs tidal waves broke when Voet was arrested carrying hundreds of vials of growth hormone in his car
  • Jan Ullrich - alleged to have been given growth hormone as part of his 'treatment' by doctors in the now infamous Operacion Puerto scandal
  • Roger Clemens and Andy Pettite - most recently, baseball was rocked by a scandal involving growth hormone (and steroids), with two of its big name pitchers being named in the Mitchell report. Clemens, for his part, denies using, while Pettite and trainer McNamee have confessed and implicated Clemens. This one should be really interesting, because someone is committing perjury!
There are other big names, but the point is, growth hormone is one of the most widely used drugs, because of it's undetectablity! And the second point is that because there's never been a reliable test, athletes who are accused can simply deny its use to millions, without any fear of being caught out.

So, when the reports emerge that Professor Sonksen has basically perfected a test for Growth Hormone in 2000, prior to the Sydney Olympics, one has to wonder what sequence of events took place to keep that test off the "market" for 8 years!

Because that's the summary of what has happened - Sonksen perfected his test in time for the Sydney Olympics, and promptly had his funding and support from WADA and the IOC withdrawn, and they chose to use another test for Growth Hormone instead. The test they chose is able to detect Growth Hormone in the blood for up to 24 hours after its use. Sonksen's test is able to detect markers of Growth Hormone use for 2 weeks - clearly, given the fact that athletes are now so advanced in their use of doping, the two week option is the better one.

The reason - it may be valid, but why settle for a second rate test?

Now, it's speculative to guess why the IOC and WADA would have chosen the way they did. These stories and decisions are never as simple as they appear with the benefit of hindsight, and WADA and the IOC may have had very good reason to pull support from Sonksen and go with the (now recognised) inferior test. Perhaps they felt that the proximity of the Sydney Games meant the test would not stand up to their legal requirements for a valid test, who knows? This would certainly be a good reason not to use the test in Sydney.

However, what is a mystery is why would they not continue to support the research and the efforts of a laboratory which was clearly very close to the answer? It may not have been useful in Sydney, but they seem to have been so close to an answer, why not pursue it a little further after Sydney? Instead, they settled on a test that only detects Growth Hormone for 24 hours. As a result, we've had a situation where for nine years, all the athletes ever implicated as using Growth Hormone can deny, deny, deny, and only Jones' confession confirms her use of it!

If the Growth Hormone problem is that large, which anyone but for the willfully ignorant (and Pat McQuaide, president of world cycling) will acknowledge, then why not plough money into perfecting the test? Why settle for a test that works for 14 days? Perhaps with more funding, Prof Sonksen would have been able to develop the test that was effective for 30?

The reason the athletes are "one step ahead" of the testers

Of course, in times like these, rumours will abound, ranging from administrative bungling to "conspiracy and cover-up". And while only those within WADA and the IOC know the true extent, what we will say is that given the battle on our hands to save the sport's credibility, and given that we are continuously bemoaning the fact that the athletes seem to stay one step ahead of the testers, it's astonishing that it takes 9 years for part of the SOLUTION to make its way to the testers!

In this particular case, it's not that they were one step ahead, it's that the governing body of the sport and it's anti-doping regulators were simply fast asleep or looking the other way! It's hardly surprising that athletes are a step ahead, when it takes 9 years and the intervention of the UK Sports authorities to push the test back into the spotlight.

But now, thanks to those efforts, the test MIGHT be ready in time for Beijing. Currently, WADA and UK sport are involved in meetings to get the test through the obvious legal requirements.

Sadly, however, it's likely that this test, if it's passed, will simply mean that athletes and their "support teams" will have to work a tiny bit harder to come up with the alternative to Growth Hormone. One gets the impression, based on this sequence of events, that it won't be too difficult to do...

Other sports news - some tiny soundbytes

And then finally, just to wrap up today's post (and to make up for lost posting!), some very brief sports stories that grabbed my attention in the last day or two.

