It’s turning into the never-ending story. What could have been a quick medical matter is turning into an ethical saga that’s now being played out across the British media. The leaked revelation that Bradley Wiggins injected cortisone on the eve of major races shows a grey area where private medical needs meet a history of steroid abuse in sport. This matter should have been cleared up but rumbles on.
As a reminder a hacking group called Fancy Bears published the confidential Therapeutic Use Exemption (TUE) notices belong to many Olympic athletes, it’s alleged this is a diversionary smear tactic in the wake of the widespread doping programme found in Russia and set out in the WADA McLaren report. Among the leaked TUEs were some for Bradley Wiggins and it showed he’d been given permission to inject triamcinolone, often better known as Kenacort.
Kenacort rings alarm bells. This and other cortisone-related medicines have an anti-inflammatory response but they have a performance enhancing effect. It’s been the choice of dopers for decades: Bernard Thevenet said he used it on his way to winning the Tour de France twice in the 1970s, Laurent Fignon admitted to using it in the 1980s, Lance Armstrong should have been banned for using it in the 1990s, the late Philippe Gaumont used it in the 2000s and in UCI’s CIRC report cited its use in this decade. The point here isn’t to name users but to show how far it goes back and for every name cited they were surely hundreds of contemporary Kenacort consumers. So our starting point with this substance has more baggage than the Samsonite factory.
Ever since the leaked TUE Wiggins and Sky have been playing catch-up. Yesterday saw Dave Brailsford make a series of media appearances across various UK channels to convey the procedural message: Wiggins has asthma > a treatment was approved by medics > the UCI issued the paperwork > therefore it was all ok.
“If we think there is anything we can do to help the health of our riders, within the rules, and it’s legitimate”
– Dave Brailsford, The Telegraph 26 September 2016
The procedural “it was within the rules” stance is fine, after all what can be better than complying with the rules? Still there are questions here, for example why is Wiggins 2011 TUE dated in June when his examination by an asthma specialist medic happened in July (eg: did the UCI sign off the paperwork on the assumption the doctor’s screening would be a formality?) and more.
Only meeting the rules is sometimes necessary but not sufficient. As we can see with, say, the tax planning of multinational corporations, compliance with the rules can differ from doing the right thing or satisfying popular opinion by being seen to do the right thing. After all Team Sky are a sports team created to make their parent company look good and right from the start the team said it didn’t just want to race clean, it wanted to demonstrate it:
“The whole point of our team is to try and demonstrate that it is possible to cycle clean and compete at the highest level”
– Dave Brailsford, The Guardian, 2011
This kind of ideal takes us beyond the procedural and the paper trail audit of gaining a TUE. If there was a clear medical justification then what Sky and Wiggins ought to have done is set out demonstrate what led them to agreeing that Kenacort needed to be taken on the eve of some big races; and possibly why they decided against its use at other times of the year or in different seasons. A fanciful demand? Not really, Wiggins’s fellow British track cyclist Callum Skinner has just released his medical records. Sticking to the procedural defence is understandable but this story has become an ethical one.
Tramadol precedent
We’ve been here before with Team Sky when Michael Barry wrote in his autobiography that he used Tramadol, a powerful opioid painkiller. This was embarrassing for Sky and they issued a press release saying they didn’t use it… but in between the lines, the grammar and the tense of the statement mattered as Sky were not prescribing it any more but the implicit admission was that they had before. Tramadol might come with warnings not to drive or operate machinery so its use in a bike race seems wrong on this level, not to mention the idea that if an athlete is in such pain that they need a high strength painkiller just to pedal then they should probably be resting rather than racing. But as it’s not a banned substance using it is within the rules. This doesn’t make its use in competition right though.
Ex post transparency
Another “we’ve been here before” aspect is the sight of Team Sky becoming transparent only once events catch up with them. This time Brailsford is musing about making TUEs public (probably a bad idea but that’s a debate for another day). But it’s often after being embarrassed that the promise of future transparency comes out, be it TUEs, power data or “altitude native” biometric data.
Conclusion
Within the rules? Yes but only if you can prove the clinical need. Wiggins has the paperwork trail from medics and the UCI as Brailsford was keen to point out yesterday. That ticks the procedural box but the story’s not going away as people question whether it was it the right thing to do? Certainly the case for pre-emptive intramuscular injection with Kenacort on the eve of a major competition is open for review at any time and rings alarm bells given so many cyclists have arbitraged the rules to their advantage with this substance; specifically in Wiggins’ case we read in his autobiography that he’d never taken injections only for the leaks to show the contrary and require a clarification from his PR entourage. The slow response and the reliance on the procedural matter – “the UCI cleared it” – doesn’t settle the issue. The casual onlooker – not the pro cycling blog reader – will glance at Sky and Wiggins and think they’re no different to other teams and Tour winners, athletes with their own scandals. That’s presumably just what the Fancy Bears wanted.
Thanks for this, INRNG – must say I’d been waiting on it. Clear and concise as always.
The whole issue about the difference between ethics and rules is a complex minefield and one that all of us traverse everyday in various ways. Context is clearly everything but expectation is also key. However the rules are written, there will be grey areas, if they re-write the rules the grey areas will shift too.
It is suspicious and it is in the rules. TUE ‘s are clearly not being checked carefully or rigorously enough so become a temptation to push the boundaries in order to take substances which are known as performance enhancing (otherwise they wouldn’t be banned). Most medications have alternatives so it should be up to the doctors to provide alternatives and then reasons why these are not suitable and a banned substance required.
Not even sure that the rules are being applied strictly never mind the ethics. The four UCI conditions for approval of a TUE request seem solid but did Wiggins TUE satisfy fully condition b?
“The therapeutic use of the prohibited substance or prohibited method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the rider’s normal state of health following the treatment of the acute or chronic medical condition.”
The widespread opinion seems to be that the treatment could have provided a performance enhancement. If this is the case the TUE, according to UIC rules, should not have been granted.
Good point and this puts the onus on the UCI to explain but I doubt this will ever happen.
These TUE’s also don’t fit condition c:
There is no reasonable Therapeutic alternative to the Use of the Prohibited Substance or Prohibited Method.
Injecting corticosteroids is not something any ‘normal’ doctor would prescribe for asthma/hay fever unless the patient is having a severe attack.
Ask any doctor. I’ve asked a few.
You are right.
UCI have been caught out awarding a TUE without the required criteria being satisfied and where a performance benefit was, at the least, possible.
Sky/Wiggins have been caught out trying to obtain an unfair advantage and no amount of PR can smooth over the harm to reputation.
Interesting that TUE approvals have declined from 239 in 2009 to 13 last year. We could be encouraged though experience indicates that would be very unwise.
Yes, ‘no reasonable Therapeutic alternative’ is the key phrase, but the ‘It was within the rules’ straw will continue to be clutched by some.
It’s only in the rules if you don’t get some shonky doctor to lie for you and then get an equally shonky one to sign it off.
Yes, the fact that they’ve cut down on the obscene number of TUE’s very probably only means that the problem has moved elsewhere.
Can you clarify what dosage Wiggins took, and how this compares to data for performance enhancement?
Wiggins took 40mg. As Motormouth says above, Jaksche said ‘You would get 50 mg injections before the Tour.’
So, pretty similar.
And how much of a PED that is not the drug that any independent doctor would prescribe would be alright?
Search K Collomp, “Short term glucocorticoid intake combined with intense training on performance and hormonal responses”; A Arlettaz, “Effects of short term prednisolone intake during submaximal exercise” and M Duclos, “Glucocorticoids: a doping agent”.
All available prior to 2011 TdF.
I’ll give up now because it really does come down to belief in Wiggins or not. Wiggins’s supporters have gone from ‘Drugs are bad’ to ‘This isn’t a very good PED’ (it is) and ‘No rules were broken’ (they very probably were).
For me, the evidence is there and I’m also cynical enough to believe that if Sky are using corticosteroids in competition with a TUE why would they not be using them out of competition legally – they seem happy to do whatever is legal.
Might explain the massive weight loss and susceptibility to illness that we’ve seen with so many of their riders.
Maybe.
I did see an interesting discourse between two posters on Cycling Tips’ comments, and ‘Neuron1’ quoted 60mg as a study baseline on performance enhancement.
40mg is a third less.
I have no idea of its effects frankly. But I agree that it does not cast Wiggins in a favourable light and it does make Sky look hypocritical.
J Evans;
“I’m also cynical enough to believe that if Sky are using corticosteroids in competition with a TUE why would they not be using them out of competition legally – they seem happy to do whatever is legal.”
Well, it would explain their lack of involvement with the MPCC perhaps.
The decline in TUEs is explained in part by the fact that you no longer need one for an asthma inhaler. A very large proportion of those released by the hackers seem to be for asthma medication in 2009.
“Sky/Wiggins have been caught out trying to obtain an unfair advantage and no amount of PR can smooth over the harm to reputation.”
It’s only unfair if others aren’t doing it. Did anyone else have a TUE for the same substance or similar, around that time? We don’t know yet. Not that I’m defending Wiggins, I’m just questioning use of the term “unfair advantage”. The “everyone else is doing it” defence is invalid, but may go some way as to explaining why Sky did.
“It’s only unfair if others aren’t doing it”
While that sounds nice, it’s just a tiny bit off. And that tiny bit makes all the difference in “fairness”…
It should be:
“It’s unfair is somebody else isn’t doing it” .
One or two other competitors “also doing it” does not make something fair. Only one or two others competitors “not doing it” is needed for it to be unfair.
So, Brad Wiggins, suffers from an asthmatic condition, that regularly occurs, during the peak season (June -August) each year.
Team SKY medical team, follow the TUE rules, and the team, act, to ensure the rider remains healthy.
Much emphasis has been placed upon the need to ensure Brad’s health isn’t compromised.
Wonder why, as an asthmatic, Brad didnt declare his smoking habit ……
http://www.telegraph.co.uk/sport/olympics/cycling/9476594/Bradley-Wiggins-celebrates-Olympic-gold-with-wine-and-cigarette-in-Majorca.html
Im not defending Wiggo or Sky. But complaining that a pro athlete who has just won an Olympic gold has a fag and a drink equals cheating is just the sort of pathetuc asceticism that makes cycling such a joke sport to normal people who prefer to watch rhe aesthetic over the athletic, (I say this as someone with a well known (non cycling) relative whose reasonable TUE has been exposed by Putinbots. )
Personally i accept that all sport is bent,and always has been, seeing as it was only ever given rules to facilitate betting, and i sincerely believe that anyone who doesnt is dim, naive or tragic, or maybe all three.
I think “WC” was inferring that Wiggins, complains of a lifelong chest breathing complaint,
he was prescribed Kenacourt, to ease or improve – the same breathing problem, is actually a smoker.
One photo in how many years? Ha ha. He’s not a smoker. You can tell by the way he holds the cig. Just like me as a teenager trying to be cool around my mates, and being totally unnatural in the way I held a cig and inhaled.
the way he holds it suggests a spliff rather than a cigarette. I can also see that tensed-faced focus of trying to keep smoke in lungs for as long as possible
“The casual onlooker – not the pro cycling blog reader – will glance at Sky and Wiggins and think they’re no different to other teams and Tour winners, athletes with their own scandals. That’s presumably just what the Fancy Bears wanted.”
Yes and no.
For and athlete, whether or not they are are breaking the rules, they are using drugs that will boost their performance either way.
That said, abusing sports by a state-sponsored doping programmes that includes secret switching of analytical samples by secret services, in order to push a clear political agenda, is something else and a half.
