Clipless Pedal Cleat Setup

Tech Talks Presented by Park Tool is a monthly video series hosted by Park Tool’s own wrench whisperer, Calvin Jones. The series covers the A to Zs of some of the most prevalent repair jobs, with the eleventh episode tackling new cleat setup.

There’s a lot more to installing your new clipless cleats than simply bolting them to the bottom of your shoes, especially if you want to be comfortable and as efficient as possible. Calvin and Ben are here to run you through the adjustments and how they effect your ride.

Here’s the link

Tubeless setup

I have seen a lot of tubeless setups with all kinds of different ideas behind it. Rim choice, tire options, valves, fluid, tapes, amounts of fluid to use and air pressures. When the setup is wrong it can be one of the most frustrating experiences you can possibly imagine. Tires that won’t get on the rim and most infuriating is a tire that blows off the rim exploding fluid all over yourself, the room and if you’re real lucky, in your eyes.

Below is what I am running on my mountain bike which took me less than half an hour to set up both wheels tubeless this afternoon. Shop price on this work is between $40-$50 for labor and around $20 dollars for two valves.

What you will need to get started:

  • A pump for easy tires. (possibly an air compressor at a gas station, or a Co2 canister)
  • Your preferred choice of sealant, I like Stan’s and Orange Seal
  • Tubeless Valves, I have Stan’s on my mountain and Shimano on my road
  • Tire levers to get your tire off your rim
  • Some way of measuring how much sealant you are putting in the tire
  • Pliers, can make it easier if you need to remove a valve core or tighten/loosen a valve.
  • Tubeless ready tires and rim
  • Rim tape, Stan’s works very well. It can get damaged with tire levers if you are not careful.
  • A nice cold beer

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Tubeless ready tires and wheels. Usually it will say TL or TLR somewhere

Tubeless ready tires and wheels. Usually it will say TL or TLR somewhere

Stan's rim tape around $11 bucks

Stan’s rim tape around $11 bucks

There are many different opinions and ways of setting up tubeless. I like to use products that are made to be tubeless instead of the ghetto idea that maybe it will work and I’ll constantly be messing with it on the trail. I’ve seen gorilla tape work really well for tubeless tape setup, but it is porous and most likely has to be changed more often.

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First, remove your tire off your rim. I try to always start by using plastic tire levers. They are super cheap and can break easy, but they will not scar up and gouge your rim. If your tire is super hard to get off and plastic levers are breaking you may have to invest in metal tire levers that are about $25.

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After the tire and tube is off the rim install preferred rim tape and tubeless valve. Using a truing wheel makes this really easy applying the tape. I like to clean the rim with alcohol and clean rag before applying the tape. Let the alcohol dry for a couple minutes before applying the tape and make sure it is straight. There shouldn’t  be any part of the rim showing except the 90 degree curve of the rim upwards. This tape is the barrier to cover all of the nipple holes in your rim. Take your time and make sure its perfect. I’ve also used a heat gun from a few feet away to give it a little extra stick to the rim. Make sure the lock nut on the valve is tight, but not so tight you couldn’t remove it on the trail.

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Most tires have a direction arrow indicating which way the tire should be put on the rim. It’s the worst when you finish putting your wheel on the bike and realize the tire is on backwards. Take your time and figure it out.

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Once you’re sure the rim tape is perfect and the valve is installed, it’s time to install the tire. The arrow on the sidewall of the tire should be point the way the wheel will spin. With an easy tire that goes on and off the rim without much fuss this is the easiest way to add sealant. I like to put half of the tire on the rim and then leave the other half off. Shake up your sealant well and add it to the tire. I used 2oz for a 29×2.35 and 29.2.25 tire. Some people may add more, but that is a good start. Then put the rest of your tire on and pump it up. Make sure it is seating correctly and don’t exceed 40psi or the risk for a blow off could happen.

Remember the idea of the sealant is to slosh around in the tire helping to seal the bead on the rim. The tire and rim contact point is what is keeping the tire on the rim, not the liquid. The sealant helps to make that seal from leaking air or aids against flats. If a thorn goes through your tire the sealant will help make an air seal. Large objects like nails or glass may be too big of a hole for a seal alone and will need a tubeless tire plug or patch from the inside of the tire.

