Dutchman Tom Dumoulin has questioned the timing and need for the triamcinolone injections received by Bradley Wiggins prior to three Grand Tours, including before the 2012 Tour de France which he won. Wiggins’ former team doctor has also said that he was ‘surprised’ that the drug was prescribed.
Dumoulin, who finished third when Wiggins became World Time Trial Champion in 2014, said he had never applied for a therapeutic use exemption (TUE) and he told De Limburger he found it ‘strange’ that Wiggins had received the injections immediately before Grand Tours.
“And injecting? So then you have very bad asthma. This is not something they do with normal asthmatics, let alone athletes who only have exercise-induced asthma. Apparently Wiggins’ injection also worked for weeks – then in my opinion you should be out of competition for weeks. That thing stinks. "
Speaking to BBC Newsnight, Dr Prentice Steffen, who was team doctor at Wiggins's former team Garmin Slipstream in 2009, expressed similar sentiments.
"I was surprised to see there were TUEs documented for intramuscular triamcinolone just before three major events – two Tours de France and one Giro d'Italia.
"You do have to think it is kind of coincidental that a big dose of intramuscular long-acting corticosteroids would be needed at that time of year, at that exact time, before the most important race of the season.
"I would say certainly now in retrospect it doesn't look good, it doesn't look right from a health or sporting perspective."
Steffen said that when he worked with Wiggins, the rider had TUEs permitting the use of an asthma inhaler containing salbutamol – something for which a TUE is no longer required.
Wiggins’ TUEs applications are understood to have been made by Dr Richard Freeman, who is now team doctor at British Cycling.
Newsnight also spoke to convicted doper Michael Rasmussen, who said the pattern of Wiggins’ TUE use looked familiar. He also agreed with David Millar’s assessment earlier in the week that triamcinolone was a powerful and potentially performance-enhancing drug.
"There is no doubt in my mind that corticosteroids [are] very, very strong and performance enhancing.
"It would postpone the sensation of fatigue, increase your recovery speed and most importantly and quite easily I would drop one or two kilograms, which is very important when you want to climb mountains.
"It will drain the body from all excess fat in a quite short period of time. It's a very fast and very effective drug in that sense."
TUE application and approval
Steffen said Wiggins was ‘probably at the bottom of the list’ when it came to weighing who was responsible for deciding on the treatment.
"I think his doctor and his team, to make the decision to apply for that TUE is questionable and then I think for the UCI or UK Cycling or Wada to sign off on that application, all things considered, really that is the end point where the TUE committee should have looked at that and said no, this is not acceptable, so we are not going to approve it."
A spokesman for Team Sky said:
"TUEs for Team Sky riders have been granted by the appropriate authorities and in complete accordance with the rules.
"This is a complex area given the obvious issues around medical confidentiality. There is a legitimate debate across sport on where best to draw the line on transparency.
"It is very rare that a rider needs a TUE and we have robust internal processes in place that we are confident in and which we constantly review.
"Team Sky's approach to anti-doping and our commitment to clean competition are well known."
Cannondale-Drapac Pro manager Jonathan Vaughters was famously not permitted a corticosteroid injection for an allergic reaction to a bee sting while riding the 2001 Tour de France. While emphasising that some TUEs are legitimate with the athlete in question needing treatment, he advocates greater transparency.
Want a good solution for TUEs? Make it compulsory to publicly disclose all TUEs. Any athlete would think twice unless they really needed it.
— Jonathan Vaughters (@Vaughters) September 18, 2016
Dumoulin, for one, agrees with this."Then you have no hassle, everyone knows what you're doing, even if it runs counter to medical confidentiality,” he said. “If we are getting closer to a clean sport, I'm for it."
Latest Fancy Bears leak
The latest batch of athletes to have TUE data released by the Fancy Bears hackers includes Fabian Cancellara and this year’s Tour of Britain winner, Steve Cummings.
A statement from Trek-Segafredo said:
“Trek-Segafredo and Fabian Cancellara confirm that Cancellara received therapeutic use exemptions (TUE) for the treatment of severe allergic reactions to bee stings on August 17, 2011, and May 18, 2013.
“The treatments were administered in respective urgent care centres where Cancellara was treated, and not by a team doctor.
“These therapeutic use exemptions are currently being reported in the media without any context provided, damaging the image of both the athlete and the team.”
The team says that the correct procedures to find and document the treatment with the authorities were followed and also points to Cancellara having documented the incidents via social media at the time.
Cummings’ TUE relates to the use of the anti-asthma drug, salbutamol, via an inhaler. The certificate is from December 10, 2008 and was for 12 months’ use. As was mentioned above, a TUE is no longer required for salbutamol delivered in this way.