EPO Abuse

EPO (Erythropoietin) is a hormone produced in the kidneys. Once produced, it travels via the circulation into bone marrow. It is here in the bone marrow where it is used to create red blood cells. 

By increasing the amount of EPO in the body, you also increase the number of red blood cells in circulation. The advantage of this is increased oxygen carrying capacity, which of course has a large effect on endurance performance.

Because EPO is a naturally occurring hormone, it is safe and legal for athletes to boost the levels of this hormone in their body through use of altitude training (real or simulated). However, injections of artificially created EPO are even more effective, making performance boosts of 5% or more possible. There are serious health risks associated with injecting EPO, as the blood becomes much thicker with the increase of red blood cells. The chance of a clot occurring increases as a result of this. In recent years, the death's of 20 cyclists are thought to have been caused by this clotting.

Unsurprisingly, EPO is on the IOC's list of banned substances. Though for many years, it was an extremely difficult substance to test for. The original test protocol used by the UCI was too simplistic to generate clear cut results. This test involved taking a blood sample and measuring the proportion of red blood cells within it. If a high proportion of hematocrit was found, then the athlete would not be banned, but they would not be permitted to compete on the grounds of it being a health risk. It wasn't possible for the UCI to ban an athlete from these results as there was no way of proving the increased hematocrit levels were achieved through altitude training.

One of the other major problems with this test, was that it was very simple for athletes to cheat. The test protocol meant that it was necessary to give athletes a 10 minutes to report to the medical team. Within that 10 minutes it would be possible to inject 500ml of saline into the blood stream, instantly bringing the hematocrit level down by a few percent.

The second form of EPO test is a urine test. This test is much more complex than the previous one, as it is designed to expose artificial EPO from natural EPO, as opposed to just measuring the effect any form of EPO has had on the body. This method, based on the technique of Immunoblotting, was first tested to see if it could detect the use of recombinant (artificial) EPO in patients who were using the drug. It was successful. The same technique was then used to examine 102 frozen urine samples from the 1998 Tour de France. This testing revealed 28 positives. The 14 samples with the highest concentration were then Immunoblotted. All were positive for recombinant EPO, Looking at these results, it would appear likely that at least 20% of competitors in this tour used EPO.

The third form of testing takes an alternative route to the detection of EPO abuse. Instead of looking at the EPO itself, it looks at the effects EPO has on red blood cells. The Australian Institute of Sport (who developed this test) found that a specific indicator of EPO injections is an increase in the of immature red blood cells (reticulo cells). Through analysis of these reticulo cells, it is possible to distinguish between athletes who have injected EPO, and athletes who have had a natural increase in red blood cells.

There are problems with both the urine and blood tests. It is speculated that the urine sample will only test positive if the last injection was carried out a few days before the test. Any more and the EPO will have disappeared from circulation, and therefore urine. The blood test is likely to be capable of detecting EPO use within the previous 2 weeks, as that is the length of time red blood cells take to mature.

So, despite each of these tests displaying frailties which a minority of athletes will take advantage of, it is encouraging to see that there is progression and rapid improvement in these techniques. As the testing methods have become more and more advanced, this minority of athletes appear to have moved onto blood doping, as the difference in red blood cells is much more difficult to detect. However, as testing techniques continue to develop, more and more cheats will be exposed, and (I'd like to think) sport will become cleaner and more transparent.

Ben Brown

The Cost of Extreme Endurance

Ultra-Marathons are running events which exceed 50 miles in distance. These races are aimed at the fittest, most experienced and mentally tough athletes. With such huge distances to cover on foot, injuries such as Tendonitis and Muscle tears are commonplace. However, according to research carried out by Liverpool John Moores University, athletes should have greater awareness and concern over the damage which can occur to the heart during a race.

LJMU studied a group of 25 runners (aged between 24-62) competing in the "Lakeland" race. 16 of the group competed in the 50 mile race, and the remaining 9 in the 100 mile race. All of the runners had at least 2 years of Ultra Marathon experience, and had trained specifically for the race. None of the participants had any known heart conditions. Each of the 25 subjects would be given a blood test, an ECG and would be weighed before and after the race.


The Results:

- Of the 50 mile competitors, the average completion time was 15 hours, and average weight loss was 2kg.

-Of the 100 mile competitors, the average completion time was 36 hours, and average weight loss was 3 kg.

-The post race blood tests showed that Troponin 1 levels rose significantly in 21 of the 25 subjects. In 3 of the runners, levels were high enough to suggest serious Cardiac damage.


The ECGs carried out before the race are said to have shown slow heart rates along with the electrical changes you would expect from an athlete.
In the post-race race ECGs, there were significant electrical changes in over 50% of the subjects. In some of the subjects, bizarre electrical changes were shown, not usually seen in normal ECGs (At rest or during exercise).

In Professor Somauroo's summary of the results, he stated that the study "suggests that running continuously over 50 or 100 miles may not be good for the heart". The closing statement of the study however, states that "There was no proven correlation between the changes in Cardiac Troponin 1 and the ECG changes."

This study appears to show that a large proportion of Ultra Marathon competitors are likely to suffer some degree of Cardiac Damage. It is however, important to consider how the study was carried out to decide how reliable the results are likely to be.


-The study group was small and therefore may not represent the general condition of Ultra Marathon competitors.

-The Lakeland race, where this study was carried out, suffered very difficult weather conditions. This could have affected the results.

-The subjects may have extremely varied levels of experience, as the only information we're given is that all subjects have been competing in Ultra Marathons for at least 2 years.

-The subjects were not given a full medical check-up prior to the race. This could mean that subjects with unknown heart conditions took part in the study and harmed the validity of the research.


It is expected that further data (Heart function levels) concerning this subject will be released at a later date. This data could go towards creating a greater understanding of the effects extreme endurance events have on the body, and how these adverse affects can be minimised.




Ben Brown

Heel-less Running Shoes

The development of new technologies designed to allow athletes to extend their career's to points previously thought to be impossible is rapid. As the average life expectancy increases, the market for sport equipment products designed for people of middle age and beyond has grown too.

One of the main problems for older athletes, is the frequent occurrence of injuries. The development of a new Heel-less running shoe intends to solve that problem, at least for runners.

Most running injuries suffered by older runners can be attributed to poor technique, with Over-Pronation, Supination and Heel-strike being widely accepted as the main causes. Each of these technical issues cause similar problems for the athlete's body, as they place large stresses on joints, tendons and muscles.

Supination or Pronation of the foot in a running stride mean that the landing force cannot be absorbed properly, increasing stress on the bones and joints. Heel-strike creates similar problems for runners, as the large impact force created by landing on the heel travels in a linear fashion directly though the heel bone, fibula and tibia, as well as placing a great strain on the achilles tendon.

Ideally therefore, a runner will land further forward on the shoe, allowing the force to be partially absorbed and spread by the sole, and the foot itself. This means the stress placed upon the joints is reduced.

The Healus running shoe forces the runner to run in this safer, more sustainable style, in much the same way that an insole would force an athlete to become more neutral in their running stride.

The Healus shoe also uses a shock plate to dissipate the force across the whole foot. This is used in combination with a sole constructed using "HelixVA." This material makes the sole more shock absorbant than the sole of a normal running shoe, meaning that the Heel bone is able to decelerate over a greater distance.

So, it would appear that the Healus technology could help athletes lengthen their running career's considerably through the prevention of injury. It is important to consider, however, that this product is still in the development stage, and that it may be long time before it enters production.

If this product can be designed to be as durable as standard running shoes, with the necessary testing to prove that the theory behind the design is correct, then they could have huge potential.

Ben Brown