UPDATE: I’ve since written additional posts to the CVAC pod post below. Please check them out if you’re interested: 1) Here’s one about the biological passport program, that can be used to detect abnormal shifts in an athlete’s blood profile. 2) This is a short summary of what two physiologists had to say about the CVAC pod and why the biological passport system is a great method to test the CVAC pod for “unfair advantage.” 3) The third link is an additional explanation on the reported differences between the CVAC pod and oxygen tents (hypobaric and hyperbaric chambers)
So a week ago, the WSJ ran a story about Novak Djokovic’s use of a pressurized egg called the CVAC pod. It created a bit of a stir.
The $75,000 CVAC pod device, which is one of only 20 devices in the world, is different from the $5,000 hyperbaric chambers that are commonly used by athletes. Hyperbaric chambers serve to “saturate the blood with oxygen and stimulate healing.” The CVAC pod device, “is a considerably more-ambitious contraption. It uses a computer-controlled valve and a vacuum pump to simulate high altitude and compress the muscles at rhythmic intervals.” According to the WSJ article,
The company claims that spending up to 20 minutes in the pod three times a week can boost athletic performance by improving circulation, boosting oxygen-rich red-blood cells, removing lactic acid and possibly even stimulating mitochondrial biogenesis and stem-cell production…
CVAC Systems chief executive Allen Ruszkowski says the treatment seems to have many of the same effects on the body as intense exercise. He claims that the technology may be twice as effective at helping the body absorb oxygen as blood doping—a banned form of performance enhancement.
Boosting oxygen-rich red blood cells and “mitochondrial biogenesis and stem-cell production” seems to be toeing the line of fair versus unfair advantage. Now why the CEO of CVAC systems would try to market the device as being twice as effective as blood doping, is beyond me. I don’t know if that’s an effective or particularly sane marketing strategy, especially in these times when doping is an ever-sensitive issue for athletes, their governing bodies, and their increasingly vigilant fans. The purported effects of this device, combined with the fact that it is much more sophisticated than the commonly used oxygen tents or hyperbaric chambers, raised more than a few eyebrows.
Per the article, “In 2006 the World Anti-Doping Agency ruled that such oxygen tents enhance performance and violate “the spirit of sport,” but did not add them to the list of banned substances and methods, saying they would wait until further studies were conducted.”
If you go to the World Anti-Doping Agency (WADA) website, you can find their anti-doping code. According to the comment to Article 4.3.2 of Version 3.0 of the World Anti-Doping Code (pg. 32-33):
A substance shall be considered for inclusion on the Prohibited List if the substance is a masking agent or meets two of the following three criteria:
- It has the potential to enhance or enhances sport performance;
- It represents a potential or actual health risk; or
- It is contrary to the spirit of sport. None of the three criteria alone is a sufficient basis for adding a substance to the Prohibited List. Using the potential to enhance performance as the sole criteria would include, for example, physical and mental training, red meat, carbohydrate loading and training at altitude. Risk of harm would include smoking.
Notice the WADA code specifically states that none of the three criteria is sufficient on its own for inclusion to the Prohibited List. That’s why red meat and carbohydrate loading, while they are considered to be performance-enhancing under criteria #1, are not on the Prohibited Substances list, because they do not represent a health risk to the athlete (at least not in the same way that recreational drugs would) and are not contrary to the spirit of the sport.
Altitude training, whose effects the CVAC pod is supposed to imitate, meets criteria #1 of performance-enhancing measures. So if I were to treat those two as equal, then the CVAC pod device meets criteria #1. WADA has already commented that the CVAC pod device, unlike altitude training on its own, is against the spirit of the sport. So the CVAC pod device meets two of the three criteria for inclusion on the Prohibited List and should be on that list. Now, I’m sure there is more research that needs to be done on this device before WADA makes a ruling, but it seems if you put #1 and #3 together, use of this device should already have been prohibited by WADA. From my understanding, the CVAC device is different from a basic oxygen tent because the pod increases barometric pressure on the person to more effectively deliver oxygen to the blood.
