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Expert Comment: Lance Armstrong documentary

0137 Dr Simon Marwood Profile Monday 14 July 2014

In the light of last week's BBC documentary on cyclist Lance Armstrong's use of performance-enhancing drugs, Senior Lecturer in Physiology Dr Simon Marwood looks at Armstrong's career.

On the opening weekend of the 2014 Tour de France, the BBC showed a feature length documentary about Lance Armstrong, focusing on the use of performance-enhancing drugs and relying heavily on testimony from former team-mates and associates.

Lance Armstrong is perhaps the most well known cyclists in history, perhaps the most well known there ever will be. Unfortunately, this particular cyclist is only so well known because of his use of systematic use of performance enhancing drugs which helped him win the Tour De France (the most prestigious cycling event in the world) a record seven times in succession.

The story is well known; Lance Armstrong is diagnosed with cancer in his testicles, lungs and brain and given a very low chance of survival. Instead, he recovers to win the most gruelling grand tour of cycling there is, a far cry from his pre-illness specialism of one-day races which had previously brought him a world championship. He became a hero to millions world wide, not just because of his extraordinary feats in the Tour de France but also because of the cancer charity he set up in his name.

However, following many years of accusation, and despite apparently no failed drug tests, Lance Armstrong finally admits his use of performance enhancing drugs to Oprah Winfrey. One of the main drugs relied upon was EPO, an otherwise naturally occurring hormone which promotes the production of red blood cells which carry oxygen; later when a test for EPO was developed Armstrong arranged to 'blood dope', whereby blood is drawn form the body and re-infused some weeks later when the amount of red blood cells has risen to normal levels. The result is the same, a large increase in the capacity to transport oxygen to the exercising muscle.

The ability to sustain high intensity exercise for prolonged periods of time is related to oxygen delivery, which can help explain Armstrong's ability to accelerate away from his competitors up the final mountain climbs of the day, a tactic which underpinned all of his overall victories. The maximum intensity that can be sustained for prolonged periods is known as 'critical power'. Exercise above this intensity is possible of course, but there exists a fixed volume of work that can be completed before the cyclist must reduce their power to critical power or below. If on long mountain climbs Armstrong has a higher critical power due to blood doping, his "fixed volume of work" is protected, whereas all others are depleting theirs. When the moment comes to jump away from the rest of the field, nobody could match it.

Although the vast majority of the vitriol is saved for Armstrong, he was not alone. It is well known within cycling that all of his major rivals during the period of his victories were undergoing a similar regime of drug use and blood doping. Indeed, since Armstrong's name has been scratched form the record books, nobody has staked a claim to replace him. So why then has Armstrong in particular become the figure of hate?

Probably this is due to him having such a high profile, a vast wealth but also due to the bullying and intimidation he used to silence those who would speak against him and drive those not wishing to be a part of the drug use out of the team and out of professional cycling. Others such as David Millar, a British Cyclist previously banned for EPO use, co-operated with the cycling authorities and now works hard to ensure a clean sport.

Armstrong still firmly believes he won those seven Tours fair and square in an era when everybody was using EPO, blood doping and all the other drugs of choice at the time. The most frustrating thing for me is that whilst Lance Armstrong had the most sophisticated drug taking and blood doping regime ever in professional cycling, this incredible drive to win (at all costs) was also manifest in training and racing. He would train harder and longer than anybody else and nobody could match him for sheer intensity of racing and will to win.

Lance Armstrong, together with the likes of Jan Ullrich and his other competitors robbed the world of seeing and the himself robbed the world of some of the best racing in cycling there might ever have been. Unfortunately, because of the cheating, it was all for nothing.

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