21 January 2011

Lance Armstrong: inspiration or a cheat?

Dr Ross Tucker asks some tricky questions around the latest Lance Armstrong doping allegations; namely do we care that he may be a cheat, given that he's inspired millions?


Dr Ross Tucker asks some tricky questions around the latest Lance Armstrong doping allegations; namely do we care that he may be a cheat, given that he's inspired millions?

Lance Armstrong is a polarising figure. He is either the greatest cyclist who ever lived, a man who conquered cancer and then – a record seven times – conquered the toughest endurance sports-event in the world, the Tour de France.

Alternatively, he is the greatest fraud sport has witnessed, a man who has systematically doped and lied, driving a sophisticated doping programme within his team en route to his revered status. His appeal (or his cheating, depending on your point of view) transcends sport.

The latest batch of allegations, published on Tuesday by Sports Illustrated following an exhaustive investigation, have once again thrust the debate into the media. There are some difficult questions. Do we care that Armstrong may have cheated, given that he has inspired millions? Should we care that one of sport’s great champions may be a fraud?

 Evidence that demands a verdict

 The allegations against Armstrong have built steadily over the 11 years since his first Tour victory in 1999. Back then, his status as a cancer survivor was weighed up against the fact that only the year before, the Tour de France had been rocked by the largest doping scandal in the history of the sport.

Major champions were tarnished, the sport had lost its credibility. And then suddenly, a surprise champion, who had been given a less than 50% chance of survival, was dominating the Tour.

Surely not? Reaction was divided, but the desire to restore hope and belief to cycling won over and most, particularly in the US where Armstrong’s PR machine and sponsors were aggressive, were sold on the idea that the sport had found a saviour.

More significantly, cancer had a role-model. Armstrong wrote books, lobbied for funding, set up organisations and inspired millions. That he went on to win six more Tours only added to the magic. In the words of one cynical journalist he became “some God come to earth on two wheels to lead us into some glorious future after the ‘war’ on cancer has been won.”

I have to point out, however, that the naysayers are not unreasonable in questioning Armstrong’s cleanness. In the last 20 years, there is not a champion cyclist who remains untainted by drugs. Marco Pantani, Bjarne Riis, Jan Ullrich, Richard Virenque, Floyd Landis, Roberto Heras, David Millar, Alberto Contador, Michael Rasmussen.

The list goes on. Basically, the champions have, almost without fail, been exposed as dopers. One former five-time winner of the Tour, Jacques Anquetil, once said: “You have to be an imbecile or a hypocrite to imagine that a professional cyclist who races 235 days a year in all weather can keep going without stimulants.”

So Armstrong was always going to be questioned.

What has emerged cannot be dismissed. There is a growing mountain of evidence and allegations, some no doubt fuelled by ulterior motives, but all requiring a look. These include:

  • A former mechanic Mike Andersen has testified to discovering steroid hormones in Armstrong’s bathroom, and being asked to cover for Armstrong by destroying traces of doping products and lying to testers about Armstrong’s whereabouts.
  • Greg LeMond, himself a former Tour de France winner, asked pointed questions about Armstrong’s relationship with the notorious Dr Michele Ferrari, an Italian doctor and coach who has been instrumental in doping programmes for many elite athletes, and who once famously compared EPO (a blood boosting drug) to drinking too much orange juice.
    Armstrong was involved with Ferrari secretly until the media exposed their relationship, forcing Armstrong to first declare that he saw Ferrari for “routine checkups”, and then later publicly distance himself from the controversial coach.
    However, the new allegations by Sports Illustrated suggest that this relationship was alive and strong as recently as 2009.
  • A Paris laboratory reported that research testing of samples from the 1999 Tour de France revealed that Armstrong had been using EPO when he won his first Tour. The test for EPO was only created in 2000, and so in 1999, this drug was undetectable. When the lab went back to the 1999 samples, Armstrong tested positive. However, because the testing was for research purposes, and no B-sample was provided, this finding carried no sanction.
  • In 1999, Armstrong tested positive for a corticosteroid, also banned unless the cyclist has medical permission to use it. This medical certificate was quickly created and back-dated, allowing Armstrong to escape sanction.
  • Allegations that Armstrong was paying the UCI, the sport’s governing body, through donations allegedly used to fight doping. This has led to speculation of bribes and cover-ups of positive test results and more lenient treatment by doping controls. Certainly, there can be no doubt that cycling is complicit in many of its doping problems.
  • Former team-mate and 2006 Tour de France winner Floyd Landis made explosive accusations that Armstrong was the instigator of doping within the team, that he pressurised team-mates into doping, and that they adopted elaborate and sophisticated methods to avoid detection by the doping controls. Landis is not alone. Former team-mate Stephen Swart alleged the same in the recent Sports Illustrated expose, being explicit that Armstrong was “the instigator”.


More serious allegations emerge

In the Sports Illustrated piece, even more serious allegations have emerged that include insider information from an ongoing federal case against Armstrong. These include:

  • That Armstrong had unnaturally high levels of the hormone testosterone, dating all the way back to 1993, before he was diagnosed with cancer. This high testosterone level, picked up in doping controls, was not acted on by the US Olympic Committee, which is also accused of covering up positive tests. When the US cycling authorities asked for the test results in 1999, they were told by the lab that they could not be located
  • That Armstrong gained access to a drug called HemAssist, which was not yet approved for human use. This drug would theoretically improve performance in the same way EPO would, by boosting the body’s ability to carry oxygen. Because it was not approved by the FDA, it would be illegal to even be in possession of it.
    This may be the most serious allegation to date, because it has repercussions not only for Armstrong, but for cycling (undetectable drugs are clearly the target of riders) and the medical community.

