Sky - gaming the system?

[citoyen]

Ross Tucker ‏@Scienceofsport
The greatest marginal gain Brailsford identified is the gullibility of so many sheep coming to the sport with poor knowledge of its history
https://twitter.com/Scienceofsport/status/780712008496873472


Ouch!

[mattc]

I don't think these TUEs are within the rules. It looks like another example of official bodies tacitly accepting doping.

It's a borderline case that hinges on whether you accept Wiggins and Brailsford's explanation that he was suffering from a pollen allergy in the build-up to the Tour in 2012 and was legitimately prescribed the drug by a consultant purely for medicinal reasons..

There will always be borderline cases - this is sport! Watch an Olympic sprint relay final. Look at the UCI dimensions-of-bikes rules. etc

You can either accept that, or you can take the oh-so-clever-sceptic role.

[LittleWheelsandBig]

This isn't borderline.

[citoyen]

You can either accept that, or you can take the oh-so-clever-sceptic role.

Those aren't the only two options available.

This isn't borderline.

Hmmm, let me think about this...

Did Wiggins use a known performance-enhancing drug ahead of the 2012 Tour? Yes.

OK, fair enough, I'm with you.

[sojournermike]

Wiggins' case doesn't look marginal, just egregious.

Froome's TUE was for prednisolone, which, based on the research piece I referenced earlier and that Dr Mekon provided anecdotal information on, appears also to performance enhancing. Also for the treatment of severe asthma. I know the shape my daughter needs to be in to get it, and she won't be running or riding a bike.

I've been thinking about how you run a microdosing program for a team and give a boost to the leader who needs to be protected and to perform exceptionally from time to time through a 3 week tour. I think it could be done.

[DrMekon]

Is it right that prednisolone can be used out of competition? If so, what about the training effects of being about to push harder and recover easier?

I was chatting to an anaesthetist and he was saying you could get away with about two years continuous use before the side effects would really screw with you. I keep my use to a minimum because I can't sleep on it, and when I come off, I get all weepy.

[LittleWheelsandBig]

I wondered about the amount of time during the racing season that Sky's GC riders spend training at altitude and out of competition. It is quite difficult to recover sufficiently while maintaining such high intensity training with very low body fat percentages. Blood passport anomalies are excused by altitude effects and cortisone (and similar) isn't tested out of competition.

[Cudzoziemiec]

The possible ramifications of these cases could be worse than the Armstrong case was. Lance was cheating and everyone who knew what he was doing, knew it was illegal. With TUEs people can believe, be convinced or choose to believe that it's all above board; after all, it is legal, unless someone lied on the TUE application, which I haven't actually seen alleged – and if they did, it wouldn't have been the rider competitor (abuse of TUEs obviously isn't exclusive to any one sport). Not marginal or borderline but not straightforward in determining where the abuse happens, since the system is designed to allow it.

[LittleWheelsandBig]

I think TUEs are a reducing problem. The absolute numbers approved by the UCI are dropping noticeably. Are national federations also able to approve TUEs?

Unless something quite odd is being done nowadays, the benefits of performance-enhancing TUEs aren't as great as from blood doping. Still cheating though.

It does seem surprising that cortisone can be used out of competition with virtually no restrictions. Cortisone was stuffing up riders four decades ago.

[Jakob W]

So is the whole marginal gains stuff just a smokescreen? I've just finished James Witts' _The Science of the Tour de France _ (I thought it was pretty good - road.cc review here: http://road.cc/content/review/203921-science-tour-de-france-james-witts ), and his take seems to be that there is an awful lot of effort being spent on nutrition, super-aero kit, altitude training etc for - at the elite level - indeed pretty marginal gains; if anyone's running a doping programme it can only be providing the slightest of edges, unlike EPO.

[bikenrrd]

So is the whole marginal gains stuff just a smokescreen? .... if anyone's running a doping programme it can only be providing the slightest of edges, unlike EPO.

Now read "The Secret Race" by Tyler Hamilton and Daniel Coyle.  The protocol of doping that Lance (and Tyler to some degree) and his doctors developed towards the end of his career could easily still be carried out today and not be detected.  That is (out of competition): microdosing EPO last thing at night - the testers cannot test overnight and the detectability of a small dose of EPO is about 7 hours; small amounts of synthetic testosterone to aid recovery; corticosteroids to aid recovery - not banned OOC, and small blood bags in competition.

The new drugs since then are peptides - like AICAR, which was not banned until 2011.  These aid weightloss without reducing power output as much as a calorie deficit would.

[Karla]

So is the whole marginal gains stuff just a smokescreen? .... if anyone's running a doping programme it can only be providing the slightest of edges, unlike EPO.

Now read "The Secret Race" by Tyler Hamilton and Daniel Coyle.  The protocol of doping that Lance (and Tyler to some degree) and his doctors developed towards the end of his career could easily still be carried out today and not be detected.  That is (out of competition): microdosing EPO last thing at night - the testers cannot test overnight

They can now.

