PARIS | By revealing that he had daily recourse to injections of anesthetic product at Roland-Garros, Rafael Nadal opened the debate on this legal medical practice, between ethics, anti-doping regulations and differences with other sports.
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What does the regulation say?
“We blocked (the pain) by injecting anesthetic before each match,” explained Rafael Nadal, who suffers from Müller-Weiss syndrome in his left foot.
Numbing products are not prohibited by the World Anti-Doping Agency (WADA) World Anti-Doping Code.
Another way to deal with pain, the use of corticosteroids is however prohibited during competition since January 1.
“The use of anesthetics is a practice that has surely become more frequent since this year since it is all that is possible to limit pain locally”, comments for AFP Dr François Lhuissier, president of the French Society of Exercise and Sports Medicine (SFMES).
An athlete could however use corticosteroids in competition, possibly by injection, if he had a Therapeutic Use Authorization (TUE).
“No TUE committee would give a TUE for the reason of Nadal, sweeps Mr. Lhuissier. A TUE is when you have a health problem that will handicap you in everyday life, not just in sports, for example asthma or hypertension. TUEs are not given to allow athletes to practice their sport again, but to return to a normal level of health.
Other sports
“In football, infiltrations are very widespread”, assures AFP from a general point of view doctor Jean-Pierre de Mondenard, sports doctor, who keeps a blog (dopagedemondenard.com). “But these are not treatments, you treat the result but not the athlete,” he warns.
In athletics, “these are not at all common practices, at least in France”, indicates to AFP Dr. Antoine Bruneau, doctor of the French teams at the French federation.
“Whether it is the use of an anesthetic or the injection method, both are not common at the time of competition. It is probably more common in team sports championships with matches every weekend.
“It’s part of the therapeutic arsenal at our disposal. But putting a nerve to sleep on a lower limb would cause problems in terms of balance and gestural control. There is a difference between the races with translation and the slides of tennis and the quality of foot necessary for a jump or a race in athletics where you need all the sensations, it seems to me hardly possible in principle.
An ethical practice?
Only cycling, a sport regularly mocked on the question of doping, has gone further than WADA by including in its sports regulations the prohibition of any injection within the framework of a competition. Engaged with his team in the Movement for Credible Cycling (MPCC), Thibaut Pinot scolded Nadal on Twitter “today’s heroes…”, then developing on the ethics of high-level sport: “we see too many athletes use this kind of practice in recent weeks.
“From an ethical point of view the only thing that interests me is whether it is authorized or not, indicates Mr. Luissier. WADA has ruled on this matter. They have ethics specialists. I wouldn’t do it for myself, but if an athlete asked me, as long as it’s allowed, I would.”
For Mr. Bruneau, the new regulations on corticosteroids “is a message addressed to the sports world about injections” and their symbolic needles.
A health risk for Nadal? “The injection of anesthetics will have no consequences on his health, believes Mr. Luissier. On the other hand, the fact of being anesthetized means that you feel your foot and its support less, so it increases the risk of suffering a sprain.
“Pain is a natural alarm signal of the human body,” recalls Mr. Bruneau. I wonder if it is beneficial to anesthetize during a competition by depriving an athlete of sensation…”