Out of thin air

Athletes are using more performance-enhancing technology than ever. But how much is too much?
November 16, 2011
Oscar Pistorius competing in the men’s 400 metres semi-final at the World Championships, 2011




What happened to Ron Clarke in the 10,000 metres at the Mexico City Olympics of 1968 is now virtually forgotten, though at the time it was headline news. That race continues to influence many elite athletes today, whether or not they know it. Clarke says he’s lucky to be alive.

Nineteen sixty-eight was the year of the Paris riots, the Soviet invasion of Czechoslovakia and the assassinations of Martin Luther King Jr and Robert Kennedy. The Vietnam war was still raging. The Olympics were not shielded from these social and political currents. A widespread boycott over the participation of apartheid South Africa was only averted when the International Olympic Committee banned the country. And the iconic image of those Games is of the African-American sprinters Tommie Smith and John Carlos at the 200m medal ceremony: heads bowed, clenched fists in the air, giving the Black Power salute as the “The Star-Spangled Banner” played.

Ron Clarke never made it to the podium, though he was at the starting line for the first track event of those Olympics. The Australian was the bookies’ favourite to take gold in the 10,000 metres. At that time he was the greatest distance runner in history; he’d broken more world records than anybody else.

But in front of 55,000 horrified spectators, the event went disastrously wrong. In the third lap, one runner keeled over and with six laps to go, two more were carried away. Yet the race was being conducted at a relatively leisurely speed: the halfway time was the slowest since the Paris Olympics of 1924.

With two laps to go, Clarke was in the leading pack. “I’d never felt better in a race,” he says. But suddenly he too began to struggle, and as the frontrunners moved up a gear, a gap opened up. He remembers nothing of that last lap, which he ran in 90 seconds: “normally I would run 64.” He stumbled across the line in sixth place and collapsed, “looking like a zombie,” according to one account; a Los Angeles Times columnist wrote there were healthier-looking people in a morgue.

“Luckily there was a team doctor there who saw me go from white to green,” Clarke says. Clarke was administered oxygen, covered with a blanket, and stretchered off. It was by no means certain that he would survive the night. There’s a photo of the doctor crying (right), “because he thought I hadn’t made it.”

Clarke is now 74 and mayor of Gold Coast City in Queensland. He has administrative responsibility for over half a million people and is obviously fit enough to carry out his job. But he nonetheless believes that his health was permanently damaged by the 1968 race, and he’s taken medication daily ever since.

The lowest point of his career occurred at the highest point he raced. Mexico City is surrounded by mountains and is over 7,000 feet above sea level. That the altitude would have an impact on the Games was predicted. Clarke had raised concerns himself, but had been told by the Australian sports authorities that whingeing was bad sportsmanship.

Since those Olympics, however, scientists have stepped up their investigation into the link between athletic performance and altitude. This research, in turn, raises some deceptively simple questions, which have bafflingly complex answers. What counts as sport? What is its purpose: what are the rules designed to achieve, designed to measure? Where does sport end, and science and technology begin? The difficulty of these matters, and the lack of any clear principles, have made sporting authorities at times appear capricious and contradictory.

In the short duration events in Mexico City—sprinters and jumpers—there were some eye-popping feats. Bob Beamon, a one-time juvenile delinquent from Queens, New York, rocketed almost 2 feet beyond the world-record distance for long jump. Footage shows him dropping to his knees in disbelief and having to be helped up. Lee Evans smashed the record in the 400 metres by nearly half a second. Both these records stood for 20 years.

In the long-distance races, there were few standout performances. Nonetheless, those Games marked a watershed: the start of an astonishing dominance of distance running by east Africans. While Clarke lay crumpled in a heap, runners from Kenya and Ethiopia were celebrating their gold and silver medals.

The record books confirm how entrenched this pattern has become. The names of the seven fastest men in history over 5,000 metres are Bekele, Gebrselasie, Komen, Kipchoge, Sihine, Songkok and Chereno. They are all either from Kenya or Ethiopia. Since 1997, the 10,000 metres men’s world record has been smashed five times, dropping from 26:31.32 to 26:17.53. Each time, the record was broken by a Kenyan or an Ethiopian.