First of all, in Men's Hurdles, Cuba's Dayron Robles is having a spectacular start to the 2008 Indoor season. The reason this is interesting is because at this Summer's Beijing Olympics, one of THE BIG EVENTS is going to be the Men's 110m Hurdles final. That's because it involves the Chinese favourite Liu Xiang. Liu has been the poster boy for the Beijing Olympics - he is China's huge hope for a track and field medal, and has been under massive pressure for about the last 3 or 4 years.

But towards the end of last year, his "lead" over the rest of the world has started to erode, and in particular, it's Robles of Cuba who now poses a huge threat to him. The significance of Robles' early form is that in indoor racing over 60m, the athlete with the fastest start tends to dominate. So Robles' ability indoors suggests that his start and first 40m is a strength. This, in turn, will put pressure on Liu (assuming Robles produces that form in Beijing) and should make for a great race. Liu is already carrying a billion people's hopes on his shoulders - the prospect of Robles 2 m in front of him at the 60m mark is one to look forward to! In our "Review of 2007" post, we gave Liu Xiang the tongue-in-cheek "Losing sleep over the future award". Well, given Robles' early season form, he might yet retain that award in 2008!

Bekele going for indoor 3000m record

Then, in other news, this weekend sees Kenenisa Bekele gunning for the world indoor 3000m record in Valencia, Spain. The record currently stands at 7:24.90, by Daniel Komen of Kenya.

The reason this is so interesting is not only because Bekele is shooting for a massive PB - his current outdoor PB is only 7:25.79, so he's going to have to run faster indoors than he ever has outdoors - tough ask!

Rather, the reason this is interesting is because it suggests that Bekele's focus early in 2008 has again been on the shorter distance, speed-oriented events. Last year, I think it was really noticeable after his loss at the World Cross-country championships, that he came back and reeled off a string of fast times over 3000m and 15000m, running PB's in both distances. However, I feel his longer distance form was not quite as good - his victory in Osaka, while spectacular, was a 'fragile' one, and then he didn't look as strong in some other 10000m events.

So my suspicion is that after his loss, his focus changed to shorter events and perhaps his training to include more speed. It would appear that this remains a goal. That will be encouraging to Tadese and the Kenyans who take him on in Beijing over 10,000m, since they may well be able to find a vulnerability in the longer race. At least, in theory, that's what might happen!

But we'll let you know the results of his world record attempt - my prediction, by the way - he will run 7:27, maybe a low 7:28!


Tuesday, February 05, 2008

NFL, Gatorade and bananas

It must have been the bananas

Superbowl Sunday has come and gone, and New York Giants played the part of giant slayers by upsetting the New England Patriots, a team that steam-rolled the competition during the regular season, and even when against the ropes always seemed to be able to pull out a win from somewhere. Not in Superbowl XLII however, and Manning (the younger one, amazingly) led the Giants to two fourth quarter scores to win the title.

There are plenty of talking heads and pundits on the web, television, and in print to provide you all the detailed analysis of the game you need. Neither of us have tremendous insight into the game of football, and so we will leave the breakdown to the other guys. However, there is one story that emerged from the Superbowl that does fall within our "playbook", so we thought we'd spend some time on that instead!

New York coach Tom Coughlin does not read The Science of Sport

Back in October of 2007 we did a series on muscle cramps. In it we looked at the different theories of cramps, looked at the prevailing and perhaps dogmatic theory, presented a novel theory to explain cramps, and finally used the debate around cramps to demonstrate how science and knowledge evolve as new evidence comes to light.

The gist of this debate is that for years cramps have been attributed to dehydration and electrolyte imbalances and deficiencies. We suspect many of you who played youth sports were told, when playing in hot weather, to eat lots of bananas. The hypothesis there is that potassium depletion causes muscle cramps, and it is commonly accepted that bananas are a food stuff that is rich in potassium. So, quite simply, to stave off cramps one must just eat plenty of bananas - elementary school knowledge (or so we thought), and it turns out that even in the Superbowl, they adhere to that same dogma!

So in the big game, late in the first half, the crack Fox TV broadcast team crossed to their onfield reporter, who informed the watching nation that as a result of the high humidity in the stadium (the roof was closed), the Giants players were having problems with cramps, and that the coaches, sharp as they are, immediately had boxes of bananas brought to the sidelines. Sure enough, a couple of minutes later the cameras spotted it---a pile of bananas on the Giants sideline!