Agreed that of course what Wiggins did sounds very questionable, but it is still nothing compared to what Russia was doing. It feels very clear that Wiggins was not riding on bread and water, but the Russian athletes were on another level entirely in terms of doping.
The interesting thing for me is not so much the ethics of this particular treatment (I can see it making sense to take anti-allergy medication just before a 3 week race in France in July – if less so before one in Italy in May), or the nature of Wiggins’ response (what else would he say), but the tone-deafness of the Sky response. Sure, they’re entitled to view “clean” as “within the rules”, and that’s a step above the traditional cycling culture of translating “clean” as “not been caught”. But having held themselves out as representing a different approach, and trading on the *image* of that, it beggars belief that they can’t see that this *looks* bad.
I had thought that they were just hanging Wiggins out to dry, but perhaps they just can’t deal with criticism.
It looks bad because it is. I’m not sure there is any PR smoothing/message controlling that they can do here.
Froome is already trying to distance himself…athletes need to take responsibilty for themselves…. TUEs need sorting out… etc etc…
maybe, just as the track team got on fine without Sutton, it’s time for life without Brailsford…
Whether it is bad or not depends on the extent to which the Doctor and UCI satisfied themselves of the genuine medical need for the prescription, something we can’t know at this stage. But either way it looks bad, and it’s bizarre that Sky don’t see that.
+1 Cheating is one thing, hypocrisy another. SKY might be OK on the former but the latter not so much. “Team Sky becoming transparent only once events catch up with them.” sums it up well.
“Cheating is one thing, hypocrisy another.”
And, on balance and in general, I’ll take the latter over the former.
Take someone who pretends to be 100% good and is, in reality, 80%. Take someone else who says nothing at all, expresses no ethical opinion either way, and is, in reality, 50%. Which is better? Which is worse? And why?
Janus – the second person who is 50% good is actually guilty of hypocrisy by omission, and therefore is the exact same as the first in terms of hypocrisy.
As a pro cycling fan for some time now I am glad that this is the biggest ‘doping’ story we have had in a while.
If LA was the high point (or low point) of doping in pro cycling I think we have come a long way in a short period of time. Sky may be pushing the rules to the very limit on this one, but its not i the same universe as before. I see this story as a progression!
That’s a very good point
Agreed. Great point Goldy
Agreed that this entire story shows that cycling and sport has turned a corner.
For one moment forget the fact that a) the public feels corticoids use is cheating, regardless of b) WADA’s rules allowing for it out of competition and c) assuming that Team Sky really isn’t doing anything beyond what we all suspect (that is they aren’t using any specifically banned substances).
We have a situation where the top teams are apparently working within the framework of the rules to prepare their riders. Team Sky appears not to be outdoing the testers, but is following the rules to the letter. If this really is the case, then our anti-doping system is working exactly as planned, and the next step is to continually reassess what the framework should say.
If the above is true, then I agree that cycling (and sport) indeed has made a huge step forward!
However, if Team Sky is really using this system and the TUE’s to cover-up other doping, then we’re all screwed, haha.
The sceptic in me wonders whether this is because there are less people cheating? more undetectable methods being used? or simply the “pro’s” have brought professionalism into the world of doping as part of the everyday life as a pro. I’m suggesting the latter fits Team SKY, because beyond all the – team issue pillows, and other trivial marginal gains, some serious planning goes on for every race in the season. It surely can’t be a coincidence that Wiggo was abusing the TUE system to get to some corticosteroids right before his biggest goals of the season. I wouldn’t say it’s surprising to anyone to learn that SKY were bending rules putting Wiggins in the yellow jersey, on what was a superbly bias route. But just shows how easy it is for teams to excel in PR spin, and hide behind the facade of it all…
No cycling teams ever brought their own pillows to races before Sky. No cycling teams ever used turbo-trainers to warm-up or warm-down before/after races before Sky (seriously, use Google Images and the advanced search to restrict the time; absolutely no photos at all). No cycling teams were obsessive about rider weight before Sky, measuring rider weights every day and before and after races to check for dehydration – look how fat they were prior to 2011! (Oh wait, they never measured Froome’s weight regularly, did they?).
I fail to see why everybody is becoming so exercised over this matter, it is after all legal and above board.
Except of course the hypocrisy at SKY, which this matter illustrates only too well.
TUEs need a serious revisit. I personally don’t see the need for their existence at all. Not well – don’t race.
I think thats a good starting point, certainly you shouldn’t be able to use corticosteroids in competition.
But the WADA list of suspect substances is pretty long, I think the NovoNordisk team of riders with diabetes each need a TUE for just insulin.
“I think thats a good starting point, certainly you shouldn’t be able to use corticosteroids in competition.”
They should be monitored more closely all over, in and out of competition – something the MPCC were implementing, if we remember the withdrawls from it due to low cortisol levels and the like.
Perhaps someone can clarify something. It is repeatedly said that Wiggins acted “within the rules.” But, surely, it can’t be “within the rules” to fabricate or exaggerate a medical condition in order to obtain a TUE. Isn’t that the reason why people are questioning Wiggins’s actions? Otherwise, the rules need to be rewritten. This should be viewed as a rules issue and not just an ethical issue.
Anyways, I need to go back and review Sky’s budget to see what they spent on PR. No matter the amount, they got ripped off. Terrible response by Brailsford and Wiggins.
The issue is – what was the real reason Wiggins needed the corticosteroids, and why didn’t he just get an inhaler.
In the past, a TUE would be used to mask the existence of other corticosteroids in the rider’s PED samples. Riders would use corticosteroids out of competition (which is not banned) for a variety of reasons, and are afraid that they’d still test positive during the race, so they fake/exaggerate some symptoms, and then they are in theory covered in case a PED test comes up positive.
I’m not saying this is what Wiggins did, but this is what he is being suspected of doing.
Absolutely correct Rich. If Wiggins took drugs that are too heavy for the condition (he managed just fine on inhalers before he joined Sky, and also after he left Sky), offer a clear performance enhancing effect (which several studies prove), or preventative (meaning, there was no acute need) he did break the rules. Everybody saying “it was all within the rules” is basically just speculating. Add to that the fact that the Giro is not even ridden in pollen season, and the type of grass pollen Wiggins is said to be allergic to (Timothy Grass) does not grow in the Mediterranean… And the fact that the mandated three doctor panel never met… And the “within the rules” argumentation becomes quite weak here.
The fact that the rules leave the possibility open to use certain drugs *under a very strict combination of demands*, does not mean that everybody who does it plays nicely within the rules. Maybe we can compare to the “self defence” rules of law: Yes, if somebody physically attacks you in the streets trying to take your wallet, then you’re allowed to defend yourself and use appropriate force in doing so. But that does not mean you can just go around hitting people in the face when it suits you, saying you wanted to “prevent” them from taking your wallet. You’re only allowed to use force after being physically attacked first, with appropriate force in response, you’re still not allowed to take the attackers wallet, you have to stop when the threat is gone, etc etc etc. You can’t say “I’m allowed to use force within the rule of law, so I’m allowed to do so always.” The intricate details of an event like this do actually count.
Whilst absolutely nothing to do with this article I’d just point out that you do not have to wait to take a beating before you can defend yourself. If you have the honestly held belief that you are in danger of death/serious injury, or somebody else is, then you can strike the first blow. There are a couple of bits of case law on this, one particularly famous one where a Police Officer shot and killed a protester with a baton gun who was about to smack a fellow Police Officer over the head with a metal bar.
See attached article on Timothy Grass –
http://www.phadia.com/Products/Allergy-testing-products/ImmunoCAP-Allergen-Information/Grass-Pollens/Allergens/Timothy-grass/
“Timothy grass is a very prevalent aeroallergen in Mediterranean countries, including Spain…”
Basically, some prat on Twitter probably has looked on Wikipedia and read “oh, Timothy grasses don’t grow in Mediterranean countries” and it’s been re-tweeted ad nauseum.
It took me all of two minutes to find the above.
It’s really getting ridiculous. Posters have mentioned bias, and this is what is happening. Bias on both sides of the fence are just trolling out crap that none of us have the foggiest about. We’re all suddenly doctors / sports scientists / horticulturists etc etc etc.
Hopefully there’s an article on Il Lombardia about to get pollenated in the meadow that is Inner Ring!
Timothy – Phleum pratense – and other grasses in the genus Phleum grow in Italy as natives and exotics and are also deliberately sown as pasture grasses.
If you’re going to make a stand on “facts” and accuse everybody else of speculating the least you could do is make sure of your “facts”.
Details count 🙂
Now the Sam Allardyce (England football manager) story has broken the UK media’s outrage will be directed elsewhere for a while.
I think the biggest surprise for me to come out of TUE leaks is how few there are, when certain athletes were rumoured to have enough to fill Dr Finlay’s casebook.
It seems they only have the details of Olympic medallists.
Does the dosage of Kenacort /Triamcinolone that Wiggins was prescribed compare with what might be expected to ease symptoms, or on the other hand to aid performance? How might the dose compare to what Armstrong /Millar et al were using? Does the real performance benefit come when used in conjunction with other drugs in a cocktail. I’d be interested to know the answers to these questions too
I’m not sure, but I agree that these are really important questions. Please someone with a scientific background help us out!
I believe I saw more than one quote from a rider saying the dosage was same/similar, for example Jaksche stated:
““It was always the same procedure [to get the drug]. You would apply for a TUE, telling WADA that you had hay fever. Your team doctor would tell them you were having certain problems like [watering] eyes, blah blah blah. You would get 50 mg injections before the Tour. It was an old and traditional way of doping.”
http://cyclingtips.com/2016/09/jaksche-on-skys-tue-controversy-we-used-the-same-excuse-in-my-era/
From one of the references doctors use:
Inflammatory/allergic conditions/other steroid-responsive systemic conditions: Acetonide (Kenalog-40): IM: Initial: 60 mg; adjust dose to a range of 40 to 80 mg. For patients with hay fever or pollen asthma who are not responding to pollen administration and other conventional therapy, a single injection of 40 mg to 100 mg per season may be given.
As a physician I’ll say that it’s pretty unusual to treat hay fever with an injection without first relying on other medications such as oral/inhaled. The 40mg dose is a fair one to treat hay fever though I haven’t read the literature on what dose provides PE benefits. I believe the explanation above of using the substances out of competition and later getting a TUE in the interest of not getting popped if you are caught is a salient one though just conjecture. Clearly those involved aren’t going to fess up to what actually happened.
The underlying issue through most of the doping scandals has been complicity by “doctors” who actively (injecting riders) or passively (approve questionable TUE’s) aid the doping regime. Dr. Ferrari has been exposed, but there needs to be more heat on the medical profession to stop other doctors from going along with the charade.
Fancy Bears – who are believed to work for the KGB – must be laughing at their success in obscuring the Russian problems. Am I the only cycling fan that remembers BW repeatedly complaining from 2005 onwards, long before he tried riding for go, about how his allergies were always a problem in July but that when he rode for French teams he couldn’t get anything prescribed that fixed the problem. I also feel like the only one who knows TUE’s specify the dose and that the controls do check the levels present against the prescription and administration date. When assessing the Tue applications UKAD require evidence of the condition,that alternates have been exhausted, and that the dosage is no more than required therapeutically and is too low to be performance enhancing. Sky’s team doctor is a crash trauma specialist, the Tue wont have come from him, instead almost certainly coming from (as DB has stated) an external ENT consultant, and cross checked with a 2nd expert opinion. The date inconsistency on BW’s TUE that you mention, Inrng, will almost certainly be because the consultant had to be asked for further evidence/reasoning as a part of getting the Tue approved by UKAD’s independent (which they are in the uk at least) TUE assessment panel.
