SSA Blog: Anfield asthma analysis
A few weeks ago we wrote a blog that highlighted the danger of pseudoscience. That article focused on how products and activities that don't stand up to scientific rigour can harm the industry and individuals. The issue put simply, is that by offering quick fixes and false hope, people don’t engage in proven strategies to support health or performance gains and therefore miss out on benefits in either health or performance.
It’s not just products and services where pseudoscientific thinking can cause issues. Despite a relatively poor start to this season, rumours about Liverpool FC players’ overuse of asthma medication persist. This sort of messaging can create deep misunderstandings about how and why to use this sort of medication and trivialise what is a very serious medical issue for millions.
The story, which as far as our research shows has no substantive evidence base, is that over 60% of the Liverpool squad is registered as asthmatic. This compares to an asthma prevalence among the UK population of around 12%. The insinuation is that players are being registered as asthmatic to access medication which will provide a performance benefit.
It is true to say that the prevalence of asthmatic conditions is higher amongst elite sports people. Research has reported between 20%-70% of high-performing athletes suffer from some form of asthma-related condition, dependent on the sport.
But the prevalence of the condition is not really the issue in terms of the accusation made against Liverpool FC. The real question should be “does asthma medication actually provide an unfair advantage if taken by healthy fit adults?”
This is where an evaluation of the scientific basis for this story comes into play. In order for an athlete to take asthma medication legally in the English Premier League, they would need to apply for a therapeutic use exemption (TUE). Wada states that the purpose of a TUE is:
A TUE ensures that athletes can be treated for medical conditions - even if the treatment involves using a prohibited substance or method – while avoiding the risk of being sanctioned.
The purpose of a TUE is to allow an athlete to use medication which returns them to a normal level of health without affording them a competitive advantage, but rather ensure that they can compete in a proper state of health. It also gives them a sense of security that they will not trigger an anti-doping violation for being treated for a genuine illness. At the doses allowed under a TUE, evidence suggests that asthma medication doesn’t support performance advantages (Riiser, et al 2020).
At extremely high doses, there is the potential for increases in strength and power. However, these would be well above the therapeutic levels allowed. As such, any athlete taking this much medication would still trigger an anti-doping violation and likely serve a ban regardless of having a TUE. It would likely also prompt anti-doping officials to focus more testing throughout the club causing significant disruption over a prolonged period of time. This is not a strategy any credible medical department would pursue.
Liverpool FC has remained tight-lipped on the matter. Choosing to not issue statements on what they see as rumours not based on any facts.
But is this the right strategy?
Based on the scientific evidence, the accusation holds no weight. The club could therefore be confident in turning the story into a positive. So, with the help of its performance and medical team could it address some of the misunderstandings surrounding asthma and other areas of player health and wellbeing?
Players are seen by fans as examples of peak physical health and fitness. While they are a common conversation topic, the details surrounding what actually goes into treatments, recovery and return to play protocols are not well understood outside of the elite performance environment. Illness or conditions such as allergies are discussed even less. For reasons of medical confidentiality, some areas should remain off limits. However, many injuries and areas of health and wellness could form the basis of a content series looking at how to keep players fit, healthy and ready to play.
At Sport Science Agency, we would like to see clubs like Liverpool FC talk more about performance. By taking the opportunity that this type of story provides, they can explain what is required to keep an Liverpool FC player performing at their best. This type of information can help amateur players and regular exercisers to improve their own health and fitness by using some of the techinques that are employed by their sporting heroes.
While pseudoscience continues to create issues via misleading and misguided information, the genuine science that maximises on-pitch performance and player health can provide a useful antidote. It can help educate fans and, via the development of content, drive commercial income from partners seeking to align with credible performance messages. If clubs and elite performance programmes can learn to harness this approach and are willing to embrace sharing of their own expertise, the potential benefits are huge.
Sport Science Agency uses its insight and expertise to tell performance stories and unlocks their value for brands, broadcasters and rights holders. To see some of our work click here If you want to know more about what we can do for you, drop us a note via info@sportscienceagency.com and we can arrange to go for a healthy vitamin packed drink.