[David Martin]

The TUE is only needed during competition. Asthma can be seasonal. The dosage taken is at the very bottom end of the scale.  Looking at Pubmed for what was known about performance enhancement prior to 2012:
https://www.ncbi.nlm.nih.gov/pubmed/17609220 - no effect on overall performance though some indicators change - 2008.
https://www.ncbi.nlm.nih.gov/pubmed/17614029 - effect on various dietary metabolism parameters but no overall effect on performance - 2008
https://www.ncbi.nlm.nih.gov/pubmed/18048433 - positive effect in recreational athletes - small study - 2008

There are no other relevant studies in pubmed prior to 2012.
It is reasonable to take from this that there are three small studies, together providing only marginal evidence that prednisolone has an effect on performance. I don't know enough exercise physiology to know whether changes seen would be expected to be replicated in elite athletes (though I know someone who might know). Recreational athletes do show a bigger response than elite athletes to specific interventions, so it is entirely reasonable to put forward a case that prednisolone has a minimal performance enhancing effect beyond therapeutic use, and the dose in question is much lower than used in the studies.

Locker room tittle tattle on the effect of drugs is just that, biased and unrepresentative. There does appear to be reasonable grounds for the selection and use of prednisolone as a purely therapeutic agent at that time, though as more data is determined, it may be more appropriate to remove it from the TUE list.

[Hot Flatus]

Whereas what Wiggins had shot into his arse was full lead PED.

[bikenrrd]

It is reasonable to take from this that there are three small studies, together providing only marginal evidence that prednisolone has an effect on performance.
*snip*...
Locker room tittle tattle on the effect of drugs is just that, biased and unrepresentative.

This is very interesting, as it is (almost) impossible to study the effects of doping on elite athletes due to the ethics involved - i.e. you are helping them to cheat.

Instead, you have a setup where a (large) group of riders, and an associated group of "race doctors", are trying to find substances that give them an advantage over the competition.  So, you have a large, uncontrolled experiment with many variables which produces a list of substances that riders can take to give them that advantage.  Or at least lead them to think it gives them an advantage.  Prednisolone is one of those substances.

[Morat]

There is a fair bit of the old Pavlovian dogmatic response to Rule Britannia, going on here.

There are none so blind as those that will not see...

and all Wiggins supporters voted Brexit, but don't like Froome because he's an immigrant.
amirite?

I really don't think your arguments stand up to scrutiny.

[Hot Flatus]

You may think that. I couldn't possibly care comment.

[Henryk531]

Of course  it's handy having a brit as head of the U.C.I. and the I. O. C.




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[TigaSefi]

https://www.linkedin.com/pulse/asthma-medication-cycling-teams-disrespect-riders-all-nick-marshall

Hmmm interesting.....

[Terry72]

Personally, I find it hard to believe that three injections mean Wiggins whole career was a fraud. Could one injection really have lasted for three weeks of the tour?

[Hot Flatus]

Why did he lie about never having injections?

[sojournermike]

Personally, I find it hard to believe that three injections mean Wiggins whole career was a fraud. Could one injection really have lasted for three weeks of the tour?

Yes, the point of giving triamcinolone intramuscularly is that it is effective over a 3 week period, that is as a treatment for severe, uncontrolled chronic asthma of course.

It doesn't mean his whole career is a fraud, but it raises significant doubts. The more so when considered on conjunction with the lies told about 'needles'. A similar discussion is ongoing in the running world about Mo Farah and his inconsistent explanations of how he was photographed Jamaica Adenosine etc, and that before his triamcinolone TUE was revealed.

The trouble is, there is a real stench about elite sport in general amd the governing bodies have such a chequered history they appear part of the problem. The idea of TUE as permitted doping is widespread and not new.

Mw

[Carlosfandango]

I'm asthmatic and use inhalers which are fine in everyday life, but occasionally when exercising I am wheezing like an old steam train with lungs that feel solid and immovable. My exercise is Audax, twiddling along at 20kph. I suspect that if I was a proper athlete I'd have more issues, so hypothetically it's conceivable that I might need intramuscular steroids to compete on a similar level with non asthmatics.

It's difficult to find a way to balance genuine medical need for drugs that may are necessary for a persons medical condition against use for performace enhancement.

Wiggins worked within the system to obtain his medication, he hasn't broken the rules, we don't know how he was suffering at the time, we have his explanation and his Doctors opinion, his hayfever and asthma could have been bad at the time, not ameliorated with inhalers and to be at his peak performance other treatments may have been required, you can't win the TDF at below your best.

Who knows in Wiggins case?

Maybe the system needs to be improved though.

[Hot Flatus]

It's just a coincidence that a bunch of ex-dopers have said that they took the exact same drug, administered in the same way, and at the same time in relation to big races as Wiggins, but for purely performance enhancing purposes.

[David Martin]

It is also for a pollen allergy (allegedly) and pollen is extremely seasonal. Allergies can also be quite species specific.