The first important (though tongue-in-cheek) point here is that Tom Coughlin and his coaching staff clearly do not subscribe to The Science of Sport. . .or perhaps they do, but they missed our series on muscle cramps? The second interesting point is in spite of all of the technology the NFL teams and coaches have at their disposal, all the high-tech strategies they employ, their wealth of human resources---19 coaches for the Giants and 14 for the Patriots---they rely on techniques that are entirely unproven and which no scientific evidence supports.

And then thirdly, and perhaps most thought provoking, is that Gatorade are the Official sports drink of the NFL, and copious amounts of it are available on the side of the field. Yet for some reason, the Giants were not told this - they chose the banana instead of the Gatorade! So calling for the banana backup is an indication that...the Gatorade wasn't working...? That wasn't an ad you saw in the Superbowl! Imagine the tagline..."Gatorade appears NOT to prevent cramps. Try bananas instead..."

No, science does not always have the answer

Admittedly, science does not always have the answers. Human performance even in individual events is incredibly complex. One only has to look at our previous post for some insight into will power and motivation to understand that many factors, perhaps too many and too complicated to measure, predict performance.

But it is still fascinating that at what many consider the pinnacle of professional sports---the NFL---the coaching staff turns to bananas during a game to alleviate muscle cramps. This is a sport in which assistant coaches, perched high above, take moving and still pictures, analyze them, and relay information about their opponents down to the coach on the sidelines. It is a sport that makes exstensive use of video analysis as players watch hours of game film of opposing teams to "get to know" them and their offensive and defensivee formations. They appear to be on the edge of technology. . . or are they? The bananas suggest otherwise, and give hope that maybe there is room for basic science.

In any case, it was a cracker of a game, and in our honest opinion the better team on the day won the match. Somehow the Patriots never really looked like the team that dismantled their opponents 18 games in a row. The Giants found a way to get to them, and came out ahead as a result of their efforts.

Be sure to come back later this week as we move on to Part III of our series on exercise in the cold.

Monday, February 04, 2008

Marathon survival: Courage and physiology

Marathon survivorship – physiology of some courageous marathon finishes

Last week, we featured the debut marathon of Kayoko Fukushi of Japan. As the fastest Japenese woman ever over the HALF MARATHON, much was expected of Fukushi’s debut marathon in Osaka, but in the end, she left the world with memories of a different kind – 15 minutes to cover the final 2km, three falls in the final 300m in the finishing stadium, and testament to the challenges posed by the marathon distance.

In the aftermath of the race (you can watch the final 400m, as well as our analysis of the race at our previous post), Fukushi’s final 400m was a hot topic on discussion boards and running websites. So in this follow up post, we thought we’d look back on other famous marathon finishers. We tip our hats, and our physiological paintbrush, at the following three famous “Marathon survivors”.

Gabrielle Andersen-Scheiss

In 1984, for the first time, women were allowed to run the marathon at the Olympic Games. The race was won by Joan Benoit, in a remarkable time of 2:24:52, beating off a stellar field including Weitz, Kristiansen, and Rosa Mota. The time was remarkable for a number of reasons. Not least of all, conditions in LA were hot and heavy – ahead of the Games, there was a great deal of anxiety over potential problems caused by the pollution – much as there are around the Beijing Olympic Games this year.

But in the end, the heat caused the problems, and the biggest problems of all were encountered by Gabriela Andersen-Scheiss, of Switzerland.

Andersen-Scheiss entered Olympic Games AND Physiology folklore thanks to her performance over the final 400m of the race. This video, shown below, is often shown at physiological conferences as a demonstration of what happens to the physiology when the body temperatures rises to reach a ‘critical threshold’.

What you will see in the video below (apologies for the poor quality – if anyone has a better version, let us know!), is that Andersen Scheiss enters the stadium clearly in distress, and over the next 400m, staggers around the track, taking an incredible 5 minutes to cover the final lap! The video edits out much of this last lap (again, let us know if you know where a better version exists), but you can get a good idea of just what is wrong – it seems as though the left side of her body is dragging the “paralysed” right hand side behind it. And this is typical of what happens when the core body temperature rises to above 40 degrees Celsius.