My guess as to why WADA hasn’t outlawed the CVAC pod device is that the device is not an actual substance that can be ingested or injected into the athlete’s body. You can ban drugs but can you ban an athlete from using a device? This is clearly new territory for WADA and they are treading cautiously. Note that as part of heightened efforts against blood doping, the International Olympic Committee has instituted a no-syringe policy for the 2012 Olympic Games. The no-syringe policy was already implemented by the Union Cycliste Internationale (UCI) in May 2011 this year. But anyone who looks through the history of doping in sports knows that as soon as new anti-doping measures are adopted, more advanced techniques are soon found to skirt the rules. Use of these devices is clearly new ground for anti-doping authorities. Yet it seems like only a matter of time before WADA will have to confront matters related to ‘non-invasive’ techniques.
Also, in my argument for why the CVAC pod should be banned, I equated use of the CVAC pod device with altitude training. Perhaps there is more research that needs to be done on this matter. Does the CVAC pod really offer the same benefits as altitude training? Does it do more or less? These are the types of questions that need to be examined.
Note that for blood doping, autologous blood doping (transfusing one’s own stored blood) is undetectable. There is not yet an accredited test that can show that an athlete has received an illegal blood transfusion of his/her own blood. Tests only exist for homologous blood doping (tranfusing someone else’s blood). As you can imagine, homologous blood doping is nowhere near as prevalent as before. So how do anti-doping authorities in cycling, a sport that’s had many high-profile doping cases, monitor autologous blood transfusions in the sport?
The UCI and WADA monitor the percentage of red blood cells (hematocrit level) in an athlete. The normal hematocrit level for an adult male is between 41-50. The UCI sets the upper level at 50% for cyclists (anything above 50% is illegal and requires an immediate suspension). Even under these rules, there is room for athletes to continue blood doping (so long as their hematocrit level stays just below 50%).
Whether or not the CVAC pod device can increase an athlete’s hematocrit level to above 50% should play an important role in determining its legality. So there is in fact a way (not a fool-proof way, but still effective) to test for unfair advantage through use of the CVAC pod device, by looking at the hematocrit level of the athlete. The same method that’s currently used to monitor blood doping in cycling.
Notice I have barely referenced the player whose use of the device garnered so much attention. I am not calling Djokovic a doper. From the available information, it’s clear that he has been acting in accordance with the WADA. Since the WSJ article, more tennis players have been linked to using this device. For the purposes of this blog post, that list does not concern me. My post is an argument against WADA’s stance on the CVAC pod device. I am questioning whether the rules should have allowed use of this device. There is a pretty clear distinction and I hope any/all readers can acknowledge that.
I think discussion of this issue is timely where tennis is concerned. Tennis, not unfairly, has been accused of being too lax in its approach to athletes and drug-testing. As a cycling fan as well, I can only agree that tennis players are not placed under the microscope with as much frequency and scrutiny. Yet tennis athletes, compared to their cycling counterparts, earn more money on average at their tournaments.
Readers recall when Nadal started cramping during his press conference, following his R3 win at the 2011 US Open. The news of his cramping incident first broke out over Twitter, as tennis fans tuned in to find out what was happening. As a cycling fan, I was shocked to find Twitterers on my cycling feed commenting on Nadal’s incident and strongly implying that Nadal was experiencing a collapse from performance-enhancing drug use. In the end, they were jumping to conclusions based on incomplete information, as anyone who saw Nadal’s press conference can see that it was a straightforward case of muscle cramps and not a collapse. Quite unfairly, I think Nadal’s Spanish nationality had something to do with their accusations, as one of the most high-profile doping cases in cycling originated in Spain.
But the reaction to Nadal’s incident outside of the tennis world got me thinking. How do the International Tennis Federation and the ATP/WTA’s anti-doping efforts compare to other sports? Twitterers have pointed to the ITF’s anti-doping cartoon video, available for viewing on its website. At first glance, it seems even the ITF seems to view their anti-doping program as a laughing matter, which is quite concerning. Their perceived lack of gravitas in the face of a serious issue like doping, along with the focus that the CVAC pod has brought to a high-profile player, seem to indicate that the ITF, ATP, WTA, and WADA need a facelift in their approach to anti-doping in tennis. If the greater public feels that tennis is not giving anti-doping the full treatment, they will feel free to insert their own narrative. Too often, these narratives will be baseless and that’s due to the lack of complete information and the lack of stricter anti-doping controls in tennis.
If you’ve made it this far, I want to thank you for reading and would greatly appreciate your comments. I hope I’ve done enough to raise the issues on this topic, but please feel leave comments if I’ve overlooked something or you want to share your opinions.