Thank you – great response, and I wish others had picked up on these points. Not even Wiggo himself discussed this.
Fancy Bears really missed the boat though, they’re trying to put the blame on others, but really Russia did more to dope their athletes than even Lance Dopestrong and all athletes in the 80’s/90’s combined. My Russian friend messaged me before the first Fancy Bears stuff came out bragging that the world’s greatest doping fraud was about to be told to the public. It was funny when all that Fancy Bears had was a batch of TUEs…
It is the tip of the iceberg. What can you get through legally? A significant amount it seems. But it does reveal the hypocrisy within sport. What level of doping is acceptable? The hypocritical element was far more easily revealed with Lizzie Armitstead evading a ban despite being caught contravening the rules, while the Russians just got banned because of evidence provided (not for failing a test note).
Note: all this shows is that athletes are willing to try anything and any means. It doesn’t tell us all that they are taking.
Totally agree with Ben. And medical records are private. But on reflection, perhaps an ‘off the cuff’ voluntary disclosure by BW at the time would have avoided all this. If the allergy problem was pre-existing and well known, why be silent about the solution?
What is not explained is why he needed a TUE for the Giro. The Giro does not occur in the allergy season.
How come everybody is suddenly an allergy expert?
“The Giro does not occur in the allergy season.”
Really?
Tell that to Giacomo Nizzolo; tell it to Dan Martin; tell it to Eros Capecchi; tell it to Vincenzo Nibali. All of these guys have gone on record in recent seasons about being affected by allergy problems in the spring and at the Giro.
Not grass pollen.
Another anonymous allergy expert! This is fun.
Please share your medical expertise, your extensive botanical knowledge of plant distribution and flowering times, and your intimate knowledge of the specific allergies for each and every one of those riders.
You entertainment expert can’t read pollen calendars?
kgb ceased to exist in 1991 with the collapse of the soviet union
Don’t destroy their still stuck in cold war world view!
As a general rule: one instance of doping does not distract from another; and one instance of doping should not be ignored in favour of another.
Dave Smith’s article sums it all up pretty well, as does – surprisingly – cyclingnews’s collection of questions.
This has got to the stage now that everyone who is not terminally biased knows what went on.
‘Within the rules? Yes but only if you can prove the clinical need.’
The clinical need is the problem:
UK NHS guidelines for the treatment of asthma and allergies: “injected preparations are not recommended unless under exceptional circumstances” and “compared with other available treatments, the risk benefit profile for the intramuscular corticosteroids is poor.”
Australian therapeutic guidelines:
“Intramuscular corticosteroids are not indicated for asthma control, particularly without a background in acute and severe exacerbations of asthma manifesting with significant airflow limitation and requiring hospital treatment.”
Neither of those really apply to a guy who was winning the Dauphine a two weeks previously.
Sky have been shown to be ‘no different to other teams and Tour winners, athletes with their own scandals’.
This shouldn’t just go away. As with Armstrong, only when you catch the big boys at it is anything done.
And without all this, nothing was being done about TUE’s, out of competition corticosteroids or other drugs.
+1. ‘Within the rules’. I remember watching a Brailsford interview in Sky’s early days. He was being pressed on the ‘clean TDF in 5 years’ goal, how would he do it, what techniques did Sky use, how would they beat everone etc. After a while he started to lose his patience slightly and said “if it’s legal, we’ll do it”. And lo, they did.
Part of ‘marginal gains’ involved reading and re-reading the rule books. Finding loopholes. Hopefully now, there’ll be some re-writing of the rules. We can’t keep revisiting various murky aspects without seeking to learn and change the sport.
exactly, its long been clear reading between the lines that sky’s definition of “clean” is anything they can get away with. if they had actually been upfront and said that i would have some understanding but instead they postured about it and claimed to be above it all so now they should be held to the standards they claimed to be setting.
most of all though, this highlights that the TUE system needs an overhaul which is WADA’s responsibility
I’m not really in a position to second guess the doctors who apparently examined Wiggins at the time, but either way wouldn’t hold too much store by this phrase “not recommended unless under exceptional circumstances”. In the context of those guidelines – applicable to an entire population – taking part in a 3 week bike race could well be seen as exceptional.
It means medical circumstances, not how you choose to spend your time.
A 3-week bike race can have an exceptional physical affect on a person’s health and medical condition.
But you don’t have to do it. And if you can’t do it, that’s just how it is.
That’s part of the sport. It’s the same for everyone. Except for those on PEDs.
Joop Zoetemelk responding to claims that he only won the 1980 TdF because Hinault dropped out: “Surely winning the Tour de France is a question of health and robustness. If Hinault doesn’t have that health and robustness and I have, that makes me a valid winner.”
Plus Wiggins took those drugs before the effects of the three week race – and he came third without them in 2009 (riding for Slipstream).
Are you quoting Joop Zoetemelk who tested positive 3-times for blood doping but was never punished because it wasn’t considered that big of a deal back then?
Haha, I’m sorry J Evans, but quoting a pretty prolific doper in this scenario is a little ridiculous.
Of course Joop was robust! He was using his own blood to regenerate his depleted immune and other systems! But, corticoids are bad.
Haha! Fair point, well made.
I think my points still stand – I just didn’t choose the best guy to illustrate those points.
Zoetemelk was positive for Pemolin ( astimulant) in 1977 though I have seen a comment that it was not actually banned at the time, in 1979 for “hormones” whatever that means, and in 1983 for nandrolone, which if memory serves me right was the steroid that Ben Johnson got busteed for in 1988. No mention of blood doping.
1976 Zoetemelk admitted to blood doping on a tv interview immediately after winning stage 10. It wasn’t illegal in 1976, so technically not illegal.
Even if he stopped blood doping after 1976, the drugs that gelato4bahamontes quoted are a lot stronger than tylenol! So… yes he might not have blood doped after 1976, but the stuff you say he actually did is really bad in terms of doping. Same thing… thanks for clarifying though.
But, regardless of Joop’s treatments, J Evans’s basic point is still standing, and by failing to address it, you are acknowledging he’s right: if your organism is not robust enough to go through the 3 weeks without treatment, then that’s it, you have lost the race, by faling to comply with the basic requirement of physical robustness. It’s a fitness test, you know?
Thanks Ferdi – it was a funny moment.
I wasn’t aware that cycling was a fitness test…. i thought it was a religious experience.
Intersting tactic here, CA:
Zoetemelk cannot be taken seriously, because he is “a pretty prolific doper”, even though the PEDs he used were well within the rules.
Wiggins, who basically also used PEDs within the rules, needs to be defended because “A 3-week bike race can have an exceptional physical affect on a person’s health and medical condition.”
You can either take both men seriously and defend their right to do whatever it takes to win within the rules, or condemn both men for getting an unfair advantage even if it was within the rules. You can’t pick and chose.
You’ll say “but it’s not the same”. And you’re right: It isn’t. At least Joop had the guts to admit exactly what he did, and that he did it to win.
Ebbe – I WAS KIDDING with J Evans.. geez. It wasn’t a tactic and I wasn’t agreeing to anything Ferdi.
All I was doing was pointing out the irony that J Evans used a doper to defend an anti-doping stance… that was all. It was funny. Get over it. Well, I should ignore these comments but, well, next time I will.
I’d be surprised if a patient’s behaviour wasn’t among the circumstances considered by his doctor.
All those riders in the peloton with asthma/allergies and only one received this drug.
And a rider who was on top form.
This is a reply to the post from Anonymous: ‘All those riders in the peloton with asthma/allergies and only one received this drug’
How do you know this? Several riders who competed in Rio, had their files hacked, and their TUE records made public. Several. Selective is the word. Selective.
Also you actually have no idea who was prescribed this drug OOC as OOC doesnt need a TUE.
Yet you have made this statement ‘All those riders in the peloton with asthma/allergies and only one received this drug’
Does not compute.
Team Novo Nordisk riders choose to spend their time racing bikes. They don’t have to do it.
They all need a TUE for insulin. They can’t do it without insulin. That’s how it is.
Ban TUEs and Team Novo Nordisk folds. That’s part of the sport. It’s the same for everyone.
Happy now?
Not sure why you’ve replied to me (apologies if you didn’t – but you seem to have.)
Personally, I wouldn’t ban all TUE’s – primarily for the reason you give.
I’d have them all being public – for the reasons others have put here (embarrassment or medical confidentiality don’t count: you don’t have to have a TUE – it’s a voluntary thing – so if you want it to be a secret, you keep it a secret and don’t race; plus no medical condition is anything to be ashamed of and that shouldn’t be perpetuated).
Then, I’d have all TUE’s only granted by a group of doctors totally unrelated to the UCI or any other party who have a role in cycling or any other sport.
And I’d ban some drugs altogether – e.g. corticosteroids. A tiny number of genuinely ill people might not be able to race, but frankly if you need those you’re too ill to race.
In actuality, diabetics would be one of very, very few justifiable TUE’s and I can see why people call for a complete ban of them: it would be simpler and most of them are probably not justified.
@J Evans
“embarrassment or medical confidentiality don’t count … no medical condition is anything to be ashamed of and that shouldn’t be perpetuated” is all very well as a prop to an argument on an internet forum.
But it’s so far divorced from the real world that its serious espousal beggars belief. You’ve got absolutely no chance of getting that to fly.
You say in another post – “Ask any doctor. I’ve asked a few.” Ask them about your views on medical confidentiality while you’re at it. They’ll treat them with contempt. And rightly so.
TUE’s are voluntary. You want medical confidentiality, you have the treatment and don’t race. Only by CHOOSING to race do you CHOOSE to give that confidentiality up.
As a long time supporter of Sky and Wiggins I’m appalled. A pro cycling blog reader who has read the details knows that the 2012 win should have an asterisk beside it. Wiggins and Brailsford should be ashamed of themselves.
Why the need for the asterisk? Sky/Wiggins didn’t break the rules. Sure, the ethical issues, and whether the rules are good enough, can and will be discussed for some time, but that’s a different matter
And if you asterisk 2012’s result, then you might as well asterisk nearly other post-war win. How many were *only* won on “pain et l’eau”?
Actually, it probably is easier to asterisk the ones where chemical assistance was within the rules than without, so perhaps NXB’s suggestion has merit?
Sign my Get rid of Carlton Kirby petition and we might finally stop this man from ruining our viewing. I will send it to Eurosport.
http://www.ipetitions.com/petition/get-rid-of-carlton-kirby
Depending on how Eurosport respond, you may be forced to invoke the nuclear option: deploy the Mute button.
This is the kind of improvement of our sport i can wholeheartedly support.
Be careful what you wish for : they may replace Kirby with Hugh Porter !
Kirby during today’s Milano-Torino: he was talking about the 1949 plane crash that killed the entire Torino football team amongst 31 people.
He then seamlessly moved on saying ‘So, Peter Kennaugh happier times for him? Well, not as disastrous, clearly’.
That alone would be reason to sign the petition, even if you’ve never heard of the man.
Wow – I’m not very familiar with Kirby but what a ridiculous comment to make.
remember back before the TdF I was asking where can we see the TUEs ? Inrng pointed out that we can’t.
Wiggins is a fraud… yeah asthma and allergies, I want to be a bicycle racer, wrong choice asshole…same for the exercise induced asthma gang… fk off…
As one who first raced in 1958 and recently had to stop because of EIBS I suggest you take your own advice
Excercised Induced Bull Sh*t?