Personally, I am more concerned of the added weight of adding another 1-2oz of liquid in my wheels and that is why I use 2oz. If I am loosing a lot of air I can add a splash more. If you are prone to riding over a lot of thorns giving you flats maybe add another ounce of sealant. On my road bike I put about 3oz in each wheel because of the higher air pressures and most of the flats are from small objects like household tacks. The sealant sprays out pretty intense at 100psi on a 700x25mm tire versus a 29.2.25 with 30psi.

On a new tubeless setup you must check your air pressure for a few days. The air will slowly seep out a few psi everyday and could be very low when you get ready to ride. After awhile the liquid will seal right up and you won’t loose as much air.

In the end it is a good idea to always ride with a spare tube, pump/co2, tire lever and multi tool. Out in the woods or on a long road ride it isn’t the best to rely solely on tubeless sealant to get you out of any situation.

Here’s a pretty good video from Stan’s about the myths and misconceptions regarding tubeless:

Hozan spoke threading machine.

Hozan what? Hozan who?

Be sure to download your favorite Dead show.

Be sure to download your favorite Dead show as this sucker drains a lot of time.

What an incredible and slow machining tool for the bicycle. This tool allows an experienced mechanic to cut custom length spokes to their desired needs and thread them. Maybe you didn’t know, but bicycle spokes come in all sorts of lengths, diameters and colors, just like people. The Hozan spoke threader mingles all of these mathematical equations none of us can figure out without the use of some sort of computer.

How does it work? Watch the video below. It will be my next $99 purchase straight from the glorious country of Japan via Ebay.

What does your drivetrain look like?

I totally get it that you like to ride, and for some ride as much as possible! Trying to pay the rent here in Jackson Hole is enough of a time suck to keep anyone busy, but your expensive drive train cries when it’s soaked in grease, grime and dirt. Some put lubricants on their chain every time they ride even if it doesn’t need it.

Mile after mile and hour after hour these parts are going to wear out and cost a ton of money to replace. With the newest 1x drivetrains the cost of cassettes is ridiculous. A low end SRAM GX 11 speed cassette now retails for $150.

With a little bit of work you can keep your drivetrain shifting perfect and in the long run save a bunch of money on parts.

Are you a neglector or precision tune type of rider?

Are you a neglector or precision tune type of rider?

New workbench

Spring has Sprung here in the Tetons or at least for awhile. The skiing hasn’t been the best the last few days so I decided to get more organized. Here’s a sweet bench my friend Griffin gave me. I bought some bar topper epoxy yesterday and it has to cure for a few days.

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Playing around with Gaia Mapping

I enjoy looking at maps. My favorite is google Earth because you can fly somewhere though your computer and zoom into a specific area and see what it looks like from a lot of different angles. I remember seeing my first topographic map as a kid and it seemed so confusing.

The intricacies of moving through the mountains on skis and looking at the surrounding peaks, couloirs, vast bowls, tightly spaced trees, and steep cliff bands is a constantly changing environment. As a skier seeking new terrain full of untouched areas and the silence of the woods has pushed me to use more mapping tools.

Last winter I started using Gaia GPS on my cell phone. It’s a nice tool to see exactly where you are in real time. I hope to use it more as we get more snow here in the Tetons and I am able to push into new terrain. Here is a quick tour from today on Edelweiss.

Grand Targhee and Teton Pass Hillclimb races

This past weekend were two back to back hillclimb races. It has been a tough Summer only being able to compete in three small races in preparation for Lotoja. I have made myself suffer massive vertical trying to get back in shape this summer. My goals were simple: be able to ride 10,000 vertical feet in under 100 miles, and get my base miles up to 3000. So far I’m at 2500 miles and 150,000 vertical of climbing this Summer. Now that we’re into August I’m going to concentrate on intervals on the flats to build my endurance. I am going to try to see how hard and how fast I can ride 100 miles mostly on flats for the next two weeks.