There is a complex mix of economic, political, social and cultural explanations for the pre-eminence of east Africans. But one factor is surely that many of these Kenyan and Ethiopian athletes have lived most of their lives in thin air.

***

There was a time when the only requirements for competing in the athletic elite were raw talent combined with single-minded dedication. These are still prerequisites, of course, but they’re nowhere near enough. Now an athlete has to rely on physiological knowledge and science as well. Scott Drawer, head of research and innovation at UK Sport, the national agency that supports elite sportspeople, says it’s scarcely conceivable that an athlete could succeed at the highest level without technological backing and know-how. “It’s fundamental to becoming the very best.”

Take altitude. At high altitudes, the body undergoes a number of physiological changes; most importantly, it tends to produce more red blood cells and haemoglobin. This, in turn, increases the capacity in the blood to carry oxygen, which feeds the muscles and which gives an advantage to the athlete when they return to sea level. However, it is impossible to train with the same level of intensity in the mountains—aerobic capacity and cardio-respiratory function both suffer at altitude.

As a result, the consensus is that the optimum approach to athletic preparation is LHTL: Live High, Train Low. Yet that has obvious practical drawbacks. Not many people live in the mountains and those who do would prefer not to spend several hours each day driving up and down windy, treacherous roads.

That’s where the altitude tent—sometimes called the hypoxic tent—comes in. Around two decades ago two different scientists had similar eureka moments. If they could artificially control the air atmosphere within a confined space, they could simulate the effects of high altitude and save an athlete at sea-level from the time and expense of travelling to higher ground.

In Colorado, microbiologist Igor Gamow designed “The Bubble” to simulate high altitude, a precursor to his more successful invention the Gamow bag, an inflatable pressure bag used by climbers to treat altitude sickness. In Finland, Heikki Rusko, a professor of exercise physiology, built the first “Altitude House” in 1993: fixed accommodation, spacious and swanky, with pumps installed in the basement to maintain low oxygen levels. “Since we don’t have altitude here, we wanted our athletes to have the same benefits as those who do,” says Rusko.

Altitude tents have improved over the years: they’re not as hot or noisy as the early prototypes and are much cheaper too. They are now routinely used by athletes in endurance sports. Mo Farah, Britain’s Somali-born runner, uses a tent all year round; he did so during the 2010 European Championships, when he won gold in both the 5,000 metres and 10,000 metres. Middle and long-distance runner Helen Clitheroe is a recent convert. Her tent is a loan from UK Athletics, the national governing body for the sport, which owns a dozen and is buying more. She uses it for a few weeks to acclimatise before flying to the mountains to train. The tent fits over her bed, so her husband—a non-athlete—sleeps under it too. It’s hot and a little uncomfortable, and run by a noisy generator in the next room.

These tents are perfectly lawful. “I’m totally against doing anything illegal,” says Clitheroe, “I’d be devastated if people thought sleeping in a tent was like taking drugs.” Five years ago the tents were investigated by Wada (the World Anti Doping Agency). Wada makes its assessment on whether to ban a substance or procedure on three criteria. First, does it enhance performance? Second, does it put the health of the athlete at risk? Third, does it violate the spirit of the sport? Failing two of these criteria will result in a ban. The altitude tent, Wada ruled, boosted performance, but it had no detrimental effect on health, nor, crucially, did it “violate the spirit of the sport.” What this phrase means is left unexplained. In the 18th century, gentlemen believed it wasn’t in the spirit of sport to train.

Clitheroe argues that if they stop athletes from using the altitude tent, they might have to ban training at altitude too: “I don’t see the difference really.” It’s a fair point. But similar logic might lead to the legalisation of blood doping (when blood is removed from the body, preserved and reinserted once the athlete’s blood has returned to its normal level) and the drug EPO, both of which also serve to increase red blood cell count.