Sorry.
Accepted
Difficult times for Wiggins and sky.
I remember a Christophe bassons interview from a couple of years back where he suggested that the wrong lessons were learnt from Puerto and Armstrong… That although some select drugs were agreed of limits, the win at all costs mentality (I think he even mentioned the marginal gains mantra) had remained and as a result teams will still look for every edge and inevitably cross lines.
This will sting a bit for British cycling fans, but ultimately they’ll learn to accept it. Hopefully it won’t affect the massive growth that we’ve seen in the sport over here in the last few years.
Worth noting that none of Wiggins’s three TUE’s for triamcinolone mention asthma – only grass pollen allergy.
This again raises the question of why he would need this for May in Italy.
Is that why Wiggins/Sky have brought asthma into the equation after the fact?
Allergic asthma?
And pollen counts in Naples in May can be high –
https://www.goodtogoinsurance.com/holidays-abroad-during-the-hayfever-season
Not grass pollen. The pollen season isn’t two months apart between Italy and France.
And isn’t all this besides the point? This is not a treatment for normal hay fever or asthma. You take anti-histamines and beta-agonist inhalers. Then you might take corticosteroid inhalers. If you’re really bad you might thake coritcosteroid pills. Injections are for ‘acute and severe exacerbations of asthma manifesting with significant airflow limitation and requiring hospital treatment’ (NHS). They’re not for people who have just won a 7-day bike race up mountains.
Yeah but if everything you had worked towards for the last couple of years, your dream and your life defining moment was on the line would you go with something that might work or something that you know will work even if it’s a bit over the top and unnecessary? People are getting carried away here. He had one injection before the race, when Fignon, Thevenet et al were using they were probably getting an injection before every race and whilst training. To cheat first you have to break the rules, he didn’t.
I tend to agree with this rationale.
Wiggins’ had maybe a two year window to realistically win a GT and he did what he did.
It’s not like going to work with the sneezes etc. Making comparisons to ‘normal’ situations doesn’t apply in this case.
But I’m going to pack it in now too, people can make their own minds up.
He had one medically unnecessary (against the rules?) injection of a drug that would have a performance-enhancing effect (against the rules? – see DJW’s post) in 2011 – this was granted before the medical examination (is that in the rules?). He had another in 2012 – this was based on a medical examination 6 weeks previously (so why the wait – is that in the rules?). He had another in 2013 – for the same allergy despite this being two months earlier and thus outside the grass pollen season.
These are facts.
All of these TUE’s would have allowed him to mirco-dose during the races. That is speculation.
What we also don’t know is whether or not he was also using corticosteroids out of competition (his weight change was about 30lb between track rider and GT rider).
This is also true of every other rider. And that is the much bigger picture.
I for one find it very hard to believe that many riders and teams are not using this PED out of competition.
According to recent documentaries and research you can micro dose EPO and not get caught without the need to resort to steroids. So on that basis, because we don’t have any proof that they aren’t micro dosing, are we accusing the entire peloton of this? Also you’ve said ‘what we don’t know is if he was using corticosteroids out of competition’, which strikes me as a bit of classic 2 + 2 equals 5 conclusion jumping to me. We don’t know if he was dealing them to his mates back in Lancashire either, are we accusing him of that too? You’ve mentioned ‘is that in the rules?’ 3 times as well. The fact that he hasn’t been pulled for it would suggest it was, unless you know that he is paying off the UCI to cover things up for him? Maybe, just maybe, he didn’t want to suffer from hay fever/asthma during a 3 week stage race when he was going to be highly dependent on his respiratory system for achieving success. We wouldn’t be prescribed it if we went to our doctors this morning, but we aren’t professional athletes desperate to win something and being reliant on our ability to breath to do so. The drug in question is performance enhancing, but it is allowed with an exemption, and he had the exemption. On that basis he’s no worse than anyone dropping a double espresso and paracaetomol before they head off on their local 10, or before the last 25km of a monument.
I’m no horticulturalist but I know the growing season for plants is longer in the northern hemisphere the further south you go, so I’m willing to believe you can suffer from hay fever in a Mediterranean country in May. Maybe not on the way up the Stelvio but possibly in the south.
On top of what I’ve said above (and elsewhere), he won the Dauphine in 2011 and 2012, and competed in the Giro del Trentino in 2013.
He was beating the best riders in the world up mountains in June 2011 and 2012 with breathing difficulties?
(And in 2012, the TUE was based on a medical examination from mid-May – so he supposedly had those same difficulties before the Dauphine.)
On each occasion, two or three weeks later he was given a drug that should only be prescribed if breathing difficulties are so severe that you need to be hospitalised.
After these facts, it comes down to if you believe that his allergy suddenly became bad enough to warrant this PED or if you believe that he took them for the performance-enhancing effects.
Whichever of those one believes – and whether or not he broke the rules – he still gained the performance-enhancing effects of those drugs.
(I did say that the other things I mentioned after the facts were ‘speculation’ and ‘don’t know’s.)
I thought the weight loss was part of a careful calorie controlled diet! ha ha if Wiggo was Russian he would have been hung drawn and quartered by now! The Andrew Marr interview was pitiful, “so Dave what can we get away with so nothing spoils July” Yes the casual observer thinks exactly that those skinny buggers are all at it, always have been.
Please, if he was Russian it wouldn’t have been revealed.
Anyway, Fuglsang had a TUE for the same substance. I can’t read Danish, but are their press going over him to the same degree?
Fuglsang’s TUE is quite different, as I suppose you know.
However, I’ve seen that a lot of British athletes from several sports are involved. I didn’t check their TUEs, but I wonder if anyone deserved the same attention.
Most of the other Brits revealed so far are from sports without the same public association with doping that cycling has. So as the majority of early releases by the hackers all seemed to be TUEs for asthma and other conditions, I think the press got a bit bored.
There was a brief flurry of interest when Mo Farah’s details were revealed (given that athletics is another such sport, and he’s been accused before) but it soon transpired that they were consistent with some of his previous statements (like Froome). So Wiggins has been the only real story here. (Until the football manager stuff broke.)
Caffeine is a known performance enhancer, and it’s not illegal.
Beetroot juice is a probable performance enhancer, and it’s not illegal.
Good night’s sleep also enhances performance. Should comfortable hotels and mattresses be banned as “unethical”?
What Wiggins did is within the rules.
Are all the above “gray” or “borderline unethical”? If they all enhance performance, why or why not is one unethical and the others not?
Caffiene is allowed within limits actually, so thats not totally accurate.
They banned the Sky camper (and any others) as an unfair sporting advantage, didn’t they, so that is also not totally accurate.
And finally what Wiggins took is not actually legal in competition, excepting with an exception (the e in ‘TUE’), so he in fact took a banned substance but got a doctor’s note to be technically compliant (need we look at who was approving these), so that is also not totally accurate.
Does that answer your question?
“Caffeine is allowed within limits actually” – wrong. TomH is totally accurate.
You can take as much caffeine as you like. It’s not on the 2016 WADA Prohibited List. It is on the 2016 WADA Monitoring Program.
I’m not sure comfortable beds are unethical…
But yes, it was within the rules, that isn’t in doubt. What is in doubt is why Sky are happy to do everything that is just within the rules.
As a friend of an ex Sky rider (don’t want to name him) they would do anything and everything they could that was legal. In some ways I applaud them for this, this is their profession and each gain, however small, should be sought out and achieved.
In fact, it’s not so clear cut “within the rules” as many people would like it to be.
Was this (quite heavy) drug really the only option, or could he have survived just fine on inhalers as he did before and after Sky? We don’t know, but many doctors have commented on these drugs being a “last resort”, and not advised by NHS because of it’s harmfull and quite risky side-effects.
Did they try other options first? We don’t know
Was there an acute need, or was it preventative? It was preventative in at least one case, and therefore illegal. To be completely within the rules, they should have given him an inhaler as a preventative measure, and only do the injections if he would go on to have (severe) attacks. Severe enough to take him out of the race alltogether. That, by the way, is the official NHS recommendation as well
Does the type of grass Wiggins is allergic to (the pollen of Timothy grass) actually grow in southern France and Italy? No it doesn’t. And were all TUEs only grantend in pollen season? No.
Does the drug offer performance enhancing gains next to treating the symptoms of a condition? Yes, it absolutely does! Unlike coffee by the way which also offers some performance benefits, but is not a drug in the sense that it’s a treatment for any medical condition. Coffee is on the doping list, but is allowed (not on the *banned* doping list) because it has no/little risky side-effects. Coffee is being monitored for just how performance enhancing and risky it is buy the way, since athletes in various sports have taken up highly concentrated caffeine pills/shots/gels lately.
Did a panel of three independent doctors meet before the TUE was granted? No. The TUEs were signed off by one doctor, a shady one to boot. And that was done after the TUE had already been granted.
So “it was within the rules” is in fact very much in doubt. I’m not claiming it was all against the rules either, since there may be good explanations for all of the above. … But as things currently stand, there are some serious doubts and inconsistencies, which still have not been properly addressed by either Wiggins or Sky.
What ethical and what’s permitted by the rules (anti-doping or otherwise) are not mutually overlapping sets. The former is defined for us by WADA, the latter is somewhat subjective and is context specific. Hence the problem in discussions/debates like this.
I have a diagram I use to help make the distinctions between permitted, laws and ethical considerations. e.g. what’s ethical for the same substance can be different depending on the circumstance (e.g. consider what supplement is reasonable for an elite pro vs what one might suggest for a junior)
Here’s the diagram:
http://i220.photobucket.com/albums/dd226/ASimmons/8c2849ce-2bd8-4955-80bc-d56f6260561e_zpsc2bb9e13.jpg
I think the main difference being that the substance taken was illegal, not that it was performance enhancing per se. So your example would be valid if caffeine was illegal, but Wiggins would have taken a TUE to have an espresso.
Beetroot juice and the nitrates it is a good source of are a part of food. There is no practical way to ban or limit food.
Caffeine is deeply embedded culturally across many parts of the world. Similarly difficult to ban – was attempted – but is monitored.
Bit different from injections of strong corticosteroids that you only get from a pharmacy with a doctor’s prescription.
Well said INRNG. I agree that making TUEs public is not a simple matter or necessarily the right approach. Like it or not these are medical records and such information must be treated with due care. Full or even partial disclosure of some TUE types is IMO problematic.
Consider that TUEs can cover the following conditions and tell me if you think it’s reasonable for such things to be made public without informed consent:
ADHD (Attention Deficit Hyperactivity Disorder) in Children And Adults
Adrenal Insufficiency
Anaphylaxis
Androgen Deficiency-Male Hypogonadism
Asthma
Cardiovascular Conditions: The Therapeutic Use of Beta-blockers in Athletes
Diabetes Mellitus
Female to Male Transsexual Athletes
Growth Hormone Deficiency in Adults
Growth Hormone Deficiency in Children and Adolescents
Infertility/Polycystic Ovarian Syndrome
Inflammatory Bowel Disease
Intravenous Infusion
Intrinsic Sleep Disorders
Musculoskeletal Conditions
Neuropathic Pain
Post Infectious Cough
Renal Transplantation
Sinusitis/Rhinosinusitis
At least we now know why Team Sky refused to join the MPCC.
How long did you have to sit on this article so that you could use that headline? 🙂
If this is what doping scandals are going to look like from now on, I’ll take it. This is more a problem for the SKY PR machine than for cycling.