Exploding the last watts of power towards the finish line at Grand Targhee Resort, WY

Exploding every last watts of power towards the finish line at Grand Targhee Resort, WY

2 minutes faster than last year

2 minutes faster than last year

Finally did sub 30 minutes

Finally sub 30 minutes

Dr. Ferrari Was Right, a chapter from Spitting in the Soup

Dr. Ferrari Was Right, a chapter from Spitting in the Soup

Exploring how the deals made behind closed doors keep drugs in sports

drugs

Editor’s Note: This book excerpt is used with permission of VeloPress from Spitting in the Soup: Inside the Dirty Game of Doping in Sports by Mark Johnson. In Spitting in the Soup, Johnson explores how the deals made behind closed doors keep drugs in sports. Johnson unwinds the doping culture from the early days, when pills meant progress, and uncovers the complex relationships that underlie elite sports culture. Spitting in the Soup offers a bitingly honest, clear-eyed look at why that’s so, and what it will take to kick pills out of the locker room once and for all. Learn more at www.spittinginthesoup.com and www.velopress.com.

On April 20, 1994, three cyclists from the Italian Gewiss-Ballan team made a mockery of the pro peloton with 30 miles remaining in the 127-mile Belgian classic La Flèche Wallonne. Entering the center of Huy, a city of 14th-century churches and cobbled squares straddling a languid loop in the Meuse River, the field jolted onto the precipitous Chemin des Chapelles, also known as the Mur de Huy. As the road headed up, Moreno Argentin, Giorgio Furlan, and Evgeni Berzin flicked their shift­ers into gears that only they possessed. By the top of the 1.3-kilometer climb, the trio had a 14-second gap on the field. The peloton never saw them again. After a 30-mile final loop through the rolling Ardennes coun­tryside, the Gewiss-Ballan trio started their final climb to the finish atop the Mur de Huy. There was no need for them to send a fleeting prayer for victory toward one of the ascent’s six roadside chapels; Argentin won with Furlan and Berzin taking second and third. The trio’s nearest competitor, 1991 and 1992 road world champion Gianni Bugno, rolled in 1:14 later. Two and a half minutes drained from the clock before 1993 world champion Lance Armstrong finished.

Even before the Gewiss-Ballan threesome crossed the finish line, fans and riders were suspicious. Pull up the race on YouTube and you’ll see why. It is a show of effortless, inhuman domination. When the team­mates attack, they float away with a fluid animation a universe apart from the bobbing and heaving field gasping behind. That spring day in Bel­gium broadcast the awesome, performance-enhancing potential of EPO.

Ferrari would have none of it. “EPO is not dangerous,” he retorted. “Its abuse is.” Ferrari then added, “It is also dangerous to drink ten liters of orange juice.”Following the race, a French sportswriter named Jean-Michel Rouet spoke to the Gewiss-Ballan team’s Italian doctor, Michele Ferrari. The physician was rumored to be a keen proponent of the relatively new blood-boosting anemia treatment drug, recombinant human eryth­ropoietin, or EPO, and his riders’ unbelievable victory made Rouet eager to pin down the Italian. Reporting on their encounter in the April 22, 1994, issue of the French sports daily L’Équipe, Rouet raised the widely accepted rumor that EPO had caused a rash of Dutch cyclists to die in their sleep. Referring to events that many accepted but none stopped to challenge, Rouet all but accused Ferrari of trying to kill athletes. “A dozen Dutch riders died a few years ago,” the journalist asserted. When Ferrari demurred, Rouet pressed on. “In any case, it is dangerous!” he said.

Ferrari was a protégé of Italian blood-doping pioneer Francesco Conconi—a man whose groundbreaking research into autologous blood boosting helped Francesco Moser shatter the hour record in 1984. For most reading this exchange, Ferrari’s response to Rouet’s interrogation immediately became evidence of the doctor’s cavalier attitude toward anti-doping laws. When growing moralism about drug use in sport was superimposed upon Ferrari’s statement of fact—EPO isn’t dangerous, its abuse is—the Italian’s willingness to challenge hardened anti-doping orthodoxies also became a sign of moral treachery. Sure, orange juice was benign, but just pick up a newspaper or cycling magazine and you’d see—EPO was a killer set loose among the peloton.

