Number Three, August 2001    -    SPORTS MEDICINE
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Dr. Michael Hartle
Medical Committee Chair 		Drug Testing Committee Report to the
USA Powerlifting National Governing Body Meeting
July 12, 2001

Since March of 2000, I have been the Drug Testing (DT) Chairman. What that means is I oversee and direct the DT of USA Powerlifting. I also send out the letters to notify the athletes when they fail a drug test and set-up the Out of Meet Tests (OMT) on the various athletes in our organization. After I took over the duties as the DT Chair, I decided to start keeping track of all DT done by USAPL. What that entails is whether the test results are either negative or positive, I track them. Everything about the test is placed into a database for future use. One of the interesting aspects of doing this is I am able to track a history of testosterone to epitestosterone ratios (TE Ratio) on each athlete, negative or not. This enables me to see a deviation of an athlete's normal or average TE ratio. For example, if athlete A averages over 12 tests a TE ratio around 1.2 and has a negative test come back with a TE ratio of 3.8, that athlete may be selected for an OMT as there was a substantial increase in their TE ratio from the normal levels seen for them. This will continue to be an ongoing project as I will be tracking all 700+ drug tests done every year.

The following are some interesting trends and results of tracking this information from March 1, 200 to May 1, 2001.
  1. TE Ratio: We have had some as high as 411 to 1, 181 to 1 and 150 to 1. In the last 4-6 months I have noticed an alarming trend among the negative tests that have come across my desk: the negative TE ratios on a whole are staying the same generally, but I have seen more and more TE ratios lately with ratios from 3 to 1 up to 5 to 1. These are negative tests as the allowed level is anything under 6 to 1. However, since this trend started showing in the last 4-6 months, it alarms me.

  2. Positive tests from 3/1/00 - 5/1/01 numbered 57.

  3. Nandrolone: Everyone by now in the strength field has probably heard of nandrolone. We had 39 A sample positives for nandrolone out of the 57 total mentioned previously. Of those 39 A sample positives, 26 were positive only for nandrolone, the rest were combined with another banned steroid. We also had 5 B sample positives that were only positive for nandrolone in that same time. These B samples had their corresponding A samples also positive for the same substance: nandrolone.

  4. Seven B samples were requested to be tested after the A sample had failed. These B samples failed for the same substance as did the A sample. The 7 B samples failed for: nandrolone (5), boldenone (1), and methyltestosterone (1).

  5. There has been some recent information regarding the specific gravity of the positive samples. If the level of the specific gravity of the positive sample is higher than 1.020 and the positive substance was nandrolone, then the use of a formula has been used to reduce the levels of nandrolone. The thinking here is if the specific gravity is greater than 1.020, then the sample is considered concentrated and the athlete was presumed possibly dehydrated at the time the sample was given. The IOC has used this in 1 case so far that I am aware of. USAPL and the DT Committee are looking into this further.

  6. There has been some recent questions as to the possibility of endogenous nandrolone. Up until recently, unless you were taking exogenous steroids, there were not nandrolone positives. Now we have people who are having nandrolone show up in their tests and they are stating they have not taken any steroids. Endogenous nandrolone? I don't believe this is possible. There were not problems with this 10-15 years ago unless, as I said earlier, you were taking exogenous steroids. What could be causing these positives tests by people who claim they are not taking steroids? If these athletes are truly clean, then I suggest it is either coming from contaminated supplements, our food supply and maybe even the water supply (stretching it here, but water supply has been known to carry many different chemicals). I hope we can find what is causing this if the athlete is truly not taking steroids.

  7. In the coming year I hope to establish some criteria and possibly some testing programs to create a well-structured Drug Control Officer (DCO) corp. This would be utilized mainly at the National and International levels, but anyone is welcome to become a DCO. What I hope to accomplish here is standardization of protocol and procedures for testing.