Wiggins’ talk of levelling the playing field is such tripe. Wiggins said he did it so he could compete on an equal level. What is that?
I am a small guy with small legs so does that mean I can also get on steroids and take EPO or whatever so that I can also “level the playing field” and compete with the strong boys like Sagan et. al.?
This is cheating pure and simple. He’s just as a bad as Armstrong IMO. Same intent. Same excuses. Same coverup. Thanks for showing us cycling is still so fraudulent Sir Wiggo.
Agree there totally JohnB, what the hell does “compete equally with the others mean”? If things are going to be equal, lets have bikes that are exactly a percentage of their body weight. Why should a little guy have the same weight of bike as a big guy!
A legal and UCI approved, if slightly over the top, treatment for an existing and known condition is not the same as taking the same steroid (without a medical condition to justify it), Human Growth Hormone, EPO, Testosterone, blood transfusions and whatever else as prescribed and monitored by an infamous Doctor who has spent his working life researching and implementing pharmaceutically enhanced training programmes for cyclists. That’s before we get on to the cover ups and bullying.
‘slightly over the top’?
‘UCI approved’ – by Zorzoli.
Richard S…this just begs the question: What is a “medical condition?”
Athletes have to compete NATURALLY as they are, in order for sport to be fair.
I mean, if one medical condition is “I have allergies” and another is “I have low blood-cell counts” and another is “I have genetically small legs” then why can the allergies guy take corticosteroids legally, but the other guys cannot take EPO or muscle-building steroids legally?
The point is: the only level playing field is the natural body itself.
In cycling we test, is my body/mind better than yours?
This test is only fair if NO DRUGS are involved. If I’m sick, I’ll lose. If I have allergies, too bad. It’s the same has having an disability. It’s just too bad. You can’t compete if you only have one leg or what not. If you have allergies, then don’t be a professional cyclist who plans to win the TDF.
Wiggins chose to take DRUGS. Therefore he is DOPING. Therefore he cheated just like ARMSTRONG.
Completely agree with this John. Let’s say I want to be a MMA fighter, but I’m a old puny git and the other guys are younger, fitter, bigger and stronger then me… So to “level the playing field” I’ll take a bunch of steroids and undergo do Tetosterone Replacement Therapy. I’ll justify myself by getting a doctor to declare “steroids are a common treatment for people with growth disorders” (this is absolutely true) and the TRT helps to prevent the consequences of ageing (also true), and off I go: I have a free pass to turn myself into a terminator. I mention this (not cycling related at all) as an example, because this is exactly what happened up to just a few years go in MMA. And nobody cared.
Fair? “Level playing field”? Noop. If I’m too old, too unfit, too puny, I should not be an elite MMA fighter … If I’m injured, I should not be in a fight. “Elite” being an important caveat! Being an elite athlete is not a human right.
That reminds me of an article I read on the problem of masters athletes getting TUEs for testosterone replacement as part of age-related HRT.
I completely disagree. What is a drug (or DRUG, if you prefer)? Paracetamol? Vicks rub? Beetroot juice? No, there are only two classes of ‘drug’; those which are legal, with or without a TUE, under the rules, and those which aren’t. Armstrong et al took plenty of the latter; Wiggins only the former. This does not mean that Sky and Wiggins do not deserve scrutiny what what they have said in the past (and I see there’s a long interview with Wiggins in today’s Guardian), or that the TUE rules don’t need looking at, but the cases of Wiggins and Armstrong are not at all the same.
My reply below was meant as a response to George Vest.
I think we can agree that Wiggins didn’t do the right thing, whether or not he was within the rules is a grey area. However, there’s no way anyone can really say Wiggins and Lance did the same thing.
Lance and the other dopers from his era used methods and drugs that don’t even compare to what Wiggins did.
Let’s just say Wiggins also did what Lance did, on top of what we suspect he did, wouldn’t it be a fair assumption that he would have been significantly faster than he was? I assume so.
As drug this was abused in the past i wonder what levels were taken arbtrarily by dopers VS the prescribed dosage within the TUE rules and whether that would give us an indication of the REAL benefit of taking it within the TUE structure.
Interested to know why the publication of TUE’s is a bad idea.
This is all good as once again it puts a squeeze on the ethics
Thanks for the update INRNG
Its a bad idea because there’s been a general legal principle of medical confidentiality built up in courts the world over during most of the time that doctors have been treating patients. WADA can’t require something that the courts would immediately prohibit and award damages for.
BS. No one would be forcing anyone to break the principle of medical confidentiality, simply because if you don’t want you confidential medical condition to be known, you simply make, in the first place, the choice of not racing or not applying for a TUE. Which brings us to the first question that should be asked (and that Inrng fails to ask in his piece, perhaps because he doesn’t want to dwell on the subject too much), which is why TUEs should continue to exist at all.
+1 I’m with Ferdi.
Agree. And it would even be possible to leave the medical justification out of the publication: Just say “athlete X has been granted the use of drug Y for this period.”
Even further, names of individual athletes can be left out all together. It could be “team/country X has applied for Y exemptions and been granted Z”. Only if certain countries/teams are real outliers (which Sky is! They request and receive far more TUEs then you would expect looking at the size of their team as a percentage of all elite level cyclists worldwide) would 9eg) a journalist dig into the case to see if there is a story.
Having said all of that. I stil don’t see the problem with just being open about having (eg) ADHD. Why should we teach young people to be ashamed of having a condition like that, and hide it? I’d say: Elite athletes are in a perfect position to be a positive role model for young kids with these types of conditions, proving that you don’t need to be ashamed and can achieve a lot.
+1
Instead of ‘Wiggins’ imagine this was ‘Lutsenko’. Then ask yourselves if you would be saying the same thing.
I would. Though whole thing people are missing here is that the E in TUE stands for exemption. As in your exempt from breaking any rules for taking a substance if you have a TUE. The TUE rules probably do need tightening up but until they are you can’t have a go at anyone for taking a substance that is allowed by one.
Excellent analysis thank you.
So much vitriol over 3 corticosteroid injections for BW. No vitriol for the French team (tdf stage wins, yellow jersies, polka dot jersies) that were notorious in the peloton for several years for loading their riders with cortisone injections for most major races (lots of big gear grinding on that team too). No vitriol either for the TDF winning team that had the entire team on corticosteroid TUEs.
I appreciate Sky have held themselves up to a higher standard but there comes a point where they’re getting bashed for something within the rules (including being accused of breaking them), but other teams aren’t subjected to any comparable scrutiny at all far more questionable practices.
According to Jonathon Vaughters, during a period in which his team had 1 TUE, Sky have had 13. Let the bashing begin. Recall as well that Sky refused entry into the MPCC because Sky held themselves to a higher standard. Sky certainly deserve to be laughed at.
Because of a lack of proof. Feel free to name names (I’d genuinely like to know who ‘the TDF winning team that had the entire team on corticosteroid TUEs’ was) and give evidence.
A lot of people here going for the ‘two wrongs make a right’ argument.
And other teams – e.g. Astana and Katusha – receive a great deal of vitriol, and right so.
If those corticoseroid injectons worked for that French team and for the other team, they worked for Wiggins too.
All the obsession for “within or out of the rules” is pretty much misplaced… The question should be: how and why could the UCI or whatever authority give green light to such a TUE, which struggles to respond to the set requirements?
Every rule will always have a discretionary area, and to grant fairness we must be sure that the deciders act in such area according to consistent principles. Which is the main problem *possibly* exposed by the present matter.
And I say “possibly” because I acknowledge the need of further details – what’s happened now is that to provide them is becoming more and more due on the institutions’ part, since doubts currently look more than reasonable.
I feel that this is a direct consequence of the huge disproportion introduced in the sport by the gargantuan growth of budgets in recent years. And I’m pretty sure it’s not only about Sky – though, to say that it’s about “everyone in the sport” would mean to go a long way, with more elements against such hypothesis than those you might have to support it.
PS Obviously, note that something surfacing doesn’t mean that nothing else is lying away from eyes. It’s quite laughable to read people writing: “how good, this is just peanuts, no EPO” as if it meant that’s the only thing going on. Even more obviously, this doesn’t mean that there *is* anything else, either. Yet, what already was worrying and what’s becoming more and more clear is the mentality in the team – by the way, totally contrasting with their public discourse, but that’s quite secondary (does anyone really believe a single word of any press conference, by Sky, Astana, the UCI or whoever?).
Precisely.
The ‘it was within the rules because they got away with it’ argument doesn’t really stack up against how the rules were bent in order for them to get away with it.
+1
I think the UCI, and WADA, need to take a long hard look at TUEs.
On the one hand, if someone is genuinely ill, then they shouldn’t be racing. On the other, TUEs cover a multitude of long-term and permanent illnesses. And it’s for this reason that they really can’t be made public. I’m not sure I want to follow a sport where we essentially prevent some people entering the sport just because they have illnesses that need ongoing treatment.
But from a wider issue, I think we need to be a little careful in concentrating solely on Wiggins. We’ve had a very selective leak of athletes’ details, so we’re not at all seeing the wider picture. We can only anecdotally attempt to piece together the extent to which TUEs are being used or misused.
This leak has come from a group that clearly wanted to shift the concentration away from state sponsored Russian doping and onto others. The hack may itself have been state sponsored too.
Have Sky and Wiggins been especially heavy users of TUEs? Or is it just that key riders from their team have been targeted? We don’t really know at this point.
If people are ill there are cases when taking medical treatement is suitable and they can do sport too. The TUE process is supposed to have safeguards to check the illness is real and that the proposed treatment is both suitable and not performance-enhancing in its own right. But that’s the debatable part here.
Finding it hard to locate the exact source of anger about Wiggins. Is it because TUEs are allowed? Or that they’re allowed for certain specific substances? Or is it that Sky are using them despite their stance? Or is it how tenuous or otherwise the connection to his illness is? Or is it that he didn’t reveal it?
If it’s any of the first three, then why has Froome not received as much attention?
Interesting too how many athletes have asthma – we do spend our time behind exhausts so in some ways it’s not surprising, but in others you’d think it’d hold a man back. Tricky as we’ll never be able to show one way or the other – I know asthmatics who really struggle on the bike, and if there’s a way to help them it’s inhuman not to grant it. I feel like this stuff is only going to get more complicated in the future..
I suspect it’s because (a) Wiggins had been on record as not having had injections, and (b) Sky had been on record as preferring to withdraw a rider from a race than obtain a TUE. Both of those statements were plainly in conflict with the facts, so add that to the ongoing newsworthiness of doping accusations against Sky & Froome, and the fact that this was a substance abused by many past dopers, and you can see why it’s been a source of interest.
I recall a position where Denis Menchov was found to be using Corticsteroids, amongst his bio passport, which caused a shitfight amongst rival team management, whom had “an agreement”.
TUE or not TUE….. that is the question
The Doc’s agreed a sledgehammer would be needed to crack Wiggo’s walnut. Worked a treat too, we would never have known if it wasn’t for a group of Vodka neckers.
A couple of points on the article,
re the headline, Never-ending TUE – I suspect in the British media this story has finished now. Allardyce and the England Manager’s job will chuck all other sports stories from the front and back pages. Will be interesting to see if this TUE story does die down now.
