Jean Medelli, French Physiologist specialized in effort adpatation and medical testing has accepted to speak with us about Cycling, health state of Pro Riders and Cycling evolution.

Medelli's experience is impressive and is based on 30 years work and research; more than 10,000 tests database

Drug-Free Cycling : Hello Jean and many thanks for this interview.
As you’re not very mediatic, could you please introduce your work and your experience in some words. 
 

Jean Medelli : I’m responsible for the department of Sport Medicine and Effort Physiology in Amiens Hospital (North of France) since 1983.

I’m a trained pneumologist specialized in Sport Biology and Medicine and I lead research programs in Sport. 
 
I created this department in order to work in particular on the athlete’s exercise muscular adaptation. 
Regarding our experience our research is based on a quite significant database as we have tested more than 10,000 athletes.
To finish with my activities, I work with Pro Riders as we are a sport laboratory officially recognized by the UCI and the French Federation and I’m used to working with Pro teams as an advisor.  

D.F.C : With all your cycling testing experience what have been the main changes regarding performance and doping ?  
 

J.M : If I have to summarize quickly, I would say that we can divide the last 30 years into 2 periods :

      - The first one was characterized by archaic training methods and behaviours with the use of ‘classical’ Drugs such as anabolic steroids, stimulants and Corticosteroids. During this period, I tried to develop regular Medical fitness tests to find relevant physiological parameters with the aim of defining a personalized way of training. 
The introduction of Heart Rate Monitors during training changed mentalities in cycling. For the first time Performance could be planned, measured and analyzed rigorously and not only submitted to Chance and Prohibited Substances.

Riders were performing regular tests in laboratories to check their fitness level and to improve the work done with their Coach.

   
 - The second period began in 1996 with the generalization of EPO in the peloton, then came the Immune Growth Factor, IGF1 and the blood substitutes. All these drugs could be considered fantastic weapons. 
Increase in performance on road was obvious and when we were testing riders the gap between 2 tests was abnormally large. This abnormality was further confirmed by sudden abnormal blood parameters.
Fighting against doping were thoroughly beaten. The French anti-doping law passed in 2000 created additional difficulties: every physician in France had to denounce to the authorities each athlete liable to have doped. 
Riders began to drop fitness laboratory testing and any discussion with them became impossible. 
To my mind, the authorities’ major fault was to consider repression as the only way of fighting against doping. The principal fight is exclusively allocated to the drug detection ignoring scientific teams in charge of the medical follow-up of the athletes.

D.F.C :  As a doctor how do you consider the state of health of Pro Riders in 2009 ?

Recently I’ve led my research on non-invasive technics (due to the situation explained before).The results of this research were to highlight 2 cycling pathologies:

• Bronchial Hyper-Reactivity or Asthma (mainly due to hyper ventilation in traffic)
• Osteopenia : Bones mineralization fragilization (intermediate state between normal bones and osteoporosis)

D.F.C: Except Ethical aspect (doping is cheating) do you think that athletes are sufficiently aware about doping side effects?    

J.M : To be honest, I’m not sure that athletes are unaware of the risks taken when they dope themselves.
The doping side-effects sensibilization campaign has done good work in France and Media highlight the risk after each doping case.
The main problem is our society: short term or immediate profit by every possible means.

Regarding Ethics, Ethical values have to be clearly defined but I’m still convinced that if we want to safeguard our athlete’s health, we need a real Sport Medical follow up Program. 
This public health mission must be realized by Hospital and Universities even if hospital profitability is impacted.
Public health is more important!