Sports Doping via Elective Surgery

BikeMonkey Guest PostProfessional sports continues to suffer from doping scandal. Although it is understood that preparation for the highest levels of competition involves considerably more than “training”, most sports have enacted rules to distinguish allowable training/preparation aids from “cheating“. This is by no means new. Nor is it over, the cycling world is poised for the now-traditional pre-Tour revelations of doping which will re-shuffle the lineup on July 4th.
But rules violations are in some ways uninteresting. There are rules to sport and if you break them you are penalized. Within that context, the nature of cheating and the ethical concepts of fair play are operationalized. Boring.
More interesting is to consider the essentially arbitrary distinctions that create the rules in the first place. Take Lance Armstrong. Winner of a record number of Tours de France, dominant rider and all around cycling icon. Did I mention he was making a come-back at his ripe old age and after a several year layoff? Great stuff.
And this was all possible only because he decided to have cancer.

Well, no, of course he didn’t decide to have cancer. And it is wonderful that this person was able to survive a pretty bad case and come back to the pinnacles of human physical performance.
Still….prior to cancer, Armstrong was a great rider, make no mistake, but he was a one-day Classic race threat. A powerful all-rounder who was too heavily built (this is very relative) to be a threat in the three-week Tour, Giro or Vuelta stage races. Because those races depend heavily on the ability to ride up high mountains at a rapid pace. When it comes to climbing on the bicycle, power to weight ratio is all. The emphasis typically being on the weight, too. It is no accident that the so-called “pure” climbers of renown in pro cycling are all wisps. Skinny and short. Tiny dudes. Really tiny. There is just no avoiding the fact that stripping all (and I mean nearly all) unnecessary weight off of the body and rebuilding with just the specific musculature needed is the way to build the perfect Grand Tour cyclist.
Of course, most cyclists do the best they can with diet control and hard training. Remember however, pre-cancer Armstrong was a professional cyclist. I’m sure he was doing his due-diligence like any other pro. But having a dramatic event occur, outside of his will / lack thereof, which stripped off more weight was a boon.
So what if someone went under the knife intentionally to benefit their professional athletic performance? Liposuction, removal of unnecessary body tissues (you can make it on one kidney, right?)..heck, why not replace bones with lighter and stronger synthetic components? Should this be against the rules? Does this violate our sense of ethics and fair play?

sourceThis brings me to the case of one Simona Halep, a tennis prodigy of whom I was not previously aware. A Medscapes blog entry by Jennifer Walden, MD a reconstructive / plastic surgeon tells us that this professional athlete intends breast-reduction surgery.

Simona Halep, as you may or may not know, is from Romania and is a budding Junior tennis player. She is ranked #258 in the world. She won the Junior French Open tennis tournament in 2008, and although not yet fully developed as a professional, she reached the second round of the qualifiers for the Senior French Open in 2009. In May 2009 she received widespread media attention all over the world for expressing her desire to go through breast reduction surgery in order to perform better on the tennis court. I found it surprising to read on blogs and sports pages online how much fans and readers did not understand the purpose and benefit of breast reduction surgery. Comments ranged from disgust to outrage to frank misunderstanding of what the indications and outcomes are for breast reduction surgery.

The blog then goes on to demystify and explain the reasons for breast reduction surgery which is great. Nice public service blogging on health conditions which they seem to like around these parts. However, the sports fan in me got a little tweaked about the argument that this was justified on the following grounds:

In Simona Halep’s case, it is clear that her very large breasts are causing a functional interference with her tennis game. Her swing is somewhat impeded by what is in the way, and she just can’t move as quickly with her figure as it is now. There is no doubt that Halep’s game will improve after a reduction of her breasts, and likely make her able to swing more quickly and react on the court faster. This is not for vanity, it is for comfort and to function in a more effective manner.

Well….yeah. But….but….. Do we really justify surgical modification of the body based on optimizing athletic performance? Yes of course we do- surgery to fix congenital defects (including poor vision…hmm) and repair injuries are okay, right. But is this something a little different? More like liposuction in that pro cyclist that can’t drop that final 5 kilos necessary to climb the Alps with the front group?
Sticky question.