• Explainer

The Explainer – WADA, the NFL and platelets

by Charles Pelkey

• February 25, 2009
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By Charles Pelkey

Dear Explainer,
There is something that I don’t understand following the recent reports that A-Rod tested positive for steroids. Why is Major League Baseball not required to conduct drug testing in accordance with the rules of the World Anti-Doping Agency, given that baseball is an Olympic sport? It has been said many times in VeloNews and other publications that the UCI must test per WADA requirements in order to maintain IOC eligibility. Why the double standard?

On another note, did you catch the sideline reporter at the beginning of the Super Bowl talking about Pittsburgh player Hines Ward undergoing a “controversial” new treatment that consisted of removing some of his own blood, filtering the red blood cells and re-injecting those cells to treat his injured knee by increasing the oxygen supply? Sounds like blood doping to me!

Thanks for your column.
Steve Compton, PG
Arvada, Colorado

Dear Steve,
You’ve asked a question commonly raised not only about baseball, but also about basketball and hockey.

The quick answer is that unlike cycling, the Olympic-affiliated international governing bodies (IGBs) of baseball, basketball and hockey exercise absolutely no control over their respective sports’ top professional leagues. For obvious reasons — namely, that American football isn’t an Olympic sport — the NFL also doesn’t fall under the auspices of WADA.

So, football aside, what about these other sports? Take basketball, for example. Many of you might recall the “Dream Team” era, which saw top NBA stars joining forces to become the ultimate all-star basketball squad beginning in 1992, when professionals were first allowed into the Games. That 1992 roster included some serious star power, with Patrick Ewing, Scottie Pippen, Charles Barkley, Larry Bird, David Robinson, Magic Johnson and Michael Jordan among those playing for the U.S. in Barcelona. When they did that, they fell under the rules and regulations of USA Basketball.

But 1992 was pre-WADA and the transition was relatively seamless.

Most recently, the U.S. fielded a basketball team composed of some stellar players for the 2008 Olympics in Beijing. Stars like Kobe Bryant and LeBron James joined Team USA more than a year in advance and agreed to subject themselves to all of the rules and regulations of the IOC, including full compliance with WADA rules.

Baseball, on the other hand, has not really fielded a Dream Team equivalent. Team USA has included talented high school players, college athletes and some professionals, although not from the ranks of Major League Baseball. The U.S. national team does fall under the control of USA Baseball, which as a member of the IOC, must comply with all of that organization’s rules, including the anti-doping provisions of the WADA Code. (It is likely that IOC rules will continue to apply to members of that national team, despite the fact baseball will no longer be an Olympic sport, since any sport hoping for readmission to the Games has to have a record of IOC and WADA compliance.)

So who regulates doping in Major League Baseball? The anti-doping rules of Major League Baseball — and the NHL, NBA and NFL for that matter — are governed by the provisions of the collective bargaining agreement. Anyone who has spent the time to sift through the “Report to the commissioner of baseball of an independent investigation into the illegal use of steroids and other performance-enhancing substances by players in Major League Baseball,” known more elegantly as the “Mitchell Report,” can see how ineffective those efforts have been.

Personally, I believe that baseball could learn a lot from cycling when it comes to doping — or, more appropriately, the efforts to control it. Think about it in the extreme for a moment. Applying the rules now used by the Tour de France, you could see an entire team eliminated from the playoffs, or even the World Series, if just one player tested positive.

Now to your second question. We’ve already established that the NFL has its own doping rules. You might believe those are really effective, if you also believe that 300-pound people can normally run a 4.4 40. But I digress.

PRP Therapy

Your question has to do with whether Mr. Ward’s re-injection of his blood — in this case known as Platelet Rich Plasma (PRP) treatment — would be banned under WADA rules.

My gut answer would be no, but the rules are unclear at this point. Given that the procedure is relatively new, the WADA Code and its listed of banned substances and prohibited practices does not specifically address PRP. What the code does address, though, is something known as Insulin Growth Factor 1 (IGF-₁), which is present in those platelets.

What’s at issue — and remains unclear — is whether using your own IGF-₁ constitutes a violation of WADA rules, as would using your own red blood cells. There is no suggestion that PRP increases the overall levels of IGF-₁ in your system, but it does concentrate it at an injured area. It’s a good example of how the rules aren’t really keeping pace with developments in the field.

Anyone considering PRP would most certainly be advised to contact the World Anti-Doping Agency or its national affiliate to confirm that. In other words, if you’re an athlete required to comply with the WADA Code and considering PRP, you may need a lawyer as well as a doctor.

So what is PRP therapy and how does it differ from blood doping? As you know, blood is largely composed of red cells, white cells, plasma and platelets. Blood doping involves separating out the red cells from a given volume of blood and then re-injecting those into your system. Red blood cells transport oxygen and thus increase an athlete’s endurance.

It’s called “autologous” blood doping if you use your own blood to do that and “homologous” if you use someone else’s. The effect is noticeable and immediate. One rather well-known cyclist reportedly had a baseline hematocrit — his natural level — of 41 or 42 percent and subsequently produced readings approaching the UCI’s upper limit of 50. You can imagine the performance benefits of such an increase.

But PRP therapy involves the isolation of platelets, those cytoplasmic bodies that allow the formation of blood clots. They have no impact on endurance, but studies indicate that they play a bigger role in the healing process than simply serving as a “net” to trap blood cells and form a clot. The theory behind PRP therapy is that injecting platelets into the tissue surrounding an injury — in Ward’s case, a tendon — they accelerate the healing process by delivering, as one proponent says, “a powerful cocktail of growth factors that can dramatically enhance tissue recovery.”

Others question the effectiveness of the treatment, and there will be more research to come. Meanwhile, NFL players and those not covered by the WADA Code can go out re-inject those platelets and not worry about violating the rules. For the rest, it may be a while before you hear a definitive answer.
Email Charles Pelkey