Olivier Rabin, Wada’s director of science, insists there’s a difference between altitude tents and blood doping and EPO. The altitude tent doesn’t give the same degree of stimulus, he says: blood doping and EPO give a far bigger boost to the red blood cell count. But if this is what matters, it is merely an argument for regulating the impact of drugs, not for banning them.

Others insist EPO and blood doping are dangerous—a disputed claim. Barry Fudge, senior physiologist at UK Athletics, points out that taking EPO is a quick fix. The altitude tent, by contrast, “is no soft option. It takes a lot of persistence, a lot of hard work.” This point is no doubt true, but its ethical relevance is unclear. Rabin maintains that the altitude tent is “natural.” Yet installing a high-tech canopy over one’s bed to create an artificial atmosphere is not everyone’s idea of natural.

***

The National Sports Centre at Bisham Abbey, 30 miles west of London, houses an Environment Chamber, the biggest non-military construction of this kind in the country. It’s basically a square white room, 8 metres by 8 metres, stocked like a normal gym. The day I visit, it’s set for cold sea-level conditions and is uncomfortable to stand in for more than a few minutes. Before the Beijing Olympics, sportsmen and women trained here in hot and humid conditions. It can be adjusted for altitude too. “Technically we can recreate conditions at the top of Everest,” my guide explains.

Bisham Abbey is headquarters for some of the support staff behind the country’s Olympics effort. The UK team, like all major teams at 2012, will be assisted by a phalanx of physiologists, nutritionists, medics, massage therapists, coaches in strength and conditioning, bio-mechanicists (biomechanics is the physics behind human movement), lifestyle instructors and performance analysts (mathematicians and statisticians, who might, for example, deconstruct how an athlete has run a race). In sport, the human body increasingly resembles a Formula One racing car, a vehicle to be engineered, modified and tweaked within the rules to produce maximum speed or power.

There are serious medal expectations of the British rowing team, which uses Bisham Abbey as a base. Rowing, like all Olympic sports, has been transformed by technology. Coaches have long filmed athletes in action, but now technique and power can be computed with remarkable accuracy with the aid of tiny sensors embedded in the paddles. There are ways of measuring the rower’s force on the seat, foot-positioning; the angle the paddle penetrates the water and so on, and the information gleaned provides invaluable training feedback.

Coaches and other officials are understandably cagey about the ways they deploy technology to hone performance. Every marginal advantage counts and medals will be won as much in the lab as on the track. But all this raises a conundrum. Which technologies should be permitted and which banned?

In 2008, a staggering 105 world records were broken in swimming, the vast majority achieved by competitors wearing the new Speedo LZR Racer suit. These suits use a high-tech fabric tested in Nasa’s wind tunnels, which improves buoyancy and reduces drag. (Somebody once dismissively told a Speedo executive that designing a swimsuit was not “rocket science,” at which point it dawned on the executive that it probably was.) The LZR was initially sanctioned by Fina, the international swimming body. But as better suits were produced by Speedo and other manufacturers and more records were broken, they became increasingly controversial. British swimmer Rebecca Adlington won two Olympic gold medals wearing an LZR made partly from textiles, but boycotted the next generation of the suits, which were entirely polyurethane. “I would never take a drug to help me, so why would I wear a suit just to improve my performance?” The new suit was a form of “technological doping,” she said. In a 2009 ruling, Fina changed its mind, banning all non-textile suits—a flip turn applauded by Adlington and others.

Not banned are the prosthetics of South African runner Oscar Pistorius (right) known as “Blade Runner” and “the Fastest Man with No Legs.” Pistorius, as even non-sports fans must know by now, is a double (below the knee) amputee who has won gold in the Paralympics but is also competing in able-bodied tournaments. He will probably participate in the 2012 London Games, to the dismay of some traditionalists, who howl that his carbon-fibre blades give him an unfair advantage, a claim about which experts disagree.

