With
today’s final imminent it is worth asking what, if any, role doping played in
the World Cup? It is true that football teams today are required to be much
fitter than before; it is unlikely that even some of the great teams of the
past would have performed optimally in the last 30 minutes of a modern match.
However, the endurance levels required for the footballers of today still
require little more than a sensible diet and a lot of hard work in the gym or
training field (although it has to be said even this does seem beyond some
players).
Unlike
athletics or cycling, In terms of performance enhancement it is difficult to
make dramatic changes in skills-based team sports performance by chemical
enhancement. It is theoretically possible that “cognitive enhancers” might make
a player more alert, even when tired, such that they find that critical defence
splitting pass. But I suspect any change would be small, and there is no
evidence that teams are attempting to use this route.
Where
there is more concern in drugs that are “performance enabling” i.e. that make a
player play in a match that they would otherwise not be able to. Painkillers
fall into a ‘doping grey-zone’ [1]
because there is an obvious need to treat an athlete if they’re injured but
they can also be used to shorten the recovery time needed if given in high
enough doses. Non-steroidal anti-inflammatories (NSAIDs) in particular have
been shown to effectively decrease pain and improve early muscle recovery [2]. Footballers in
particular might tend towards painkillers before and during games as it may
allow them to both get back on the pitch sooner after an injury and reduce the
severity of any injury that may occur [3].
Whilst their use post match to treat an injury is an
accepted exercise, what happens when an athlete takes them before playing? Here
we do have evidence from the football world cup. FIFA’s chief medical officer,
Dr Jiri Dorvak, published a paper looking into the use of medication during the
2010 World Cup [3,4].
He asked team physicians to provide them with details of all of the medications
each player took ahead of the games. His study showed that 39% of players took
a painkiller in the 72 hours before every game they played in [4]
and that overall painkiller use was increasing year on year. This study
accounted for the number of players taking prescribed medication; due to the
easy availability of painkillers it is likely that the true number is much
higher.
Dr Dorvak believes that one of the factors that has resulted
in this rise is the increasing pressure put on team doctors by managers and
sponsors to get players fit and healthy again [3]; with the
incredibly high potential earnings of top international players it is also unsurprising
that the players themselves want to make sure they keep hold of the job or shine
in a match that could get them their next big transfer. And who would want to
miss a World Cup Final if at all possible?
Another issue that arose from the study was the likelihood
of further increase in painkiller use in youth teams, with 16-19% of under-17
football players abusing them [3]. Due to
the sometimes severe effects that painkillers (NSAIDs in particular) can have
on the kidneys and liver, it is a worrying sign that consumption at this level
is seen at a young age.
As I say in my book [5],
we have been here before, and not just in football. Peter Elliott won a silver
medal for Britain in the 1988 Olympic 800m; but only after receiving five cortisone
injections in seven days. Hailed by many at the time (including me) as an
example of bravery, some were critical of the methods employed.
It is no doubt that injecting an athlete with a range of
drugs can aid recovery and enable them to compete at an enhanced level than
they would have been able to without the drug. In many cases this is at the
cost of possible future injury or disability. So, as far as the individual
themselves is concerned, this is not much different from risking long-term
health damage by using a banned performance enhancing drug. And we know this is
not a deterrent for many dopers. The difference, if there is one, is that the
level reached is not “superhuman” i.e. it could be reached without doping if
someone could avoid injury.
I think in this area the medical care of an athlete is
paramount. It is surely the responsibility of the athlete’s doctor to advice on
the health benefits or damage of any treatment. This is yet another reason why
advocates of “clean sport” needs to focus as much on coaches and support team
(including medical staff) as the athletes themselves.
[I would like to thank
Jess Pritchard, a student at the University of Leicester in the UK, for doing
some of the original research on this story and writing a preliminary draft.
However, as always all the comments expressed in this blog are my own and not
those of Jess, my publisher or my university].
References
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