The role of the brain

We’ve brought this up before, but it bears repeating – until the mid to late-1980’s, the theory for exercise in the heat was that you fatigued because the body was unable to provide sufficient blood to the skin for cooling AND the muscles for exercise. In this theory, dehydration was a problem because it meant less blood, which only worsened the problem. But in 1979, Ethan Nadel found the first evidence that the blood flow was not the problem. This finding was repeated in numerous studies, where they found that the body was perfectly capable of getting enough blood to muscle and to skin.

However, the body temperature can still rise (this is a function of exercise intensity and the environment), and when it happens, the evidence began to suggest that the brain was involved. Why? Because scientists started to observe that when people in LABORATORIES hit a body temperature of 40 degrees, they started to display symptoms of neurological problems. Which is exactly what you see in Andersen-Scheiss – “paralysis” of one half of her body, inability to control the limbs, and so forth. This classic symptom was strongly suggestive of the neural contribution to fatigue.

It was later found that when the brain gets too hot, it actually recruits less muscle (Nybo and Nielsen, 2001). Of course, when you exercise in the heat, it’s not quite as simple as a brain the stops activating muscle when you get too hot – I (Ross) did a study in 2004 that found that the activation of muscle actually goes down BEFORE you get too hot. In other words, the brain slows you down by activating less muscle IN ADVANCE of hyperthermia, specifically so that you don’t reach this point of complete exhaustion and ‘paralysis’.

However, as the video above testifies, it happens, with dramatic consequences. Andersen-Scheiss, for her part, became something of an Olympic legend as a result of her courage. She ended up finishing in 37th place, some 20 minutes after Benoit. She was treated and released within 2 hours, showing how even the most intense effort is probably still within the reserve capacity for the body.

Jim Peters – the Vancouver 1954 marathon

Jim Peters of England was the Paula Radcliffe of his generation - he had broken the world record four times and was the first man to run under the 2:20 barrier, taking the record down by an astonishing eight minutes to 2:17:39!

So when he lined up in the 1954 Vancouver Empire State Games (today called the Commonwealth Games), he was the overwhelming favourite. This was the same Games, incidentally, that Roger Bannister and John Landy raced in what would later be called “the mile of the century”, with Bannister outkicking Landy to win. That race actually happed while this marathon was being run, and so Bannister actually sat in the stadium waiting for the men to finish.

Anyway, the marathon that day was particularly hot, and Jim Peters staggered into the stadium in first place, but was looking like he'd had too much to drink. He was swaying from side to side, and it looked as though one half of his body had been paralysed – much in the same way as Andersen-Scheiss would look 30 years later.

The conditions in Vancouver were pretty warm with starting temperatures in the shade in the high 20's Celsius. Reports were that the sun was so warm that the tar melted during the race! The temperatures may not jump out as being exceptionally high for those in the hotter parts of the world right now, but given that most of the athletes were not adapted to the heat, it was a tough day in the marathon. The conditions were so severe that out of 16 starters, only 6 finished the race.

Jim Peters was not one of them. After entering the stadium, with only 385 yards to run, Peters fell SIX TIMES within the first 200 yards. He took 11 minutes to cover that distance (making Fukushi look like a greyhound in her race!), before eventually collapsing for the final time – 200 yards SHORT of the finish line! He was taken to hospital, where he spent 7 hours being treated intensively before being released.

Incidentally, the athlete who was in second position with about two miles to run, Stan Cox, had also collapsed and ended up in hospital. At the 25 mile mark, he was so disoriented that he ran into a lamp-post, collapsing again. Eventually, police helped him to an ambulance, and he was taken to the hospital, where he’d later be joined by Peters.

And then finally, the eventual winner was a Scot, Joe McGee, who had actually collapsed five times on the course as well! But he heard that the two men who had been in front of him failed to finish, he picked himself up and went on to win! An attritional race if ever there was one!