Why are non-textile swimsuits banned, but not the blades of Pistorius or the altitude tent? To approach an answer, we need to enter the rarefied air of philosophy. Michael Sandel, the Harvard academic, likes to illustrate the issue by citing the case of the American golfer Casey Martin.

On one interpretation, Martin is an excellent golfer. He can drive the ball far and true, he can pitch, he can putt: what more could there be to golf than this? Well, what he cannot do is walk between the holes—at least not without excruciating pain—because he suffers from a debilitating, degenerative disorder. So Martin approached the PGA, the body that regulates professional golf in North America, and asked if he could use a golf cart as transport between shots. The PGA said “no,” Martin sued and the case went all the way to the US Supreme Court.

The Court had to rule on whether the golf cart gave Martin an unfair advantage, which required them to reach a verdict about whether walking between shots is fundamental to golf. Golfing oracles—like Arnold Palmer and Jack Nicklaus—were consulted. They decreed that walking was indeed integral to the game: there was a fitness component, an endurance element to golf. The Supreme Court dissented: Nicklaus was peeved: “We ought to take [the judges] out and play golf,” he said. “I think they’d change their minds.” But the judgement stands, and Martin is now free to use a buggy.

Sandel approves of the logic of the Supreme Court decision. He argues that if we want to work out which technology or enhancements should be allowed and which prohibited, we should seek inspiration in Ancient Greece—not in the original Olympics, but in the works of Aristotle, and his theory of essences. The Supreme Court was right, says Sandel, to ask what the essence of golf is and what qualities we want to recognise and honour in elite players. Borrowing from Aristotle, Sandel thinks that the essence of a game is derivable from its purpose—from the nature of the virtues that the game is designed to produce. The essence of golf—or swimming or running—is there to be identified.

But philosopher Jim Parry is not so sure. Parry, who will be next year’s Gresham Visiting Professor of Olympic Studies, is also a former professional football player. “When I were a lad in Derby, if you played away at Plymouth it was a heck of a long way on the bus,” he recalls. “And the bus might have been a boneshaker, and you would have the shit shaken out of you. No wonder people lost away games,” he laughs. “Now they fly to the games and then the players are given a massage.” His point is that technology can transform sport in ways that we cannot imagine. “When I started playing in the 1960s, the boots were just like those your Dad wore down the pit. Today, if you want to be a world-class sprinter you need a shoe firm sponsoring you, because the shoes cost $10,000, and are made to fit your foot.”

Parry says we have to distinguish innovations that affect preparation and performance in sport—training methods, diet, treatment to assist in recovery from injury—from those that alter the sport itself. He cites the pole vault as an example of the latter. The poles used to be rigid—initially, they were made of ash. Then they introduced bamboo poles, then aluminium, then fibreglass. Today, he says, it’s a different activity, more like gymnastics: “it’s just like flicking fleas over a crossbar.” Pistorius shouldn’t be allowed to compete against able-bodied athletes, argues Parry, because a track race ought to be between “unaided human beings.” The blades turn the event into a different sport: one no longer a test just of running ability. You might as well put jetpacks on athletes’ backs, or engines in their shoes.

But who is to determine what constitutes the essence of a sport? When does a new ball, racquet or costume create a different sport? After all, Pistorius insists he is running: his hips and thighs are pumping. What’s the difference between his blades and the $10,000 shoes of his competitors? Here Parry departs from Sandel, who has Platonic as well as Aristotelian instincts—which may be one ancient Greek metaphysician too far. Sandel implies that the PGA can be wrong about the essence of golf: that it has an essence, a sort of Platonic form, to be discovered by the courts. Parry argues, more convincingly, that the arbiters of “essence” have to be those who govern and play the sport. There’s something faintly ludicrous in the notion that the Supreme Court has a deeper grasp about what constitutes golf than the PGA or Jack Nicklaus.

