elite sport
Abuse of painkillers in top-class sport: “Bowl Smarties”
Sports physician Wilhelm Bloch. Photo: German Sport University Cologne/dpa/archive image
© dpa-infocom GmbH
A shot here, a pill there: Many top athletes hit themselves with painkillers like ibuprofen. An ex-footballer reports serious consequences. Doping experts and doctors warn.
Tennis pro Rafael Nadal could not have won the French Open title without “some anti-inflammatory” in his problem foot.
Soccer star Zlatan Ibrahimovic survived a large part of AC Milan’s past championship season with a broken cruciate ligament only thanks to painkillers. Liverpool’s Thiago kicked his foot numb after receiving a pain-relieving injection in the Champions League final. Can elite sport still work without painkillers? The development is alarming. Doctors and doping experts warn of dramatic health consequences and call for more sensitive use of ibuprofen and Co. – they do not believe in improvement.
Sports doctor sees “abuse”
It’s about pills that reduce fever, inhibit inflammation or numb pain, so-called nonsteroidal anti-inflammatory drugs (NSAIDs). Drugs whose active ingredients are too weak to end up on the World Anti-Doping Agency (WADA) banned list and which are usually available without a prescription. “Except in special situations, such as Nadal’s chronic pain, the drugs are often taken prophylactically by professionals. That is abuse, »said sports physician Wilhelm Bloch from the German Sport University in Cologne to the German Press Agency. The expert estimates that, depending on the sport and category, more than 50 percent of the participants now regularly take painkillers.
The former professional soccer player Ivan Klasnic is one of the most well-known sports cases of painkiller use and its consequences. The former player from Werder Bremen told the dpa that he had been “toxically poisoned”. “Because I was given painkillers that I wasn’t allowed to have.” The drugs destroyed his kidneys and led to three kidney transplants. A legal dispute with his former doctors ended in 2020 with a settlement.
everyday life in competitive sports
In addition to kidney damage, Bloch primarily mentions “liver and vascular damage” as possible consequences of long-term medication. “And in endurance athletes such as marathon runners, who already tend to have micro-bleeds in the gastrointestinal tract, non-steroidal anti-inflammatory drugs can increase the bleeding.” In addition, the drugs could influence the healing process after injuries. “The ability of the tissue to regenerate is sometimes limited,” explained Bloch.
The list of athletes who use painkillers can be continued behind Nadal and Thiago. Football world champion Toni Kroos revealed last year that he had played “six months on painkillers” due to an injury. Basketball legend Dirk Nowitzki said in 2016 that he didn’t have to take painkillers – “other older veterans” did, however. And the Norwegian ski star Henrik Kristoffersen, who in 2015 was able to ski down the piste again one day after a fall, reported at the time: “My hips are all blue. It hurts. I took a painkiller – here I am.”
This is what everyday life in competitive sports often looks like, said Bloch and reported on clubs in which painkillers are common. “It’s like a bowl of Smarties, almost everyone grabs it.”
Less pain, more power
An investigation by the National Anti-Doping Agency (Nada) in German professional football showed that between the 2015/16 and 2019/2020 seasons, on average every third athlete in the men’s and women’s divisions took painkillers before games. Before games in the DFB Cup, the men’s quota is even 40 percent. The proportion of women is so high; according to the study, four out of ten soccer players took painkillers. In the junior federal leagues it is 14 percent. Ibuprofen was consumed most frequently.
Experts keep discussing whether abuse of painkillers is doping. “Critical. In principle, it’s about increasing performance, »said Bloch. “With high loads, athletes reach a pain threshold. By taking painkillers, many try to push this limit in order to perform longer,” the expert explained.
Enlightenment instead of prohibition
So why not put the substances on the doping list? “It’s a hopeless fight. In principle, you are powerless when it comes to painkillers, »said doping expert and pharmacologist Fritz Sörgel. “It would go all the way to the Federal Constitutional Court if you weren’t allowed to take painkillers.”
Instead of issuing bans, Nada tries to talk to athletes about the reasons and effects of painkiller abuse and to show sensible alternatives. In addition to behavioral preventive measures, a changed understanding of the system is also needed – in the environment of athletes as well as in society, said a spokeswoman.
