Doping not the name of the game

Thai badminton darling Ratchanok "Nong May" Intanon has finally walked free of her doping scandal after she tested positive for a drug used for a knee injury. The Badminton World Federation decided Ratchanok had not technically abused the anti-doping rules.

This sends the athlete to the 2016 Olympic Games, which kick off in Rio de Janeiro, Brazil on Friday. Russian tennis star Maria Sharapova, who tested positive for the banned medication meldonium during January's Australian Open, was not as lucky. The Court of Arbitration for Sport pushed back her appeal to September, ruling her out of the Rio Olympics.

This is not to mention some 68 track and field athletes also from Russia who have been banned from the Rio Games due to doping. The International Olympic Committee (IOC) declined to issue a blanket ban on Russian sportsmen, which caused disappointment and uproar among other nations.

Sport and drugs is a bad yet frequent mix. Especially when an international-scale sporting event like the Olympics is just around the corner, stories about sportsmen being ruled out of the competition after using performance-enhancing substances make headlines almost every day.

Since 1963, the World Anti-Doping Agency (Wada) under the leadership of the IOC has issued the List of Prohibited Substances and Methods.

Serving as an international standard identifying substances and methods prohibited in-competition and out-of-competition in sports, the list is updated annually and is valid for a year. This means the 2016 list, for instance, just takes effect from Jan 1 to Dec 31 this year.

For the Rio Games, the IOC's Anti-Doping Rules incorporated the Prohibited List into its code. The international committee has also designated the National Olympic Committee in each country to make sure their athletes are made aware of the list.

Performance-enhancing substances, or in short stimulants, are one of the nine types of substances prohibited in competition based on the list, according to sport medicine specialist Dr Winyou Ratanachai.

"Basically, stimulants are substances that enhance the nervous system, as well as the body's use of muscle power," explained Dr Winyou, also an orthopaedist.

Based on Wada's Prohibited List, Dr Winyou pointed out there are three most frequently-used doping substances -- amphetamine, epinephrine and caffeine. Even though caffeine is not actually on the prohibited list, it is included in the 2016 Monitoring Programmes, meaning even though it is not prohibited, Wada still wishes to monitor its use in order to detect patterns of misuse in sport.

According to Dr Winyou, the function of amphetamine and epinephrine is pretty much alike -- they boost the autonomic nervous system, just like when a person whose house is on fire suddenly gets strong enough to lift a refrigerator by himself.

On the other hand, caffeine -- which is in carbonated drinks, coffee and chocolate -- when consumed in large amounts can act as a stimulant.

Athletes use stimulants to improve power and endurance, added the specialist. For those who want to earn extra power such as sprinters, amphetamines and epinephrines usually come into play. Caffeine, on the contrary, affects the body's endurance. To be more precise, high-dose caffeine can delay the use of glycogen -- a form of energy storage -- in muscles.

"Glycogen is a source of energy," said Dr Winyou. "While you practise sport, the body depletes glycogen. If you run out of it fast, you will not be able to play on well. High-dose caffeine enables the body to stock glycogen and slowly use it."

From 1984-2004, athletes who consumed a very large amount of caffeine mainly for doping put themselves at risk of being banned. The rule was clear -- if their urine contained more than 12 micrograms per millilitre (μg/ml) of caffeine, they were out of the game.

But, according to the sport medicine specialist, to have 12μg of caffeine in 1ml of urine means athletes must consume around 1,000mg of caffeine which is equivalent to around 10 average cups of coffee. Caffeine was later removed from Wada's list of prohibited substances due to several scientific reasons, one of which was that performance-enhancing doses of caffeine were indistinguishable from everyday use.

Using stimulants, especially in the long run, can leave a hefty price to pay. Long-term use of amphetamines is likely to lead to aggressiveness in terms of personality. Athletes who are regularly dependent on the substance, especially during training, might suffer drug withdrawal symptoms when they stop using it during the actual competition.

"The most obvious side effect is that when sportsmen stop using stimulants after long-term use, their bodies will definitely not be able to perform like when they are on drugs," he said. "And certainly these doping substances are not key to clean sporting performance."

The key, in fact, is to understand the muscles -- to train them so that they can work in a way that fits a certain type of sport or competition.

"The best prevention against sports injury is to mount up physical capacity so that it reaches a point higher than requirement," the orthopaedist advised.

"For example, if you are to compete in a 30km bike ride, your muscles need to be trained so that they can endure such a distance. When in the end you can ride for 30-40km, that is definitely better than being able to only go 20km."

And the rule of thumb for any kind of sport is adequate water intake.

"Water is vital for hydration," he concluded. "Water also helps maintain the right body temperature. When you practice sport, your body's temperature tends to rise. Even 1 degree's Celsius increase of body temperature can affect power and decision making.

"So water will keep it at bay especially during the first hour of sport or exercise. After that, athletes might consider drinking electrolyte energy drinks to replace losing fluid. With proper training coupled with a balanced diet and adequate rest, you can then rule out stimulants completely."

---

Hal of shame

Ben Johnson

The Canadian sprinter was stripped of his gold medal in the 100m at the 1988 Summer Olympics in Seoul after setting a world record time of 9.79 seconds. Johnson tested positive for the steroid stanozolol.

Lance Armstrong

Despite winning the Tour de France seven times straight from 1999 to 2005, the American cyclist always denied he was taking drugs. However, after a US Anti-Doping Agency report detailed his involvement with doping, he confessed to it and was banned for life and stripped of all his titles.

Marion Jones

In 2007, the International Olympic Committee formally stripped Jones off all five Olympic medals dating back to September 2000 and banned her from attending the 2008 Summer Olympics in Beijing after she admitted using steroids.

Payton Manning

Last year, Al Jazeera released a documentary entitled The Dark Side: Secrets Of The Sports Dopers on YouTube, alleging several US National Football League and Major League Baseball stars, one of whom was Peyton Manning, took performance-enhancing drugs such as human growth hormone in 2011. Manning denied the allegation, slamming the report as "fabricated" and "trash".

Maria Sharapova

The 29-year-old Russian tennis star tested positive for the banned medication meldonium during January's Australian Open. Sharapova said she had been taking the medicine for 10 years to help treat illnesses, a heart issue and a magnesium deficiency. The medicine was added to Wada's Prohibited List on Jan 1, this year. The Court of Arbitration for Sport postponed her doping appeal until September, which means she cannot compete in the Rio Olympics. Sharapova has called the ban "unfairly harsh".

Lee Chong Wei

One of Malaysia's top shuttlers tested positive for dexamethasone after urine samples were taken during the World Championships in August 2014. Dexamethasone is not a stimulant but a commonly-administered anti-inflammatory corticosteroid. The drug is not illegal when used off-season for injury rehabilitation, but deemed illegal if discovered in an athlete's body during competition. He was temporarily suspended from competing but allowed to resume last year. Lee is now the world's No.1 badminton player in the men's singles category.