The IronMan duel – Sian Welch and Wendy Ingram

And finally, for perhaps the most dramatic video we know of, we go to the IronMan Hawaii Triathlon of 1997, where Sian Welch and Wendy Ingram “race” over the final few hundred meters for fourth and fifth place.

This video, shown below, is difficult to watch, for the sheer agony that I’m sure most of you can relate to in some manner. It’s absolutely remarkable because it shows two elite athletes, both struggling with a combination of fatigue, muscle cramp and in the case of Welch in particular, hypoglycaemia. It’s quite clear that she’s in a disoriented state, and struggles to balance, find direction and stay co-ordinated.

Wendy Ingram, for her part, is cramping quite severely, and modifies her running style drastically in the final straight before the finish line.

What is most amazing, from a physiological point of view, is that the women move through different stages of what I would call “muscle activation patterns”. It’s as though there is a Plan A, which is to run absolutely normally, finishing strong (like some of the men who are finishing at around the same time as these two, you’ll see them in the background).

But given the difficulties both are experiencing, the brain quickly switches over the Plan B, which is this “modified running technique” – anything to keep going forward. Ingram’s “spider walk” is amazing, she’s clearly putting everything she has into what looks an incredibly uncomfortable running style!

Welch is unable to do even this – her muscles have simply been “switched off” and she has nothing left, mostly as a result of the low energy she has available and her fatigue – tired muscles with little fuel, and the brain says “No chance you’re running any more!” She’s unbalanced, uncoordinated and out of control. Eventually she staggers and walks to within meters of the finish line – she is on Plan C. But then she falls, taking Ingram down as well. And you’ll see in the video, the eventual winner between the two of them is the one who first realises the need for Plan D – Crawl!

So it’s an astonishing video, and you’ll hear reference to Julie Moss, a link you’ll find in the comments section of our Fukushi post from last week.

But this finish, and these two women, must surely go down as one of the bravest and most courageous, dramatic finishers in history!

Can you ever overcome the body’s limit through sheer willpower?

One question that is often asked when this whole area of “limits to performance” is discussed is this whole issue of “mind over matter”. What we are saying is that brain decides when “enough is enough”, and reduces the activation of muscle fibers BEFORE you even get near the dangerous levels of body temperature or fuel depletion, for example.

The logical question, however, is “Can an athlete, through sheer willpower, find that little bit extra, over-ride the brain’s protective reduction in muscle activation, and allow the athlete to go that little bit faster?” Professor Tim Noakes, who is one of the primary drivers of the theory of the brain protecting the body, often talks about the psychology and willpower aspects. And while they are relevant, I feel it’s not quite correct – it’s not simply a case that the guy who wants it most will win, which is unfortunately the spin that is often put on it.

So the answer is complex. Certainly, willpower and psychology play a role, and different people will tolerate different levels of discomfort. But I think that what these videos and stories show is that eventually, physiology wins the day. Peters, Welch, Andersen-Scheiss, and Ingram are all examples of athletes who have dug deep, found EVERYTHING their physiology has to offer, and quite literally run to the “edge of the limit”, but eventually, their physiology shuts down so completely that they simply could not run anymore. And yes, they survived. So in that sense, the brain did its job of protecting them, because all made recoveries, none “exercised themselves to death” (this happens, but it requires some special circumstances, we’ll discuss that in a future post).

So, to use a morbid analogy – no matter how badly you want to go, you cannot commit suicide by holding your breath – physiology wins. And similarly, during exercise, your willpower can take you that little bit closer to the limit. In fact, training takes you nearer that limit, since you learn what is tolerable and what is not. Motivation is of course important here too – given the right motivation, you might be prepared to tolerate a lot more than usual! But as you approach that “limit”, your body begins to progressively throw barrier after barrier in front of you. It becomes more and more difficult to hold the pace. Your brain is not activating muscle at the same level, and your perception of effort rises and rises. And eventually, physiology wins the day, and you stop, either voluntarily or because your legs fail to hold you up any more. This is human performance at the very extremes, but it’s still physiology!

Join us for exercise in the cold next post!