Ferrari became a poster boy for the mortal dangers of EPO and its distributors. While the Dutch riders Rouet referred to were never conclu­sively linked to death by EPO, the fabrication served a larger anti-doping moral agenda and the missionary effort to impose purity on sport. After the IOC expanded its definition of performance-enhancing substances and took a more aggressive approach to doping in response to the 1984 Olympic blood-boosting scandal, the characterization of sports doping as a plague gained speed. As historian Paul Dimeo explains, through the 1980s, “the construction of doping as an evil, a plague, a cancer or a temptation” was kept alive by the myth that sports were inherently good and drugs were a corrupting temptation that had to be beat out of the athletic garden of Eden. By daring to speak the truth about a drug—that under a doctor’s supervision, it is safe—Ferrari fell short of the newly emboldened anti-doping evangelists.2 Pointing out that Ferrari was cor­rect would have been to spit in the soup of anti-doping outrage that was becoming a nurturing broth for journalists and anti-doping administra­tors alike.

Three years before Lance Armstrong finished La Flèche Wallonne over two minutes down on the Ferrari-charged trio, on May 19, 1991, the New York Times startled readers with news of a killer stalking the roadways and velodromes of Europe. “A genetically engineered drug that was created for people suffering from kidney failure has become the latest substance to be abused by athletes seeking enhanced stamina and performance,” Times journalist Lawrence Fisher reported. “The consequences, in some cases, may be deadly.” Ominously titled “Stamina-Building Drug Linked to Athletes’ Deaths,” the piece connected the death of 18 European pro cyclists over a four-year period to EPO. Although the Times headline gripped readers by their lapels and yanked them into the dirty world of European pro cycling, the story’s claim that the drug was responsible for 18 cyclist deaths was based on speculation. EPO can theoretically cause stroke, hypertension, and myocardial infarction when used by dehydrated athletes, especially when taken without a doctor’s supervision. Evidence also suggests that the hormone may have an anti-inflammatory and tissue-repairing effect that can aid with recovery. What was not provable in 1991, or today, is that the drug killed a rash of cyclists.

The number of red blood cells, or erythrocytes, in our body is con­trolled by a feedback loop between an oxygen sensor in our kidneys and our bone marrow—the factory that produces blood cells. Erythrocytes don’t have a nucleus and can’t repair themselves. After about 120 days of service, they are shot, and the spleen shuffles these red blood cells out of circulation at a rate of 2 to 3 million erythrocytes per second. Like a manager calling down to the production line when a new order for widgets comes across his desk, when the kidneys sense that our red-blood-cell count is getting low (our hematocrit level), EPO signals the bone marrow to crank up blood cell production. Stem cells start a chain of sequential divisions that eventually results in fresh new erythrocytes eager to cart oxygen to our muscles for four months. A hormone, erythro­poietin, works as the middleman in this process; it binds with blood-cell receptors and triggers the creation of erythrocytes.

Like a second temporary factory manager who suddenly appears on the floor with a megaphone and starts barking out orders for more product, when a doctor injects synthetic EPO into your body, the arti­ficial hormone tricks the stem cells in the bone marrow into creating more red blood cells. It can be a life-saving event when natural eryth­ropoietin levels wane due to pathologies like bone marrow cancer or kidney failure.

This process also works in healthy people, only instead of fooling an ailing body into boosting its flagging red-blood-cell count back up to normal, injecting EPO into a healthy human causes the bone mar­row to produce more red blood cells than are normally needed. The resulting surplus of these oxygen-carrying cells can increase endurance by as much as 10 percent. The ideal adult hematocrit percentage var­ies between individuals and genders, but it is generally in the 40 to 54 percent range at sea level, and about 5 percent higher than that for peo­ple who live at altitude. When athletes figured out that exogenous EPO could juice their red-blood-cell count, they got the same performance-enhancing benefit as living at altitude or sleeping in a hypoxic chamber. Describing the effect of EPO on his performance, cyclist Tyler Hamilton said in his 2012 book, The Secret Race, “That holy place at the edge of your limits gets edged out—and not just a little.”