Re the last para, I disagree with the conclusion actually;
“The casual onlooker – not the pro cycling blog reader – will glance at Sky and Wiggins and think they’re no different to other teams and Tour winners”
I think the casual onlooker will shrug their shoulders. My initial reaction was that TUEs are accepted, Wiggins is regarded as being clean so there must have been a good reason. I suspect most of the public will feel the same, and not understand the fuss. It’s only when you drill down into the detail (how strong the substance was, timings, etc) that it gets murkier and murkier.
ie I suspect the casual onlooker will still feel that Wiggins and Sky are above the drugs and cheating.
Wiggins has got a big article in L’Equipe today. Perhaps the coverage won’t die down but there are a lot of unanswered questions now hanging around.
And to date 148 comments – lacking the sophistication of IR’s – but broadly doubting/critical of Sky and Wiggins. Brailsford can’t respond as there is no effective response. Caught out and they must know it.
to be honest, I think you are correct in how deep it goes into the ‘casual onlookers’ pysche
Yes, his reputation is damaged, and some have labelled him and Sky as cheats but many do take things at face value, and are not ending up concluding that he is dirty. Confirmed asthmatic and allergy sufferer, needed treatment before a big 3 week race around France in Jul – that’s enough for many to shrug ‘seems like the media are making a mountain out of a molehill’. Also, the reputation of the media in the UK is not exactly at its all-time highest right now, with people decreasingly trusting what they read. And it doesnt matter whether as INRNG says l’Equipe have run a big piece on it – because the British public dont read it. And its the British public that are Wiggins and Sky’s main target audiences. Doesnt matter how much many cycling fans furiously post here, or on cycling forums, or on Twitter, or in the dreaded under the line comments. In the great scheme of things, we constitute a tiny minority compared to the wider public.
Assuming he still rides London and Gent 6 Days, no tickets will be returned in protest
I’ll be interested to see how he’s treated by the crowd in Gent.
Why are we taking seriously anything from ‘Fancy Bears’ ?
Not only are they a completely transparent Kremlin sockpuppet peddling a political agenda , but anything coming from someone who call themselves ‘Fancy Bears’ just seems totally ridiculous
Google ‘Fancy Bears porn’ – just not at while you’re at work – and then tell me you can take them seriously…
They might be straight from the Kremlin, but they’re publishing TUE’s that are official, and nobody is denying what they’re printing… so the TUE’s are accurate.
Interestingly, no-one above when discussing the strength of the medication applied, or the timing apropos perceived risk (i.e. when is the peak season for the stated allergy) has raised the problems associated with immune response and high levels of load on the body in training and / or competition.
It’s well known and has been for many years, that high levels of training stress (and many other kinds of stress) have a depressive effect on the immune system.
Given that allergic response is intimately linked with immune response, it may be that a drug which in other circumstances may be seen as a “sledgehammer to crack a nut” might be an appropriate medication to use in the circumstances.
The whole question of TUEs and (especially) asthma is a vexed one – but at extremely high levels of training or competitive stress, a whole spectrum of possible adverse effects might afflict people who in “normal life” might have zero problem.
We are dealing with genetic freaks in professional sport, who are so far off the end of any normal bell-shaped curve that the general recommendations about how and when a drug might be used are in many ways useless, so a quick recourse to Wikipedia or onlineMD.com doesn’t really fit the bill for informed debate … which is all a good number of journos appear to have done, before writing their shock-horror exposes.
What we can say, is that we have TUEs for these extreme cases and whether they are well-administered by people who thoroughly understand the physiology of those whose health they seek to support, or not, is actually the key question.
This is totally separate to the question of whether they should exist at all.
There is an argument that EID, for example, even when it only appears in an athlete with a chronically depressed immune response and at maximal effort is itself a natural limiter on performance, just like VO2 max – and so whether we should even seek to correct it with drugs administered via a TUE.
Your argument above is about a further reason why they should *not* have used that sledgehammer, and it has been widely debated in the past when the subject of more common health troubles for Sky rider was tackled.
Notable dosis of corticosteroids bring even more depressive effect to the immune system (and that’s precisely one of the reasons because of which you use them against allergies).
Agreed.
Sorry – touch screen strikes again …
Agreed, corticosteroids can have a suppressive effect on the immune system and the way that they work in the body to reduce the effects of allergies is in part connected to that but it’s not the total picture. An immune system already affected by training / racing is not necessarily a contra-indication to their use in allergy supression.
Yeah, but considering the risk/benefit profile, a suppressive effect which might be not relevant for a normal person – it normally isn’t that much – could become decisive if you’re speaking of this kind of athletes, already suffering of immune suppression (especially when they’ve got a ridiculous percentage of body fat), and facing a context often exposed to pathogens, as the peloton is, plus challenging external conditions.
If as a doctor your priority is *health* you might decide for a different line… unless something else looks like it may compensate for the added risks. But they are not health factors, they’re performance factors.
And, with cyclists, you should take into account osteoporosis, too.
A strange decision becomes stranger when applied to the *peculiarity* of these subjects, not less strange.
You’re ticking all the box against health in order to tick those which say “performance”.
Sorry – typo – for EID read EIA …
Here’s the thing I’m not sure of:
1. What potential performance enhancing effect would Wiggins’ medical treatment have for his TdF performance?
2. Secondly, are we suggesting that this medical treatment was purely a coverup for use of this or a similar drug out of competition in the build-up to the TdF? And if so, what amount of advantage would this result in?
Depending on the answers to the above, Wiggins might not have had any advantage whatsoever, or he might have a lot. However, is someone here qualified to answer that? I really have no idea.
I’ve given 3 journal articles above, plus riders have been using them for decades.
Thanks, I just took the time to go above and check out your quotes. Here’s your quote that I think hits the nail on the head as it were:
“For me, the evidence is there and I’m also cynical enough to believe that if Sky are using corticosteroids in competition with a TUE why would they not be using them out of competition legally – they seem happy to do whatever is legal.”
Team Sky has been adamant that they are following the rules from day one and that they interpret the rules to be whatever is specifically allowed as per the rules. It is the whole substance versus form of the rules – well, Team Sky believes in the form of the rules. They don’t operate in grey areas so if the rules say A is allowed, then they do what A says.
Their marginal gains philosophy is to take the rule book and do EXACTLY what is allowed. That’s exactly why they didn’t join MPCC – because they wouldn’t be in line with MPCC if they followed WADA’s rules to the letter.
But they *didn’t* comply with the rules, not at all!
Their TUEs don’t respond, not even by far, to the rules which UHJ reported here…
They just paid some doctors to take the responsibility and obtained, who knows how, the signature of the dear, dear dr. Zorzoli on the paperwork.
Maradona’s Hand of God goal was “doing exactly what is allowed” just because the referee said it was legal?
Yes, it was a *valid goal*, and totally so, because the rules of football say that what matters is what the referee sees.
But this fact doesn’t make such a goal an example of “doing what is allowed”.
The rules say you can take glucocorticoids out of competition and that a TUE can be obtained for use if a doctor says there is a valid use and then approved by UCI.
Therefore, according to the form of the rules (aka, the rulebook), Team Sky followed the rules.
Please don’t confuse this statement with my personal beliefs. I fully believe that athlete preparation methods should meet the form AND SUBSTANCE of the rules! So, Gabriele, before your response, please consider that I don’t think what Team Sky did was right.
I’ve always suspected that they weren’t exactly on bread and water and I heard rumblings from my ex-teammates about what Sky was doing. I even posted them here once and got destroyed by comments in response. Regardless, there now appears to be reasonable suspicions that Sky isn’t 100% clean.
No, CA, go and seek the UHJ comment I referred to, please.
*That* is what rules say.
Then, rules are implemented through a discretionary set of actions by different institutions, but the fact that such institutions fail to keep consistency with the rules doesn’t make it “doing what is allowed”, even if the discussed behaviour remains *valid*.
The rules say you can’t score a goal with your hand, but they also say that what the referee sees is what ultimately matters. Hence the result of the match remained valid, but Maradona’s goal wasn’t “doing what is allowed”, because the institution in charge of checking the correspondence between facts and rules failed to maintain the necessary consistency (for whatever reason).
Which means that, even before we start to discuss how and why the UCI could grant that TUE (the more relevant questoin, IMHO), it’s anyway wrong to qualify as “within the rules” the fact of obtaining a TUE which looks quite clearly – albeit we don’t have every detail – against what the rulebook itself asks for.
Don’t see any UHJ posting… sorry.
I quoted the WADA code book in my response, it is accurate to the rule book. The institutions were enforcing their normal procedures in allowing the TUE. No violation.
This may or may not have been a hand goal.
Remember, I said before you blast me, I personally think what they did was wrong, even if it did satisfy the rulebook’s requirements.
UHJ never commented on this article, so I have no idea what you’re referring to Gabriele.
CA:
UHJ put them up on Thursday Shorts:
PART TWO: STANDARDS AND PROCESS FOR GRANTING TUES
4.0 Obtaining a TUE
4.1 An Athlete may be granted a TUE if (and only if) he/she can show that each
of the following conditions is met:
a. The Prohibited Substance or Prohibited Method in question is needed to treat an acute or chronic medical condition, such that the Athlete would experience a significant impairment to health if the Prohibited Substance or Prohibited Method were to be withheld
b. The Therapeutic Use of the Prohibited Substance or Prohibited Method is highly unlikely to produce any additional enhancement of performance beyond what might be anticipated by a return to the Athlete’s normal state of health following the treatment of the acute or chronic medical condition.
c. There is no reasonable Therapeutic alternative to the Use of the Prohibited Substance or Prohibited Method.
d. The necessity for the Use of the Prohibited Substance or Prohibited Method is not a consequence, wholly or in part, of the prior Use, (without a TUE,) of a substance or method which was prohibited at the time of such Use.
For me, Wiggins broke the rules because b and c (at least are broken).
c is broken because this drug is not used as prevention for asthma (not mentioned on Wiggins’s TUEs anyway) or allergies. It is only used for severe attacks where breathing is restricted and hospitalisation usually required.
b is broken because as has been shown in numerous studies (I’ve posted the papers) and as dozens of cyclists have known for years the athlete would experience an additional enhancement of performance beyond what might be anticipated by a return to the Athlete’s normal state of health.
Thanks J Evans – That’s not what I was talking about, I was talking about Sky’s alleged use of glucocoricoids out of competition… Gabriele missed that part of my response.
But regarding your comment:
– is B really violated? I mean, would the amount prescribed in the TUE be performance enhancing OR is the amount taken in the OOC period performance enhancing? If it is the latter, then you could argue that B isn’t violation.
– for C – Wiggins convinced a doctor that his symptoms were so bad that this drug was needed. I didn’t see the symptoms (none of us did), so it’s impossible to say for sure.
Regardless of whether of not Wiggins qualified for the TUE, I was actually arguing that Wiggins’ OOC use of gluco’s was correct. It appears to meet the letter of the law, but not the form of the law. Ok, that was my point all along, Gabriele missed it.
Also – is it just me or is the focus on the TUE missing the overall point – If Sky (and therefore Wiggins, et al) are using things out of competition that give them a significant advantage, shouldn’t the focus be on shutting down this use, rather than focusing on TUE’s? I mean, the advantage that the TUE gives is probably minor compared to the out of competition use of a substance while training.
CA, there’s no proof of any OOC use.
Mine – and, I think, Gabriele’s (because he said ‘Their TUEs don’t respond, not even by far, to the rules which UHJ reported here…’) – point was that the TUE did not adhere to the rules; for the reasons I’ve given.
http://www.endo.theclinics.com/article/S0889-8529(09)00084-X/abstract
https://www.ncbi.nlm.nih.gov/pubmed/17805102
http://bjsm.bmj.com/content/42/12/983.abstract
Plus decades of riders using it and finding that it worked.
