Kcr.

Good post.

Of course, there’s a documented advantage to using inhalers if not asthmatic which is where my points about the TUE system being abused come in.

The Asthma card gets brought up a lot, and I understand both the medical application for suffers to be able to maintain unhindered performance (other half is on two differnet inhalers daily), and also the benefits it can give to non-suffers to improve normal performance, and the questions that brings up about TUE abuse, so I have a question, as I’m not sure where to get the answers.

– Do we have stats for number of Asthmatics using inhalers (type?) in the tour?
– Is that number appreciably different by % to the % of Asthma suffers in general population?

> if it is NO higher then I think we have to put that one to bed not an issue, especially considering a TUE requires review and agrement, I have to believe that if the number of suffers in the tour is in line with normal population, ADN the TUE requests are reviewed then they must be genuine.

> if it IS higher then we have an interesting question to answer…

is there some reason that more Asthmatics gravitate towards the top of end of a sport? why? what mechanism is in play here? on the face of it it would seem an odd thing, if there was a higher than average % of people with respiratory problems ending up in pro sport, and then ending up right at the top of the field in that sport, <yoda>very odd it would be, explanations we must find…</yoda>

OR

is the TUE system being abused? in which case is the review board being duped, or is the review board in on it? how do you combat that?

And if the TUE system is being abused for Asthma then that throws into question the TUE review process in general, for all meds and casts doubt on anyone involved in the review and the medical advice.

so, are we making a fuss over nothing with Asthma or is it actually an indicator or something awry in the process/system?

Well you need to bear in mind that “asthma” covers more than one thing

EIA is likely to be higher in incidence in active people than couch potatos

Lots of information about asthma in elite athletes
https://www.google.co.uk/#safe=on&q=incidence%20of%20asthma%20in%20elite%20athletes

thanks for the link Nemesis, anyone know where we could get info on who in the tour has a TUE for medication?

Not sure – I always figured that while the athletes obviously need to share that with the governing body, it’d otherwise be covered by doctor confidentiality type thing – a rider isn’t going to want the world to know what he’s on X for a dodgy rash 😆

I read an interesting article recently about the asthma TUE issue. The bottom line was the suggestion some sports doctors were taking a fuzzy approach to defining the condition and prescribing treatment for people who would not normally be defined as asthmatic, but whose lungs perhaps simply didn’t work quite as well when they were competing. So they were potentially medicalising someone who simply had a less effective physiology.

Amedias.

I think its a flawed approach to try to draw a conclusion on incidence rates in the peleton, comparing word class pro cycles to the general population.

Just by shear nature of the sport, you need to be special, to begin with.

For TUE this page is interesting: http://www.uci.ch/clean-sport/therapeutic-use-exemptions/

There were 24 TUE’s given out by the UCI in total in 2014 compared to 239 in 2009. Almost like in 2009 (and before) they were used to cover up positives or something

I don’t disagree Solo, and I’m not drawing conclusions, I’m asking questions, the answers to which may lead me to formulate a hypothesis, but I’m certainly not yet drawing conclusions, which is why I specified that if it is higher incidence in the pro peleton, I’d be curious as to why.

You would naturally assume that anyone suffering form a respiratory condition like Asthma might find it harder to rise to that level in the sport due to the impact it has, I know it can be controlled and treated to a degree, remember I live with a sufferer, I see the impact it has on her and the steps she has to take to manage it during normal life and exercise.

There would have to be some mechanism at play to explain it, and what isn’t obvious (to me at least) is why a respiratory condition would be so prevalent in athletes competing at that level, unless as suggested it’s actually an increase in EIA as a result of being at that level in the sport, rather than sufferers who have risen to that level despite it.

Either way, I’m curious (as always!)

I live with a sufferer, I see the impact it has on her and the steps she has to take to manage it during normal life and exercise.

Not all asthma is the same. EIA is very different to the type of asthma it sounds like you’re seeing.

EIA if managed (via TUE…) shouldn’t (usually) restrict an athlete.

Amedias.

Ok, apologies if I’ve missed anything.
🙂

cheers Atlaz

for ref:

Year – TUEs approved
2009 – 239
2010 – 97
2011 – 56
2012 – 47
2013 – 30
2014 – 24

Definitely interesting…and quite a sharp contrast, maybe TUE abuse isn’t as rife as some people indicate.

Was something requiring a TUE in 2009 allowed without a TUE from 2010 onwards?