 The common response to these accusations has been to dismiss them as a “witch-hunt”, on the part of the jealous French, a has-been cyclist, a disgruntled mechanic, a bitter former team-mate, and so on.

Attacking the character of the accuser seems to be the standard response. It has meant that many have not stopped to consider the content of the allegations, and the ramifications if even one of them is correct. “What” is being is overridden by “who” is saying it. Of course, both should be considered, and accusations lacking credible sources should be dismissed out of hand. But these sources do not lack credibility.

Not every single source has a darker motive.

They are not all jealous or scorned, or greedy to extort money. Motivations can include conscience, or a desire to see the truth exposed. And when Sports Illustrated publishes these allegations, despite the threat of legal action, it is to be assumed they have confidence in their evidence, and proof, and that means we need to listen more closely.

So what do we believe about Lance Armstrong?

Most of the allegations have not been proven – they are circumstantial, or an individual’s word against Armstrong’s word. But documents detailing doping, records of how Armstrong may have acquired the illegal drug, and an ever-increasing body of testimony from those directly involved now constitute a large body of doubt.

It is no longer possible to simply dismiss them on the Armstrong team’s say-so.

The list above is a summary of what has emerged. Triple it, and you understand the weight of suggestion that Armstrong has used performance-enhancing drugs. Not all the allegations need to be true.

To knock Armstrong off his clean-rider pedestal, only one or two need to be true. And if two are, then the chances that the others are increases exponentially, for they are not independent allegations. If Landis is telling the truth, then Andersen’s testimony of drugs in the bathroom gains credibility.

If Armstrong did acquire illegal drugs on the black market, then the positive tests for other undetectable drugs like EPO in 1999 suddenly become a lot more believable.

Before dismissing this as “mud-slinging”, or a “witch-hunt”, it is wise to recognise that even in a capital murder case, you do not need to have a smoking gun, video footage and a confession in order to deliver a guilty verdict.

The impossibility of the physiology

From a scientific point of view, the case is strong. Without going into the technical details, it is possible to show conclusively that a human being, unaided, is incapable of producing more than about 6.2 watts per kilogram (W/kg) of power for a sustained period during cycling. It’s rather like if you were standing with a radar gun and a car drove by at 320 km/hour.

That car would have to have a mighty powerful engine. If I told you it was a 1.3-litre engine, you’d challenge me. Similarly, physiology can show that cycling at higher than 6.2 W/kg at the end of a Tour stage simply should not happen.

Yet, when you go back into the 1990s and 2000s in the Tour de France, you find a series of champions who produced 6.5 W/kg, 6.7 W/kg and even 7 W/kg. Armstrong? He often rode at 6.5 W/kg or higher, including one ride at 6.97 W/kg.

This is simply not physiologically feasible.

 Interestingly, since the testing got more stringent in 2006, the power outputs have dropped, and this year, the best riders hardly ever rode above 6 W/kg. Are the current crop just weak? I doubt it – more likely, the class of the 90s and 00s, Armstrong included, were performing above what is “possible”, thanks to doping. Again, all but Armstrong have been exposed or admitted to doping.

Or take the comparison argument – if every other major champion has doped, and doping improves performance by between 2% and 5% , then is it credible that one man, without doping, has overcome that difference and still dominated? Sport simply does not work that way – the difference between the best and second best at the elite level is 0.5% to 1%, not 5% (even Usain Bolt is only 1% better than everyone else).

The point is that evidence may be circumstantial, but it’s still worthy. And the insistence by many on a positive test result is meaningless. Remember, Marion Jones didn’t fail a drugs test, but she is an admitted doper.

Dwain Chambers didn’t fail a test for years while doping. Jan Ullrich and Ivan Basso were exposed based on police work, not doping control.

The argument that Armstrong is the most tested athlete ever but has never tested positive is an ignorant one, because doping is simply more sophisticated than detection.

 Do the ends justify the means?

Finally, the pointed question: do we care? Should be pursue a man for cheating when he has inspired and possibly saved millions from cancer? To me, this is asking whether a good deed cancels out a bad one. If the Mafia reinvests some money into the community it runs/terrorises, then does it matter that they maim and kill many on the way?

If gang leaders build community centres adjacent to the streets where they kill and sell crack cocaine, would it make them acceptable?

We simply cannot allow ourselves to create a balance sheet, where we “debit” certain actions and “credit” others. The balance sheet cannot count up what we do right and ignore what we do wrong, provided it is in the minority.

And if a sportsman has inspired many, but has done so through illegal means, then with the greatest of sympathy and without wishing to trivialise anything, we cannot simply turn away from the ever-mounting evidence of cheating.

Dr Ross Tucker, is Health24’s FitnessDoc and has a Ph.D. in Exercise Physiology from the University of Cape Town and a Post-Graduate degree in Sports Management from the UCT's Faculty of Commerce. He is currently employed at the University of Cape Town and Sports Science Institute of South Africa, and works as a consultant to various sporting teams, including South African Sevens, Canoeing, Rowing and Triathlon SA. He also blogs on

(Health24, January 2011)



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