Cash

Although endurance athletes probably began experimenting with this new synthetic hormone during the drug’s clinical trials in 1986, its use as a potential performance enhancer was first recognized in the early 1950s. Beginning in 1953, a University of Chicago biochemist named Eugene Goldwasser set about understanding how the human body cre­ated and regulated red blood cells. Solving this problem had tremendous life-saving potential. Inventing a way to artificially replace the body’s EPO would be a boon for millions of patients affected by kidney failure. After three decades of research, Goldwasser isolated the erythropoietin gene, thereby opening the door to its synthesis.

In his autobiography, A Bloody Long Journey, Goldwasser recalls that not long after he began his 1953 investigations, a man with racehorses to sell came looking for equine EPO. Horses that ran faster and longer com­manded premium prices, and the horseman wanted to inject his stock with EPO to increase their performance in claiming races—events where horses are sold based on their placings. As Goldwasser recalls, “He had done his homework and knew that for short races, increasing red cells was no help . . . but in longer races, having a bigger erythron [red-blood-cell count] was an advantage.”

Buckets of horse blood soon began showing up on Goldwasser’s doorstep. Although Goldwasser never extracted enough pure EPO from the blood to test its sporting efficacy, he, like the racing entrepreneur, saw the performance-enhancing potential in the blood-regulating hor­mone in the early 1950s.8 When Goldwasser’s lab finally isolated the EPO gene in the early 1980s, an infant biotech startup called Applied Molecular Genetics approached him, and Goldwasser began sharing his three decades of knowledge with the company that would later rename itself Amgen. The company was funded by Montgomery Securities, an investment bank founded by Lance Armstrong’s U.S. Postal Service team backer Thomas Weisel.9

Amgen finally cloned EPO in November 1983, opening the door to industrial scale production of a synthetic version of the hormone under the name Epogen. It also licensed the patent to Johnson & Johnson, which sold its EPO as Procrit. The startup exploded into a pharmaceuti­cal giant worth over $100 billion today. By 2006, annual EPO sales were $13 billion worldwide.10 After Amgen went public in 1983, the com­pany generated a stock-market windfall that seed investor and dedicated cyclist Weisel would later use to fund pro bike racing teams and pay for his own personalized coaching by Eddie Borysewicz.

The spectacular rise of Amgen and its miracle drug coincided with what appeared to be a rash of mysterious deaths among endurance ath­letes. Echoing claims made in other general news and cycling-specific publications, a May 1991 New York Times article concluded that EPO’s development came too close to a glut of pro cyclist funerals to be mere coincidence. The piece described the mysterious death of Dutch pro Johannes Draaijer, who passed away in his sleep in 1990 at the age of 27. A caption beneath a photo of Draaijer read, “Mr. Draaijer’s widow believes that the drug recombinant erythropoietin was involved with his death.” A pull quote declared, “You just don’t get 18 deaths in 4 years, mysteriously.” The story left the impression that the new life-saving anemia drug played double duty as an indiscriminate athlete killer.

EPO deaths made for good news stories, even if there was no autopsy evidence that EPO was actually killing cyclists. However, the New York Times knew the connection between EPO and the apparent boomlet in dead cyclists was speculative, and admitted so a week later. Backtrack­ing, the Times ran a correction: “A picture caption last Sunday with an article about a stamina-building drug linked to athletes’ deaths misstated what is known about the death of the Dutch cyclist Johannes Draaijer. An autopsy did not specify the cause, and it is not known conclusively whether he had used the drug.” Despite the correction, the rumor was already set: EPO was a new drug of athlete destruction.

If you take a lot of EPO without a doctor’s supervision, in theory you can kill yourself. As University of Oklahoma chief of hematology Dr. Randy Eichner explained in the Times piece, increasing red-blood-cell count can thicken blood. Take too much EPO and “pretty soon you have mud instead of blood; then you have trouble.” The results can be blood clotting, stroke, or heart failure. The Times also cited Ed Burke, the USCF physiologist who oversaw the 1984 Olympic cycling team’s blood boosting. “EPO can do wonders for your aerobic capacity,” Burke noted, before warning, “The problem is, it can also kill you.”

