Legal but controversial pain medications that allow cyclists to push through suffering, recently banned due to safety and fairness concerns.
Painkillers, particularly tramadol and corticosteroids, occupy a gray area in cycling. While not traditional performance enhancers, they allow riders to push through pain that would normally limit performance.
• Opioid-based pain reliever • Prescription medication for moderate pain • Also has mild stimulant properties • Creates sense of euphoria • Reduces pain perception during racing
• Taken before or during races • Allows racing through pain and fatigue • Particularly common in cobbled classics and mountain stages • Helps maintain effort when body signals to stop • Widespread use in professional peloton (pre-ban)
• Doesn't increase power output directly • Allows pushing closer to true physiological limits • Reduces suffering during extreme efforts • May improve performance by 1-3% in painful conditions • Enables racing through injury or illness
• Drowsiness and impaired judgment • Reduced reaction times • Dizziness and nausea • Respiratory depression at high doses • Addiction potential with regular use • Seizure risk
• Multiple studies linked tramadol to increased crashes • Impaired bike handling • Delayed reactions in dangerous situations • Riders racing beyond safe limits • Masked injury signals leading to worsened damage
• Not on WADA prohibited list • Widespread use in professional cycling • Team doctors routinely prescribed it • Considered an open secret in the peloton
• UCI banned tramadol in competition • Not a WADA ban, but UCI rule • Testing began at UCI-sanctioned races • Penalties for positive tests
• WADA considering adding to prohibited list • Ongoing debate about classification • Some teams voluntarily banned it earlier
André Cardoso (2018): • Tested positive for tramadol at Tour de France • Before formal UCI ban • Highlighted prevalence of use
• Team Sky banned tramadol in 2017 • Several other teams followed • Ahead of UCI prohibition
• Ibuprofen, aspirin, naproxen • Legal and widely used • Reduce inflammation and pain • Potential kidney damage with overuse during dehydration • Commonly used before and during races
• Lidocaine injections for saddle sores • Allowed for specific medical purposes • Can mask serious injuries • Must be documented and justified
• Is masking pain a performance enhancement? • Where is the line between treatment and enhancement? • Should suffering be part of the sport? • Athlete health vs competitive fairness • Long-term health consequences
UCI Ban (2019-Present): • Prohibited in-competition • Testing via urine samples • Sanctioned as doping violation • Penalties include disqualification and fines
• Standard urine testing detects tramadol • Detection window: 24-48 hours • Relatively easy to identify • No-advance-notice testing
• Disqualification from race • Fines for rider and team • Not typically multi-year bans • Treated less severely than traditional doping
• Voluntary bans before UCI prohibition • Medical policies limiting painkiller use • Education about long-term risks • Monitoring for overuse
• Team doctors balancing treatment vs enhancement • Duty of care to prevent harm • Pressure from riders and management • Professional medical judgment required
• Proper bike fit to prevent pain • Physiotherapy and recovery protocols • Mental training for suffering tolerance • Addressing root causes rather than masking symptoms
Tramadol highlights the evolving definition of doping. It's not about building bigger muscles or more red blood cells - it's about removing the body's natural limiters. The tramadol ban represents cycling trying to protect rider safety and preserve the essence of the sport as a test of suffering.
The biggest misconception is that tramadol is harmless because it's a legal prescription drug. The reality is it carries significant risks, particularly when used during intense physical activity and in dehydrated states. Another myth is that all painkillers are banned - NSAIDs like ibuprofen remain legal, though their overuse poses health risks.