Definitely interesting…and quite a sharp contrast, maybe TUE abuse isn’t as rife as some people indicate.

are you suggesting that people are flinging round random stuff with no evidence?

There were 24 TUE’s given out by the UCI in total in 2014 compared to 239 in 2009. Almost like in 2009 (and before) they were used to cover up positives or something

This implies that
1. TUEs are harder to get due to new rules/change in regime
2. TUEs are no longer necessary – some new drug/doping method has taken over
3. The peloton have miraculously recovered from all of their ailments
4. Cycling is cleaner, so the no-one needs the advantage from the TUEs anymore
5. Some drugs have been legalised to save on paperwork etc

Personally I’d suspect mainly 1. and a little bit of 2, possibly 5 though I haven’t seen any evidence for it. 3 is highly unlikely, and clean or not, people will always cheat to get ahead, so I don’t think 4 would apply.

are you suggesting that people are flinging round random stuff with no evidence?

I don’t have enough evidence to suggest that 😉

I was more thinking along the lines of joeydeacon list above, there will be reasons, I don’t yet know what they are.

I read on road.cc that G climbed Plateau de Beille quicker than Armstrong, stage winner, in 2002 and 04. I checked his times and apparently Armstrong climbed it in 45 minutes plus some seconds. A rewind of my recorded coverage shows G (and the group he’s with) climbing it in, yes, 45 minutes, plus some seconds. Depends on where you measure start of the climb, of course.

Views and comments?

Tried an Asthma puffer on some alpine climbs recently, it was like having 10% more lung capacity for 10/15 minutes after each intake.

Evidence? Placebo? 😉

Views and comments?

Better training and equipment, of course.

Was Lance flat out when he set his time?

Were conditions the same?

Was it measured at the same point?

But logically that’s hard to believe and that’s the problem. On a human level I struggle to see Sky as cheats but there are many practical difficulties with that position.

Were conditions the same?

You suggesting the typhoon made them faster today? 😆

Lance would have claimed it – tail wind (there’s a joke there somewhere for those in the know…)

Personal insight, take it or leave it.
is t there also less need now to take Lance type substances when the same is now achieved by weight managment, training at altitude and oxygen tents?

Because those are all new things which nobody had thought of 15 years ago?

Tried an Asthma puffer on some alpine climbs recently, it was like having 10% more lung capacity for 10/15 minutes after each intake.

In which case you probably have Asthma ! As I understand it, the inhalers don’t benefit those who don’t suffer. Also EIA is common among endurance ahletes because endurance training strains the lungs.

Have you ever done a peak-flow test? I was recently told I had EIA and so did some comparison with my friends. Unmedicated I score 450, with an inhaler I can get up to 550. Amongst my cycling buddies, the shortarses were at 650 and 700, whilst the guy who is a just slightly shorter and older than me was at 800.

Note the inhaler doesn’t increase your lung capacity, but the flow of air into your lungs. Asthma makes it harder (and more exhausting) to take a deep breath.

Interesting. I used to do annual peak flow tests because I occasionally did soldering in work. Was never that awful, but not that great either and sometimes took several attempts to “pass”. Fairly sure I don’t have asthma in a normal sense, but have had breathing difficulties when exercising occasionally. How would I go about getting diagnosed with EIA if I do indeed have that?

http://thorax.bmj.com/content/56/9/675.full

This, and other studies, suggest there is no significant performance enhancing effect to inhaled bronchiodilators, but go on to say there was a perceptible lessening of breathlessness at the beginning of exercise, which would tally with what wilburt experienced. I’m not sure how that marries with the overall conclusion, in this era of marginal gains.

My PF is currently about 525, and was down to 350-400 a month or so ago. It’s been a crap year! 800 PF – that’s just unfair.

You don’t even need a TUE for the most common inhalers. This is from the UCI website:

Beta-2 agonists for asthma (Salmeterol /Salbutamol/Formoterol)
You do not need to submit any TUE if you take inhaled Salmeterol, Salbutamol (up to a daily dose of 1600 ?g) and/or Formoterol (up to a daily dose of 54 ?g).

Terbutaline or other beta-2 agonist
If you take Terbutaline or any other beta-2 agonist for the treatment of asthma, you must submit a TUE for asthma and a full medical file to confirm the diagnosis of asthma and/or its clinical variants. The medical file should include:

A detailed medical history and clinical review;
Lung function test with spirometry;
Bronchodilator response;
Bronchial provocation tests.
To assist your doctor in completing the correct tests, and providing the correct medical information, we suggest that he or she consults the WADA Guidelines on Asthma click here.