By sensationalizing the potentially deadly effects of EPO without reporting any evidence for a correlation with actual events, the New York Times seemed to be taking up the role of an anti-doping mission­ary whose conclusions are based on faith rather than evidence. Under a hematologist’s expert care, EPO is safe. The drug saves thousands of lives every year. Yet because this drama-killing statement of fact con­tradicted the sensationalist thrust of a story about a scary new athlete killer, that is not the story that snowballed in the press.

In a New England Journal of Medicine (NEJM) article on the thera­peutic uses of EPO published on May 9, 1991, 10 days before the Times piece, hematologist Dr. Allan Erslev wrote that erythropoietin “appears to be almost nontoxic.” Born in Denmark, Erslev graduated from medi­cal school in 1945 and then traveled to the United States to conduct postgraduate research at Yale and at New York’s Sloan Kettering Insti­tute. Testing anemic rabbits in the early 1950s, Erslev was one of the first to identify the blood-regulating effect of EPO. In his 1991 NEJM piece, Erslev theorized that since EPO seemed to be nontoxic, it was viable for elective surgery patients who were concerned about contracting AIDS from donated blood. At a time when the blood-borne autoimmune-deficiency disease dominated headlines, surgery patents were afraid to use anonymously donated blood from blood banks. To eliminate the perceived risk, patients stored their own blood in advance of surgery. However, this blood banking created the problem of already sick or injured patients making themselves anemic in advance of surgery. Using America’s most esteemed medical journal to broadcast his message, Erslev told the surgical community that by using EPO, patients could safely extract and store more blood than was otherwise recommended without suffering a lower hematocrit level. With EPO therapies, “the number of donations could undoubtedly be increased,” he advised.

Pills

Erslev also wondered whether EPO could have a role as a rehabilita­tive therapy for endurance athletes. In 1991—the midst of the popular press’s EPO-kills-cyclists panic—Erslev asked if “athletes engaged in exhausting long-distance events such as swimming, running, bicycle racing, or cross-country skiing would benefit from a moderate rise in hematocrit and red-cell mass.” Since many world-class athletes were already anemic because their training regimes increased plasma vol­ume and thereby diluted red-cell density, Erslev seemed to posit that the use of EPO as a sports medicine recovery therapy would merit fur­ther investigation.15

As for EPO dangers, Erslev postulated that the combination of lower blood volume from dehydration and higher hematocrit from EPO “would increase blood viscosity and be not only detrimental to muscu­lar action but also the cause of possible life-threatening thrombosis.” In other words, an athlete would be both slower and more likely to die from a blood clot in the brain. While Erslev did not have studies to prove it, in theory, it would seem that EPO would both decrease muscle performance and potentially thicken blood to the point that it might kill you. In spite of these theoretical complications, Erslev reported that the studies he had run indicated that the blood-clot problem was “quite sporadic” and in some clinical tests “nonexistent.”

Ten days after the publication of Erslev’s article, news sources were calling the sports world to EPO panic stations. On July 14, 1991, Britain’s Independent ran a piece with a stretched-out title worthy of its endur­ance topic: “Cyclists Don’t Die Like This; Cycle Racing Gets Tough—and Sometimes Racers Die: But on the Track, Not at Home, in Bed, in Their Prime. Not 18 of Them. So Were They Abusing a Billion-Dollar Wonder Drug?” The piece began with a vignette of Draaijer’s wife, Lisa, waking up to a gurgling sound—her husband’s death rattle. It then listed other cyclists who had passed away, including Dutch pro Ruud Brouwers who fell out of bed and died on May 3, 1989, and Dutch amateur Connie Mei­jer, dead after abandoning a criterium on August 17, 1988. Heart failure had killed 18 cyclists in all, the Independent claimed.

The Independent writer rang up retired 1970s Dutch pro Henk Vogels at his home in Australia. Vogels told the journalist, “Half the people I cycled with are now dead. They often die in their early forties after 15 years of taking stuff and going all out.” In the same piece, 1984 U.S. Olympic cycling team doctor Ed Burke warned UK readers that EPO abuse “raises the red-cell count to the point where it turns the blood into sludge.”