Some people will inevitably see the recent revelations and conclude that Sky is no different from US Postal/Discovery.
That Sky divides opinion is blindingly obvious. They remind many of Armstrong’s teams in stifling the opposition at the TdF and that creates resentment and doubt. Also, their focus is on the TdF at the expense of other races and for the purists, like myself, people find that hard. There is more to this sport than the TdF.
Wiggins’ use of this drug, therefore, is simply confirmation to some people that Sky have been on it all along and are cheats just like they have always said. An open and shut case.
For me, a bit of context is necessary. Wiggins has always seemed a bit of a fragile character.
Somebody said earlier that he probably had a couple of shots at winning a Grand Tour: the one everyone has heard of is the TdF.
Sky came into being to get a British winner of a TdF within five years of being set up. Wiggins was the one they identified to do that after his breakthrough in 2009. They prised him away from Garmin with big bucks – and to Garmin’s annoyance – and what happens? In 2010, he bombed.
The following year, he was the nailed on favourite. And what happens? He crashes, breaks his collarbone and is out.
Wiggins has often spoken of not missing the TdF – hating it even. It suggests a mentally fragile individual, almost unhappy that he has been burdened with this talent to win this damned race.
He has talked about not liking the training regime, living in a special tent, missing his kids and so on. In short, he’s thinking he knows he can win the Tour but hates the palava that goes with it.
The Tour of 2012 was made for Wiggins. He’s winning all the warm-up races and perhaps the anxiety kicks in, thinking he has to win it this time otherwise must I really go through that all training/weight loss/tent business/being away from the kids again? So he frets about asthma and Sky say ‘we can fix this and it’s legal’.
Same with the Giro the following year – no Briton has won that race and Wiggins wanted to win it. He’s aware of the history of the sport. He’s also got Froome breathing down his neck and Sky are no doubt thinking Froome’s our man in the long run.
2012, then, was perhaps Wiggins’ last – only – chance to win the Tour and for Sky Wiggins was the man they wanted to do it with first. He has a better back story than Froome – the kid from Kilburn. The London gewzer the man in the street could identify with – and please stop this he’s not English because he was born in Belgium nonsense – whereas Froome is a harder sell: more reserved and an obvious southern African accent. The first British winner of the TdF couldn’t be a guy who everyone thought was South African.
That context is important I think because I think it has to be considered in all this and why he took it.
Remember, not since Robert Miller, who also had his own big move to Panasonic to lead their TdF tilt after his performances in 83, 84 and 85, had a Britiah rider been realisatically considered a potential TdF winner. But Miller was never THE favourite for the Tours he rode. Wiggins was. The pressure to deliver was there and for someone as seemingly fragile as Wiggins, a doctor at a clean team – that’s what the Sky project is supposed to be all about remember – telling you that this thing you’re fretting over, it can go away and it’s all legal then you’ll probably do it.
Where Sky and Wiggins have fallen down is their hypocrisy on the issue and inconsistencies recalling the facts.
Personally, I don’t think Wiggins is a doper but he and Sky pushed the boundaries and I think the episode has tarnished his and the team’s legacy. Morally, it’s not right. Have they done anything illegal? No.
But some of the reaction has been hysterical: fine reporter that he is, David Walsh said on Irish radio earlier this week that he believed that Wiggins’ 2012 was performance enhanced. The implication being that he doped. Who’s the rider most associated with Walsh? Armstrong. So when Walsh says Wiggins’ win was performance enhances most people think: “Doped like, say, Armstrong doped?”
David Walsh is not an expert on this. He’s an expert on unmasking cheats. Last week, the Daily Telegraph, which the day before quoted Dave Millar’s assessment of this drug, quoted a number of doctors who queried whether it would have been performance enhancing at all. One said Millar found it gave him an edge because he was up to the gills on EPO and testosterone.
I wish Wiggins hadn’t taken this drug, hadn’t had this injection. I think it’s sad. It has tarnished him for sure. Was there any real need for it in the first place? I suspect not.
But I don’t think he’s a doper and I don’t think Sky are US Postal.
Reminds me of BigTex’ question back-in-the-day. He said to someone in the press, “Are you calling me a liar or a doper?” You can sugarcoat and lipstick SKY’s TUE pig all you want, but I agree with Walsh. Having written that, I can’t help but think Walsh has been looking the other way for far too long in his zeal to portray SKY/Wiggins/Froome as the clean British saviors of cycling. Now will he flip and become a rabid critic like he was of BigTex?
David, I am not sure of the facts myself – NONE of us can be – but I would like to say thats a very good post of yours
I’ve been waiting for someone to look at this in what is not, actually, about obtaining advantage for physical performance. Having seen the interview Brad did on Sunday and then reminding myself of how Sky changed conventional training around what was actually being done back then, I’ve revised my opinion here.
I think the TUE was actually to help Brad psychologically more than anything. He said that we was “worried”, “concerned” etc. Knowing how variable his mental state can be, the team probably looked at all the available data/evidence, realised that Brad was operating on the absolute limits of his physical ability and therefore couldn’t really peak any further. He could only go down.
I remember watching his time trial up the Col D’Eze a few weeks before the Tour at the Dauphine and he absolutely emptied himself, because that’s how the season was structured. The races leading up to the Tour were, in essence elongated training sessions. When you put yourself out there, then the asthma question obviously comes up if you make efforts like that over a long period of time. He’d been at 95% peak condition + since Paris-Nice. Your body can’t stay in that condition forever without an increased risk of something going wrong or you breaking down.
The Kenacort was therefore an added extra to “an insurance policy”, to mitigate against something happening in the first week of the Tour (which is usually the most mentally stressful part of the race for GC contenders). Add in all that’s been eloquently said above, and I suspect this is probably where the truth actually lies.
Poor little diddums. If he needed a fix to get him through the first week, should he have been there at all then?
You can easily get full psychological support for a rider using a placebo, without needing to put his health at further risk and to ask controversial TUEs.
A significant part of the effects of PEDs is indeed related to the “psychological” boost (that isn’t simply a matter of “ideas” but also of physiological reactions, hormones your body will produce etc.).
Both Ferrari and Fuentes produced a lot of interesting materials on the subject. Fuentes switching sides before the last stage of a notorious Vuelta, and telling the *newly supported* rider that he was going to dope him, while he just gave him placebo (with spectacular results) is one example. And Ferrari listed interesting bibliography about the whole question on his website.
Apparently, that wasn’t enough for the kind of “support” which Brad needed…
David:
First of all, very interesting post, and overall I agree. Sky definitely isn’t US Postal, and Wiggins didn’t use anything close to what Armstrong and his cohorts used. Also, it is very difficult to say that Sky broke the form of the rules.
However, I think what this TUE static is hiding is that Wiggins may have used products out of competition in his training that probably should be banned. The use of these glucorticoids has a lot larger effect than the prescribed amount in the TUE, however the TUE may have been necessary in case Wiggins tested positive from out of competition use. The out of compeition use of the products aren’t banned, but they should be. This of course means Sky and Wiggins are technically clean but they used a method that NOBODY is really comfortable with. Even if Sky says they are comfortable with what they took, then why won’t they discuss it specifically?
I’m ready to be corrected on the following – it’s been a long time since I studied this stuff in Physiology & Pharmacology lectures at college but as I recall and as a quick bit of research shows:
The steroid triamcinolone (found in well-known drugs like Kenacort and Kenalog) is used primarily in “normal” medicine to reduce inflammation in cases where other forms of the same or similar drugs have not been effective.
It can be quite an aggressive treatment.
Triamcinolone can be used to treat a number of different medical conditions, including but not limited to eczema, psoriasis, allergies and the prevention of asthma attacks. It will not treat an asthma attack once it has already begun, in this case it is used as a prophylactic.
It can be administered in a number of different ways with intramuscular injection being one way of getting the drug into the system – in this form it’s often used in the treatment of muscle pain, tendon and joint problems including arthritis but it can also be used in this way for the prophylactic treatment of asthma.
In all cases, it is a symptom suppressant – it does not do anything to directly treat the underlying condition.
As a catabolic, the steroid can assist in weight loss if used in a way commensurate with that objective, resulting in an increase in lean mass – obviously for a cyclist, this might be advantageous but it should be understood that the catabolism affects muscle tissue as well as other tissues (fat, for instance) so it’s not necessarily a short cut to a higher power-to-weight ratio.
There can be some nasty side-effects, too, including shortness of breath, dizziness, nosebleeds and damage to the eyesight.
There’s one grand tour that no-one has mentioned yet regarding Wiggins and TUEs. The 2011 Vuelta.
He got TUEs before the TdF in 2011, the TdF in 2012 and the Giro in 2013, but not September 2011. Can someone please explain, if he was using the drug for performance enhancing purposes, how he managed to finish 3rd in the 2011 Vuelta without it and don’t say the July 2011 injection lasted all the way through to September. The drug doesn’t work like that, particularly if you crash and are off your bike for some time shortly after taking it and a month and more before starting the Vuelta.
That is a fair point, and he got 4th with Garmin in the tour (later revised to 3rd I think?) without the TUE….however that does not also mean that his win in 2012 had nothing to do with the TUE. The 2011 Vuelta was won by Cobo and Froome got second having been the better rider of the two Sky riders, and arguably could have won the race.
The Vuelta isn’t the race that the main riders target, and if that was the case then perhaps the best Wiggins would have got was top 10? I know he was recovering from a broken collar bone, but looking back we would expect a 2011 Wiggins to beat Cobo and a 2011 Froome wouldn’t we? So perhaps if he had taken the drug under a TUE prior to the 2011 Vuelta he would have won?
I think the grey area here is not that the TUE and the drug enables a very poor club rider win the tour, clearly Wiggins is a better rider than that, but it may have been performance enhancing and enabled him to win the Tour which he would not have done otherwise? Clearly this is all speculation, but the way everything has to also be dragged out of Sky and WIggins, and the contradictions with his autobiography just adds fuel to the speculation.
Personally I am inclined to the view that both the 09 Tour and the 2011 Vuelta were perhaps his best GT performances.
Think about it: 2009 Tour, up against Contador, Schleck and Lance, pretty much no support from Garmin in the mountains, tougher route than the ’12 Tour.
2011 Vuelta with its insanely steep climbs and walls which are NOT suited to him at all , a disastrous TTT for Sky on the very first stage, a lump of metal in his shoulder, no racing kms since crashing out of the Tour, and a makeshift Sky team. Compare those factors to the 2012 Tour with its 102 TT kms, an insanely strong Sky squad around him, and the lowest number of MTF finishes in recent years.
and not forgetting the ‘wtf, Chris who???’ factor….
If we’re taking his explanation at face value, pollen/hay fever levels in Spain will have peaked long before August, won’t they?
Yeah, come on, Contador returned that positive for cl3nbuter0l in what was perhaps his worst GT performance in the 2007-2012 period (especially ITT-wise, a classical doping marker).
I didn’t see all these people claiming that such quantity wasn’t due to produce performance enhancement (which was truer than in Wiggo’s case) or that it didn’t make sense to imagine him doping just to perform worse than in other occasions.
All I saw was a lot of guys imagining that for sure he was doping all the way long – even when there was no material element to suppose that – and defending a thesis, to account for the situation, which the CAS deemed “as credible as the steak”.
Note that, at the end of the day, Contador was DSQd for saying “steak” instead of “food supplement”.
Now it’s all about, hey, the Wiggo guy was strong when he hadn’t a TUE, he was even stronger, perhaps!