If the TUE for Asthma is completed correctly with valid test results, the UCI TUE Committee may grant an approval for up to 4 years.

I am not a clinician, but are you saying that someone with a chronic diagnosis of asthma doesn’t need to submit a TUE?

Love the tour! , Just ask the likes of Nibali, Contador etc , “have you turned up in the best shape you could for this years tour? think they would all say no , so any superhuman efforts by Froome are not as amazing as they may be!!
As a pretty average 47 year old rider who does the same 50 mile route most Wednesdays , there is weeks when 18 mph is fine and weeks when 15 mph is torture!!
Give them a chance ,as a good judge of character I`d say team Brailsford is what he preaches!!!

hmmmm – I’m sure Salbutamol was previously banned. I wonder if that was the 2009/2010 difference.

I’m never entirely sure why beating the times of known dopers from the past is seen as so unlikely, even if you disregard entirely the race context within which the times were set. (As the twitterati are prone to do)

Every aspect of the sport has improved massively, (“ha ha ha inc drugs lolz” – saved you the effort.) kit, training, tactics etc, riders are visibly skinnier and more fragile. Just because he was dominant at the time doesn’t mean a doped Armstrong will forever remain the pinnicle of cycling performance.

How would I go about getting diagnosed with EIA if I do indeed have that?

Go and see your GP and ask for a spirometry test – or tell them your sysmptoms. In my case I was first told I had it 15 years ago – my problem was a persistant cough after running, particularly in cold air – but hardly ever used my inhaler as I pretty much gave up running instead ! Over the years I’ve learnt that I’m a diesel engine – great for long journeys, but rubbish if an intense effect is required – and have tailored my activities accordingly. I also assumed I simply had rubbish lungs – frequently get altitude sickness on skiing holidays.

The trigger this year was a 50 mile road taking in some of the steepest hills in the NYM (Glaisdale, Rosedale, Blakey, Street) on a cold day in Feb. Stubbornly refusing to stop on the hills, it was then weeks before I could take a deep breath without coughing.

Obviously this has nothing to do with doping in le tour, but hopefully useful info….

Ivan – some good points but I’m not sure that they’re all right.

I agree that Lance et al probably shouldn’t remain the gold standard forever but we’ve seen in other sports which are maybe more consistent and measurable (eg athletics) that implementation of stricter controls has lead to changes in the results being recorded on a par with the theoretical benefits of doping – 10% give or take IIRC. 10% can be gained back but it’s a significant amount at that level and I wonder if we’ve grown accustomed to significant year on year improvement as a result of doping rather than through natural means – ie underestimating the time it takes to make those improvements naturally.

Every aspect of the sport has improved massively? I’m not sure I agree with that. Bikes remain the same weight and while bearings have got better (ceramics, etc) and bikes more aero I don’t buy the hype from the manufacturers that they’ve improved massively.

Similarly, I disagree that (top GC) riders are visibly skinnier and more fragile – that was very much the case by the early 2000s

Training? Yeah, I’ll agree on that one, particularly the likes of Sky but as I said above, it’s hard to know how much that’s gaining? Or for example maybe it doesn’t actually gain that much but it does improve consistency.

Tactics? well, not really beyond the above – Tactics we see today aren’t really all that different to what we saw in the USPS days (and I’m not talking doping, just the tactic of setting a high pace so that the more explosive climbers can’t gap the more steady pace of the more rounded riders).

That’s a kind of Armstrongesque statement I’m afraid. Nothing has actually improved massively in the last 10 years.

riders are visibly skinnier and more fragile

Erm…

When did power meters get introduced? Was that pre or post Lance era?

I’d have thought that would have made a substantial difference not just to training but also the ability for a rider to most effectively pace themselves up a hill.

According to Wikipedia (usual caveats apply) power meters were introduced around the time Greg Lemond was racing in the mid to late 1990s. They have been commercially available since 1989.

my problem was a persistant cough after running, particularly in cold air

used to get “exertive cough” after riding in my late teens early twenties and yeah cold weather caused it more. Not enough to warrant an inhaler after a bit of peak flow testing. I don’t seem to get it nowadays despite exerting myself a lot more than I used to. The smoking ban and me spending less time in pubs has happened since then tho, I think they could be linked 🙂