The aim in golf is to hit a small ball into a small hole in the fewest number of strokes. Golf like all sports, has an objective. Certain barriers are then erected to make this objective tougher to achieve. You are not allowed to install a propeller in the ball. You are not allowed to pick up the ball, walk down the fairway and deposit it into the hole; instead you have to move the ball with an annoyingly thin stick. Sport is a kind of game; in Bernard Suits’s cult 1978 book The Grasshopper, he beautifully summarises games as activities that involve a “voluntary attempt to overcome unnecessary obstacles.”

What then is the appropriate metaphysics of sport? For a sport to function successfully there has to be a procedure for agreeing on the obstacles, for interpreting the rules and for altering them. The rules of sport are drawn up with two main constituencies in mind: players and spectators (though there are also commercial interests). Some rules, such as the requirement that boxers wear head protection, were introduced to safeguard the fighters, not to enhance the spectacle. Other rules, such as offside in football, were basically introduced for the fans. Sometimes a change in the rules is good for players and spectators alike: at other times interests conflict. The rules of most games are constantly under review. Today’s boots make a football easier to control and shoot, and on balance that means the game is more pleasing to watch. But a problem with modern football, Parry points out, is that players are now so fit that the pitch seems almost too small for them. Perhaps the game would benefit aesthetically from an enlarged playing field.

When a new technology or technique is invented, there has to be a decision on whether to embrace or reject it. Such decisions will set precedents, just as precedents are established through new interpretations in case law. And just as in case law, decisions should not appear arbitrary; arguments have to be examined and weighed and the rules of logic ought to apply, such as the need for consistency. It’s difficult to conceive of a rule or principle that draws a non-trivial distinction between blood doping and the altitude tent. Some cynics think the tent was approved because it suited the rich and powerful nations.

Barry Fudge wrote his PhD thesis on Kenyan dominance in endurance running. One of his tasks is to oversee a programme which dispatches elite British athletes to camps in Iten, Kenya (2,350 metres above sea level) and Font-Romeu, France (1,850 metres). Because the French camp is lower, it allows for more intensive training and is more suitable for athletes nearer the day of competition. In Font-Rameu, Helen Clitheroe, among others, uses an altitude tent at night for an “extra boost.”

Fudge needs to know the optimal altitude for athletes to train, how long they need to be there, and how quickly the benefits wear off. The impact of the altitude tent has to be similarly investigated. There’s an evolving corpus of research on the subject, not all of it public. Some broad generalisations can be made: on return from altitude, “athletes perform well on days one and two, badly until about day ten, then well again until day 28 after which the altitude effect wears off.” Clearly, then, athletes’ schedules have to be meticulously planned. However, athletes respond to altitude in slightly different ways: and Fudge and his team are gathering measurements and statistics so that programmes can be tailored for individuals. He’s helpful and friendly, but he refuses to give away all the data and insights his backroom team has acquired—nor will he reveal whether or how endurance athletes will use altitude tents in London in 2012. The IOC has banned the use of altitude tents in the Olympic Village next year (“for health and safety reasons”—they’re presumably worried about the gases), although there’s nothing to prevent them being used outside the village.

The Olympic motto Citius, Altius, Fortius lends an inevitability to technological advances in sport, and to disputes about them. Elite athletes, who by definition are physical anomalies, are continually looking for ways to improve, whether this be through a deeper understanding of sport physics, oar-sensors or the aid of an altitude tent. Going faster, higher, stronger is integral to the logic of athletics in general, and the Olympics in particular. As Parry puts it: “They believe they need records all the time. And the only way they can achieve records is by improving the clothing, the kit, the training, the nutrition, all to identify minute distinctions between people of 0.0001 of a second.”

There’s a limit to what the human engine is capable of. We may one day see an athlete break two hours in the marathon—though even this seems almost inconceivable—but unless wheels or new blades are allowed, and without gene therapy, or as yet un-imagined drugs, nobody could run it in an hour. When athletes finally hit a wall and stop being able to break records, athletics will face an introspective examination of its soul, an existential crisis. Until now, technology has sated our appetite for faster, higher, stronger. It’s maintained a sense of progress and momentum. But for how much longer?