It’s widely used and abused in football, where players can be regularly receive local injections with large doses of cortisone and be declared fit to play because these types of injections are not forbidden and don’t even require a ‘Therapeutic Use Exemption’ certificate. Curiously, the TUE certificate was first introduced by Wada and adopted by the UCI when it signed up to the Code in 2004.
One physio at a Premier league football club, explained the problem. “The physio working with the first team is in a tricky position. He’ll have the injured player keen to play again and not that interested in a slower recovery on one side and, on the other, the manager badgering him asking him how soon the player will be fit to play again. Some club physios are under a lot of pressure to sanction cortisone injections.”
In the same circumstances – being injected with a dose of ‘therapeutic’ cortisone – a cyclist has to take eight days out of competition, not be free to jog down the tunnel and play. It’s a situation that many football observers find disturbing, even some at the highest levels.
Michel D’Hooghe, chairman of FIFA’s medical committee and President of the FIFA Medical Assessment and Research Centre reported in March 2013 that “anti-inflammatories were a bigger problem than doping.” Which admits that there is a problem in football while doing a neat step-over in body-swerving the fact that some types of ‘anti-inflammatory’ also have performance enhancing effects and are themselves ‘doping’.
You doubt the problem that the abuse of cortisone and other anti-inflammatory is widespread in football? “At the 2010 World Cup, non-steroidal anti-inflammatory were used by 34.6 per cent of players, up from 29 per cent at the 2006 tournament in Germany. There was one team where 21 of 23 players were using them,” added D’Hooghe.
Both Wada and Fifa insist that the science that determines whether or not cortisone has performance-enhancing effects is unclear. Decades of abuse in cycling, as well as some peer reviewed sports medicine papers, suggest otherwise. Here’s a quote from just one top rider who used cortisone: “Before anything else though, I decided to try a stronger form of cortisone. It appeared to have a more desirable effect on me. Kenacort, as it was called, became my cortisone of choice. I lost a lot of weight and got better power in my legs…”. (Bjarne Riis, Stages of light and dark, page 81). Anecdotally of course – as well as in affidavits from riders – cortisone is widely abused for its performance-enhancing properties.