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AG

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painkillers in sport
« on: December 12, 2014, 09:37 »
What level of painkillers should be allowed do you think


In Australia - Micheal Clarke the captain of Australian cricket team has been carrying a back injury for some time now, and caused more injury during the 1st test 2 days ago.  He underwent 4 painkiller injections, finished his innings and scored an incredibly 100

so ... while his overall ability was not enhanced by the injection - he still wasnt as good as he normally is if uninjured ... the injections (which likely included corticoids etc) certainly improved his performance in this test, allowing him to continue when otherwise he would not have been able to.

Where do we draw the limit?


http://www.sbs.com.au/cyclingcentral/al-hinds/blog/129413/meanwhile-at-the-cricket
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  • L'arri

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    Re: painkillers in sport
    « Reply #1 on: December 12, 2014, 10:47 »
    Whole swathes of the common law are built on the notion of "reasonableness", a term made ubiquitous by its deliberate flexibility.

    Applying that to the present situation, one might imagine the "reasonable" use of painkillers, which in real terms would mean a test of whether or not an individual could still reasonably perform without them.

    The difficulty of that is, of course, that it needs to be translated into an acceptable dosage, so speaking conservatively I would set the threshold of how far you can go pretty low. I think if you need to inject a painkiller, it is already too much, but that I suppose does not reflect the reality of the demands of professional sports.

    I have always thought that injury should be part of the tactical gambit, a reflection of the skill of management. So I would consider Clarke's (and therefore Australia's) effort there to be erring on the side of too much.

    Conclusion: reasonable = low dosage, for comfort rather than necessity
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    esafosfina

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    Re: painkillers in sport
    « Reply #2 on: December 12, 2014, 19:26 »
    Good question AG... and I'm torn tbh. I'd like to say "nada", but it's impossible to govern or legislate. If I dump a shedload of Tramadol, lace myself with caffeine, et al and gain a performance enchancing effect, then I'm sorry, that's a no-no from me.
    However, if (and this is disclosure...) I take low dose Tramadol to help with a persistent knee injury that, due to the ineffectual NHS in the UK, has now been ongoing for nearly a year... then I'm sorry, I have no choice... I have to take the damn thing. I have seen no performance enhancement whatsoever from taking Tramadol, and my power-output agrees. I could pursue the corticoid route, but I'd prefer not to... I had a couple of jabs when I was younger in Belg, and I'd rather go along a less invasive avenue.

    Guys/girls... I'm very open to both sides here... but there HAS to be a limit... just how one delineates the limit is something that will take this little esafosfina a bottle or two of Shiraz to ponder...!  ;)
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    Re: painkillers in sport
    « Reply #3 on: December 12, 2014, 23:34 »
    My position on this focuses on what I believe to be the most important motivation for anti-doping, which is the long term health of athletes.

    From this perspective there are two things you have to look at very seriously when it comes to athletes using painkillers: dependence/addiction, and aggravation of injuries.

    Addiction to, or dependence on, painkillers is a very serious problem and can be as damaging to one's health in the long term as addiction to illegal drugs. In some sports, most notably to my mind the NFL, athletes are given prescription and over-the-counter painkillers so regularly by their team doctors that when they retire they are unable to lead a normal life without continuing to take the medications they previously needed in order to take the field every Sunday.

    One would like to believe a doctors treating an athlete will do the right thing for their health, but we know that all too often the doctor will instead do what is necessary to help the athlete perform at the highest possible level, and that there may be pressure on the doctor from both the athlete and the athlete's team to do this. It's easy to imagine how this can lead to situations where an athlete will be given painkillers that allow them to continue to compete with an injury that would otherwise be too painful, and that in the course of competition they will aggravate the injury, perhaps without even noticing that this has happened.

    It is difficult to make hard rules about this issue, since a blanket ban of all painkillers would be ridiculous and there are some large grey areas, but I think the following are good guidelines:

    • If an athlete needs regular pain medication in order to compete and/or train, and continues to need this for more than a few weeks, they should be removed from competition and training until they are no longer in pain and no longer taking pain medication.
    • If an athlete has an injury painful enough that they cannot compete without painkillers, and there is a reasonable chance that by competing they might either aggravate that injury or extend the period of time that they need to take painkillers to manage it, they should be removed from competition
    • In sports where athletes can receive treatment for injuries mid-competition (e.g. football, NFL), an athlete sustaining an injury should not be given painkillers to allow them to immediately resume competition.


    The issue of injections is a particularly thorny one, there is of course nothing inherently evil or unfair about painkillers administered by injection as opposed to any other method. Indeed there are cases where strong pain medication delivered to the affected area by injection is the best treatment for an injury. However as cycling fans we are all too aware of the practice of 'vitamin injections' given to athletes who may not even be aware that they are receiving illegal treatments. I do not expect any sport to universally ban injections but I do see the benefit in rules that force athletes receiving such treatments to sit out of competition for a short period of time.
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  • AG

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    Re: painkillers in sport
    « Reply #4 on: December 13, 2014, 01:46 »
    yeah I agree

    I think that if your injury is so painful that oral painkillers up to a specific level isnt enough, then you shouldnt be competing.

    What that level is may be different for different sports.   Cycling for example you need very much to stay alert and focussed so the level might be less than say lawn bowls or golf where you arent affecting others so much.

    So for example it might be that dosages of say paracetamol, ibuprofen, or codeine are ok but tramadol and heavier are not.


    And for me, I am ok with saying if you need painkilling injections DURING competition, then you should not be competing.   
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