Yeah. So what?
First of all, PEDs and cycling don’t work like a videogame. You have not *got* a 78 punctuation in “GT skills” which you eventually boost to 89 with corticosteroids making you produce better performances: the variation introduced by PEDs might be inferior to the fluctuation in individual performances due to other factors.
Secondly, but not less important, it’s not that with this Fancy Bears thing we know everything there’s got to know.
It’s just a *confirmation* about the mentality at Sky. And the ease in receiving institutional support in dubious cases. These two factors are way more worrying than any single (or even multiple, depending on the circumstances) doping positive test.
However, the most incredible thing remains the fans’ attitude: how people were prone to consider that the cl3nbuter0l thing said a lot more than it actually said, while they now try to defend that the present situation might not mean that much.
In both case, you’re left with a lot to guess. A lot that can be easily imagined, indeed, but which is different from “facts”.
Anyway, in both cases the main question isn’t about the *cheating rider* as much as about the system (team, institutions, labs) he’s a little piece of.
The UK is in a place similar to the USA before there was no doubt that BigTex was a liar and a cheat. Evidence of both is slowly coming out, but SKY supporters and fans can’t help but bleat out the same ol’ baloney so many Yanks used to defend Tex. Some still do with the “Everyone else did it too!” crap that 3 year olds tell their Mommy. They’ll eventually have to face facts and admit their team (and hero) is just as hypocritical as most of the others.
As Gabriele rightly points out, the teams and especially institutions (WADA, UCI, etc.) are the real problem and pro cycling will be stuck in the current situation where few in their right minds want to be involved as a sponsor or otherwise invest in the sport until they take REAL steps to demonstrate they want to clean things up vs merely managing/minimizing scandals.
Do you think you could try for a little more civility towards fellow posters? This isnt the comments section on Cyclingnews
Sorry Sam, was that too harsh? Plenty of similar things were said by folks from the UK when US fans defended BigTex, and a lot of them while crowing about how clean their SKY team was in contrast. I’ve complained about what I call an “Anglo-Saxon” point-of-view in the past and comments comparing Wiggo’s problems to Il Pistolero reflect what I see as that mindset. Cheaters and liars are cheaters and liars no matter what country they call home or what flag they fly, but the defenders of SKY, Wiggins and Froome (just like the Yanks before them) can’t seem to wrap their heads around the idea that their boys might have feet of clay. I will admit those of us who thought the entire “marginal gains” claptrap just a little hard-to-believe might be indulging in a bit of schadenfreude at present. I hope Mr. INRNG will delete my comments if he finds them inappropriate as it’s his forum after all. Again, sorry if I offended you or anyone else.
Well said Larry – everything in both your comments here.
Don’t let the moral minority decide what is or isn’t civil based on their own biases.
Agree with all that Gabriele says too.
It’s just nationalism – and I’m sure many Spanish fans said similar things about Contador as many British fans are saying about Wiggins.
The good things that could come out of this are revising TUE’s and revising the rules on corticosteroids out of competition. If the latter is allowed you can almost guarantee that many riders are using them, with many being pressured to do so. And all prescribed by those mythical all-knowing creatures: doctors.
Very few people are comparing him with Armstrong, etc. and I haven’t read anyone say that he wasn’t a good rider.
He came third in the 2009 TdF as well, also without the PEDs (as I’ve said above).
If he wasn’t using these drugs for performance-enhancing purposes there are an awful lot of unanswered questions.
Those of us in/from the UK must give a big “thank you” to Sam Allerdyce and his mates in professional football for knocking Wiggins off the front pages…..
Couldn’t disagree more, we need the press to carry on shining the light. It’s very unfortunate for cycling fans that the footie story has come along.
You’ll be pleased to learn that Wiggins himself has put the story back in the media, by giving a further interview to the Guardian. And by showing them his doctor’s notes, but not publishing them, he’s given us scope to argue even more!
He offers no evidence at all and doesn’t answer the many, many questions people/media have asked. Just yet more PR-friendly ‘But I’m Brad – I’m innocent’ blather and includes such zingers as:
WF: How is it you can win the Dauphiné in spite of the symptoms?
BW: As I said before I’d learnt to manage it.
So, keep managing.
He then says about the triamcinolone injection in 2011: “I actually think it was a detriment to my performance. As the first week went on I felt like I was getting weaker and weaker, I didn’t have the power.”
Of course. That’s why you took it the next two years.
His hair looks weird in the photo – is that butter on it?
Wiggins on triamcinolone: ‘they use that to treat hay fever allergies because at the end of the day it’s an antihistamine, a very strong, powerful antihistamine.’
It is – as even the interviewer points out – nothing of the sort.
The interviewer doesn’t say that to Wiggins, though – and generally gives him a very easy time. Doesn’t ask the pertinent questions.
Also:
WF: Did you have any injections out of competition?
BW: No. For what?
WF: For this?
BW: No, I’d test positive. If it was in my urine [without a TUE] I’d go positive for cortisone.
Is that true? If corticosteroids are allowed OOC, would a test come out as positive for them?
I suspect it is true that the urine test would be positive… therefore, one theory is that Wiggins probably knew he was cutting it close with his OOC use of these drugs, so he exaggerated his symptoms to his doctor to get the TUE incase he tested positive in the first week of the TdF.
So, the first week’s drug test would be positive with trace amounts, but the trace amounts might really have also included out of competition use between the dauphine and the Tour…
But Wiggins and Froome have “never tested positive” for a banned performance enhancing drug. No historical precedent in this. So why be suspicious? LoL 😉
Let set aside Sky for a bit.
What about the other teams, that don’t belong to the MPCC or left the MPCC? What are the chances that everything is perfect there?
What about the consistent stories about track athletes – especially the runners?
How about having a policy that applied to all teams and all sports instead of just cycling? How is it fair that the MPCC guys, are competing against who knows what on the other side?
Read INRNG’s articles about the MPCC.
http://inrng.com/2013/06/mpcc-cortisol-test/
http://inrng.com/2014/10/astana-mpcc-team-suspension/
http://inrng.com/2016/02/katusha-suspension-uci-mpcc/
http://inrng.com/2016/02/mpcc-exodus/
Astana and Katusha were members for a bit, after all, so I wouldn’t be so concerned about the fortunes of some of the [former] members of the MPCC at least.
Teams leave when things get a bit tight over enforcing the rules. One of which is over low Cortisol levels. Why are Cortisol levels low? Use of corticosteroids, like Kenacort.
“Why are Cortisol levels low? Use of corticosteroids, like Kenacort”.
Perhaps. Or not.
Besides, if they’re leaving when they’re starting to find the situation incompatible with their practices (supposing that it’s because of that), should we imagine that until that moment *it was* compatible? Something which was never true for Sky.
Not just a hacking group but basically Russia, trying to divert attention from it’s own diabolical flouting of the drug testing system.
This issue is now done, getting tired of it
Russia likely has it’s own motives. But, nonetheless significant information is corroborating concern re: Sky that many “in the know” have had for a while. I guess tuning out is one option.
INRG,
I like how you came up with the title to the article by waiting until TUEsday. Very opportunistic, indeed!
‘Now we understand why Team Sky never joined,’ says MPCC doctor
Wiggins would not have been able to start 2012 Tour de France under MPCC rules
http://www.cyclingnews.com/news/now-we-understand-why-team-sky-never-joined-says-mpcc-doctor/
-a good read.
MPCC is good for this; -Go ahead and take the medicine but don’t race with it.!. Take the medicine but if you race with it it is no longer simply medicine.
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One reason this is not going away is because it seems like a blatant act of cheating and then lying to cover it up.
Why does anyone follow this sport?
It’s grown men riding bikes in ridiculous outfits. Not a sport at all, circus sideshow. Need actual proof (apparently hard cold facts supporting comments is a requirement for posting to this swill bag as seen over and over above. “Nobody is forcing you to read this so just don’t read it!” The airbags above will surely cry!)… Just look to the idiotic Ventoux stage!
IMO Wiggins took the drug solely for the performance enhancing benefits, especially to lose weight and reduce pain and inflammation, drastically improving his recoveries.
How sleek and slim he looked during those victories! And that makes a big difference on the climbs. He’s a natural powerhouse engine on the flats but morphed into a wiry climber during those Grand Tours.
His taking this drug had nothing to do with asthma, or that would have been just a side-benefit to the his and the Sky-team’s true ulterior motives – namely: to get every advantage they could.
Legal…yes, but they got their own doctors who they chose themselves to say whatever they wanted them to say. Moral? Absolutely not. They used a potent DRUG to get FAMOUS victories. Sorry, but SKY is a bunch of hypocrites.
As THE CYCLING PODCAST recently pointed out, if it had been KNOWN during those tours that Wiggins was riding under the influence of a TUE-granted corticosteriod, do you think that would have been fine and UNCONTROVERTIAL at the time? No way! All hell would have been raised if people had known then what they know now.
Cheat!
Undoubtedly, Sky and Wiggins are now tainted.
and the trouble is that I now look at a rider like Thomas (who I really used to appreciate) and think ‘hmmm. he’s lost a lot of weight…great rouleur and suddenly a good climber…’
pure speculation, but Sky have now lost that ‘trust’ thing completely which is a shame – if you are a genuine rider inside their system folks will now doubt your acheivements, and you are left with that unprovable negative thing….
Very good summary, with comments from doctors:
http://cyclingtips.com/2016/09/calls-made-for-wada-to-examine-wiggins-tue-corticosteroid-controversy/
More and more is being exposed…
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(Wiggins)
Complained about others injecting
Back in July 2011, Wiggins had gone a step further than merely claiming he had never had an injection.
He bemoaned the UCI’s lack of effort in policing its own no-needle policy. Speaking to The Mirror on July 1st, 2011, Wiggins said:
“The needle ban is fantastic but at the [recent] Dauphiné [race] there was no sign of it being policed.
“It would be great on the Tour [de France] if they actually raided teams to see if they were toeing the line. Medical people in our team are adamant other teams are still using syringes for recovery.”
Twenty four hours before this article was published on The Mirror‘s website, the UCI’s doctor Mario Zorzoli had authorized the TUE for Wiggins to have an intramuscular injection.
http://www.stickybottle.com/blogs/wiggins-reputation-on-brink-of-ruin-but-team-sky-asked-for-this/
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& the Cyclingtips link (right above) indicates Zorzoli (a controversial doctor to begin with…) was the only person, rather than a 3 person panel, who authorized one of Wiggins’ TUE’s. -Stating, that’s bonkers.
So many people with so much to say about what I can buy across the counter and take without giving it a second through
In what country can you buy triamcinolone over the counter?
In light of the current revelations;
Another avenue of investigation that could shed light may be Wiggins’ history with Garmin.
( Bradley Wiggins releases blood profiles )
Today, I wonder if Garmin’s talk (and walk) principals of anti-doping, partly effected Wiggins’ move to Sky.
Along with other implications which too place then… “Bradley Wiggins and Lance Armstrong were ‘best friends’ during 2009 Tour de France, says Jonathan Vaughters ” http://www.telegraph.co.uk/sport/othersports/cycling/bradley-wiggins/9826081/Bradley-Wiggins-and-Lance-Armstrong-were-best-friends-during-2009-Tour-de-France-says-Jonathan-Vaughters.html
Garmin / Cannondale et al. are on a path that would eventually lead toward MPCC, whereas Sky is not on that sort.
It’s a mess which the MPCC wishes to tackle, yet Sky resists; to their detriment.
Irony overload.