The dark side of legal doping

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Sixty players have already been ruled out of Euro 2012 in Poland and Ukraine this summer, the most in European Championship history.

Now, with the major finals just around the corner, the role of painkilling drugs and injections has come under increased scrutiny, amid claims the use of such medical methods has become so widespread, it is verging on abuse.

It's a problem that extends farther afield than football, with numerous cases evident in a wide range of different sports. Whether it is perceived as a form of legal doping, or an example of excess medication, the results are ultimately the same, as the drugs mask the effects of injuries, allowing sportsmen and women to play through the pain barrier, to the detriment of their long-term health.

Most players preparing to participate in this summer's tournament will be in a similar situation, carrying minor injuries that, although not serious enough to prevent them from playing, will cause discomfort, and have the potential to be further aggravated by a number of matches in quick succession.

As the injury list continues to pile-up, it's no surprise then, that those individuals seek scientific help at the end of a long and arduous season, that can often take in more than 50 or 60 games.

After all, representing your country at an international tournament is more often than not the pinnacle of any footballer's career. And, as a result, they will consider any form of action to ensure they don't miss out.

The challenge for the sports physicians - the doctors and medics involved in the management of professional athletes - is to strike the right balance between long-term care, and short-term cure.

Whilst they have a clear duty, it's worth remembering that their patients' livelihoods depend on their ability to perform consistently at the highest level.

The use of non-steroidal anti-inflammatory drugs - or NSAIDs as they are more commonly known - and other medications to reduce the pain and minimise the effect of these injuries on their form, is often a very attractive option for players and athletes, particularly in situations where there is considerably less recovery time than usual.

In most cases, they would all consider the very slight risk of serious side effects associated with the use of such painkillers, a reasonable price to pay for the benefits in the biggest games of their careers.

Even more important then, is the need for young footballers to be educated about the potential implications, and the clear message that these drugs are not 'harmless', particularly in light of the recent discovery that athletes in many fields are now taking large quantities of these drugs, both in and out of competition.

The deputy director of the World Anti Doping Laboratory is concerned that controlling these drugs across all forms of sport is impossible, but has called for a change in the current ruling around these prescriptions on the basis that painkillers fulfill all the requirements of a doping substance.

"It is a grey zone," admitted Dr Hans Geyer in a recent interview with BBC News. "In my opinion pain killers fulfil all requirements of a doping substance because normally pain is a protection mechanism of the body and with pain killers you switch off this protection system.

"Like if you switch off fatigue, which is also a protection mechanism of the body. Painkillers really enhance performance but they have negative effects, maybe irreversible effects."

But while pain killing medications may have performance enhancing effects, Dr Geyer believes it will not be possible to limit their use in sport.

"I think the control of these substances is impossible, as they are easily available in society," he continued. "Therefore it is not possible to treat the use of painkillers in the same way as other doping substances."

In football, the 'pain game' has almost become part and parcel of a player's pre-match routine, so regular are their medical consultations. Desperate times may well call for desperate measures, but this is an issue that needs tackling head-on, to preserve and maintain all participating athletes' long-term health and well-being.

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