  8. Last, but not least, accuracy of test taking. I cannot stress this enough: make sure you dot your "I's" and cross your "T's" before sealing the Chain of Custody document in the lab box. Read the form 2, 3, 4 times. Take your time. If it is wrong, throw it all out and start over. I would rather you take more time than be in a hurry or not want to do the test over and have it be for an athlete whose results were positive. Athletes: if you are not happy with the procedures of the test being given to you, don't sign the final line and then ask to re-do it. Throw away the test and start all over again. Better to be safe than sorry.
Michael A. Hartle, D.C., D.A.C.B.N., C.C.N., C.C.S.P., C.S.C.S.
USA Powerlifting Executive Committee Board Member
Chairman, USA Powerlifting Sports Medicine Committee
Chairman, USA Powerlifting Drug Testing Committee

What is the Sports Medicine Committee?


I am going to diverge for this issue. I would like to take this opportunity to thank all the various health professionals involved in our committee that have helped out these last 7 years at various competitions. We have had doctors of chiropractic, nurses, medical doctors, athletic trainers, physical therapists and massage therapists volunteer their time to see that the USA Powerlifting (USAPL) athlete receive the best care they can while they are at a USAPL/IPF competition.

I receive about 3-5 phone calls, 5 letters, and about 25-30 emails a month regarding strength-training and/or powerlifting related problems. The feedback I have received about helping these members is they are happy someone can help their powerlifting problem or at least point them in the right direction and not tell them that "& squatting is bad for your knees& " which some of us have heard from less than knowledgeable health professionals.

Most of the competitions we have been at have been National/International meets. If local/state/regional championship meet directors would like to have a USAPL Sports Medicine professional at their competition, please contact me and we will do our best to accommodate you. As a service to the USAPL Meet Director, we will find professionals in your area that can help you out.

Before this committee was formed in 1994, if a meet director wanted to have someone with a health professional's background cover the competition for injuries at the meet, he/she would usually elicit someone they knew, whether they were a doctor/health professional or not, or utilize the help of someone they did not know. After this committee was formed, for any health professional to treat or look after athletic injuries at any USAPL sanctioned meet, they have to go through our committee to get approved. This is being done because there is a liability and credibility issue here. We want the best that we can offer to the USAPL athlete. We want to make sure these health professionals, before they help treat any USAPL lifter, is properly licensed in the state of the competition, has the proper schooling and the proper credentials to be at that competition helping the athletes. If we do not do this, someone could get hurt or be given the wrong advice, etc.

Meet directors should be aware of this. Before a meet director has someone help at their competition, they must be properly credentialed through the Sports Medicine Committee. Even if a health professional has worked at their competition before, they must be credentialed through the committee. If they are not or do not want to be, then they can not work at the competition in question in the capacity as a health professional and treat or look after the USAPL athletes.

Since the inception of this committee, the primary goal was to serve the athlete the best that we can. This means having health professionals at USAPL competitions to take care of the various injuries that occur. This also means making sure that the professional's treating our athletes are of the highest quality. This is done via the credentialing process. Each health professional that wishes to join our committee needs to submit a current curriculum vitae/resume, a copy of their USAPL current membership, a copy of all current state licenses, a copy of malpractice (including limits) and copies of any postgraduate work relating to sports or sports medicine. If you already have a health professional that you know and would like to help out at your competition, please direct them to our committee so they can become a member of the Sports Medicine Committee. Once they are a member, they will then be properly credentialed to help out at any USAPL competition. After proving themselves at local and various National competitions, they can then move up and assist at the various International competitions and eventually move up to Chief Team Physician/Trainer/Physical Therapist/Massage Therapist at the International competitions. The Sports Medicine Committee, through this and the aforementioned credentialing process, selects the personnel to staff the USA Powerlifting health professional team for the various National and International competitions. This is done to best serve Team USA Powerlifting.

Please send your questions for the Sports Medicine Committee to Dr. Michael Hartle, 3835 W. Jefferson Blvd., Ft. Wayne, IN, 46804. If you would like a personal response, please send a SASE with $3.00 to cover additional postage and other expenses. I also welcome your comments on the committee/column e-mail at pwrdoc@fwi.com.

Remember, be healthy and be strong!!

Michael A. Hartle, D.C., D.A.C.B.N., C.C.N., C.C.S.P., C.S.C.S.
Chairman, USA Powerlifting Drug Testing & Sports Medicine Committees