Friday, August 24, 2012

Marathon Deceit

A couple of things to address today, given a couple of eyebrow raising (to me) responses to recent news articles surrounding our sports.

L'affaire Armstrong.

The obvious one.  Wow, what a couple of days in the cycling media, with Lance Armstrong playing the martyr to the evil dragon of the USADA and losing the greater part of his cycling and triathlon palmares to essentially prove a point.  Not that anyone in their right mind really believes this of course.  The prevailing opinion seems to be it was either lose his titles or his credibility.  

While I've yet to see a Phil n' Paul response I have seen fanboys playing a gallant rearguard action, usually deploying the cancer shield in short order.  Let me say this about the cancer shield.  I really don't see how one's philanthropic actions somehow cancel out one's misdeeds.  In this instance or any other.  There are plenty of ex-Catholic priests out there who I am sure were wonderful individuals, bringing spiritual succour to those in need.  Unfortunately, there is the small matter of another type of homonymic succour to be dealt with.  Regardless of the good these men played in their communities, their misdeeds were not in any way mitigated by these assorted good works.  The same applies here. 

While we're on the subject of the cancer shield, I'm pretty sure that HWMNBN never "trained competed while undergoing chemo".  And Livestrong/LAF doesn't, hasn't and won't fund actual cancer research, Sure, be a fan boy, but try and get your facts straight.  If you don't, it makes it too easy.

What I'm most glad about is the meaning behind the lifetime ban.  Remember, Ulrich, Basso, Millar, all the rest, all got two year band for using performance enhancing drugs (PEDS).  Why not Armstrong? The anti-doping code allows a penalty of four years to life for the trafficking and administration of PEDS. In other words, the days of prosecuting some poor jobbing Euro-schmuck who was given the stuff then left, allowed and encouraged to take the fall on his own ("I did it on my own", "my team was unaware", "I'm sorry for the shame it brought on my team/sponsors/family") are over.  Now it's the big guns, the facilitators, who are being prosecuted.  Maybe it is this that will finally clean up cycling.

In the meantime. lets just asterisk all results from the late 90s to early 00s.

L'affaire Heggie.

Tyler Heggie was the 10 year old who ran the PEI Marathon last year.  When faced with the same situation this year at Bluenose, with a ten year old girl entered, I suggested to the organisers that they not try to appeal to the girls parents reason (where does the apostrophe go there?) as the parents would likely think that instead of running a marathon being an unwise course of action for a ten year old, it would be the best thing since sliced bread.  This general attitude is, unfortunately, correct. When informed that now 11 year old Tyler would not be allowed to run PEI this year the father's response was "poppycock".  Although one suspects it was a bit earthier in the original.

When I posted this link on Facebook with the tag "some kids need to be protected from their parents"  I was surprised at one response.  This response suggested that I look up William (Bill) O. Roberts thoughts on the matter.  So I did.  Being a somewhat educated guy, my first stop was not Google, but PubMed.  PubMed is an on-line library with all, and I mean all, the scientific abstracts you ever need (and some you don't) all searchable to all and for free.  There is one study from Roberts, WO on children running marathons and it relied on his experiences as Race Medical Director for the Twin Cities MArathon. His outcome measure was did the child end up in the Medical tent?  No follow-up. This study appears to the basis for his Running Times article,  Roberts WO (2008)"Children and Marathoning".

This Running Times article is balanced out by Rice, S (2008) "Children and Marathoning: How Young Is Too Young? which itself seems to be based on Rice & Waniewski (2003). Instead of an retrospective cohort study observation from the RMD's chair, Rice & Waniewski is a well rounded evaluation of the literature. Round one to Rice I think.

I would be remiss to avoid quoting the American Academy of Pediatrics, where Overuse Injuries, Overtraining and Burnout In Child and Adolescent Athletes by Brenner et al  (Pediatrics 2007,  119(6); 1242-1245) states that "Ultimately, there is no reason to disallow participation of a young athlete in a properly run marathon as long as the athlete enjoys the activity and is asymptomatic". However, this is given in the context of "the Risks of distance running for children  (Pediatrics 1990,  86; 799-800) which is a doom-laden account of the medical perils of distance running, and they define distance as anything over 30 minutes. Round two to Roberts, but on a technicality.

I also fall back on normative ethics, principally, if we have reason to believe that something is harmful, but  have no evidence to support it because that evidence cannot be obtained, then we should not allow that something.  I have dealt with this branch of ethics before: in my case it was to do with pain in animals.  Pain, as a conscious construct, cannot be reported in animals because they cannot tell us they are in pan.  This absence of self-reporting notwithstanding if we think something might be painful to an animal, even if we do not have the ability to say that animal can even feel what we would call pain, then we take measures to mitigate that pain.

The same here.  There are many theoretical reasons why a child should not run a marathon. To conduct a study showing this would be unethical, at the very least.  Can you imagine the abstract? "In order to test the hypothesis that marathon running is deleterious for children under the age of fourteen, we recruited twenty untrained children.  We trained ten to run a marathon and measured physiological and psychological parameters in response to training stress. A control group of ten age- and gender-matched children were left untrained.". In laymans terms, we ran ten grade fives into the ground and compared them to ten grade fives playing Wii Sports Resorts. The Ethics Commitee is going to allow that, no questions. Apart from the obvious ones!

So, unfortunately, like Lance Armstrong's EPO levels, the answer will likely remain unknown.  In the absence of conclusive, scholarly, peer-reviewed data, moral  philosophy tells us that we must err on the side of caution.  This is best summed up by Rice and Waniewski's conclusion that "Although it is conceivable that given proper biomechanics and anatomy, a quality progressive training program, and appropriate maturity and cognitive level, a long distance runner can have a positive experience from participating in marathons before 18 years of age, this special individual would be the exception and not the rule. Examples of such individuals do exist but serve to demonstrate that decisions rendered regarding participation are not designed with the “exception to the rule” as the critical parameter".

If we do not, where does this end?  Ironman? Leadville (either the MTB race or the Ultrarun)? I suspect none of us would encourage our own children to do such a thing, so why should we encourage the children of others to do the same?