A decade later, Burke died of a sudden heart attack while cycling near his Colorado Springs home, a victim of sudden cardiac failure, the number-one killer of athletes. Burke was 53. While no one blamed his death on dope, in the early 1990s, both Burke and the journalists who quoted him were quick to pin the cardiac failure of 18 cyclists on EPO. These pieces came at such a fast pace that a supposition became received wisdom: EPO is a mass killer.

Even the Sporting News, a magazine that usually keeps its nose pointed firmly in the direction of stick-and-ball sports, got on the EPO-kills bandwagon, writing in a 2004 piece titled “Cycling’s Deadly Downward Spiral” that “death is yet the unseen rider in world-class cycling.” The story cited the death of nine riders due to heart failure between January 11, 2003, and June 30, 2004, including “one in a den­tist’s chair.” The piece also referred its readers to the death of Italian superstar cyclist Marco Pantani in 2004. Though Pantani’s autopsy sin­gled out a cocaine overdose as the cause of death, that did not stop the Sporting News from attaching its amplifier to the common speculation: “Some cyclists believe he died as the other eight did—of heart failure prompted by use of EPO.”

On January 29, 2004, the Sydney Morning Herald described soccer players who had mysteriously died on the pitch. Although none of the players’ autopsies indicated EPO as a cause of death, the Australian paper did not let medical records get in the way of a growing fiction. It promptly made the EPO connections that coroners did not. Citing a French investigation into doping by the Cofidis cycling team, the paper wrote, “Perhaps the soccer authorities should start an inquiry into these supposed unrelated deaths.”

Marathoners also got their moment in the EPO-kills glare. “Fear on the Marathon Starting Line,” blared an April 22, 2001, piece in Scotland’s Sunday Herald. It asserted that the top runners in that year’s London Mar­athon were wondering whether their days on Earth were so numbered that they would not have time to spend their appearance fees. The reason? EPO. Spanish marathoner Sergio García had died earlier that year at the age of 39, and coaches and runners were abuzz with speculation that his death was related to EPO. “Garcia’s spectre has been stalking the corridors of the London Marathon race headquarters this week,” the paper whis­pered. The connection between García’s death and EPO was hypothetical, and yet by 2001, the EPO-kills myth was so hardened that newspapers could get away with publishing gossip in the guise of reporting.

Unlike the press, EPO-using athletes separated the true risks of EPO from myth. U.S. Postal Service team rider Tyler Hamilton started using the synthetic hormone in 1997. In his 2012 book The Secret Race, the American compared the risk of taking EPO to the damages he suffered while racing—a catalogue of smashed bones from nose to back to ribs. “Bike racing is not a healthy sport in any sense of the word,” Hamilton wrote, “so when it comes to the risks of EPO, they tend to feel pretty small.”20 In light of the actual clinical facts available in the 1990s that EPO and hypertension were “not related” in healthy patients and that the drug’s causation of blood clots was “quite sporadic” if not “nonexistent,” Hamilton’s response to the public perception of EPO danger was rational. As Erslev and the European and American drug regulators who approved Epogen and its variants indicated, under a doctor’s supervision, EPO was safe. And as Hamilton pointed out, the risk of doctor-supervised EPO use was especially slight compared to the nearly 100 percent statistical chance that a rider would suffer multiple, and sometimes life-threatening, injuries while racing on Europe’s narrow roads.

Spanish scholar Bernat López researched how EPO was transformed from a life-saving miracle hormone into what he calls a “drug of mass destruction.”21 Although no evidence exists to support the claim that EPO caused any of the cyclists’ deaths in the early 1990s, López’s research led him to conclude that the rumor had ossified into received wisdom through media repetition. The fiction served as propaganda that made it professionally and personally suicidal to challenge the morality and righteousness of the antidrug movement.

As López sees it, the story of EPO killing loads of cyclists became a “flagship myth” for anti-doping interests. It was a story manufactured and spread by the press with the intent of scaring athletes. López, a professor at the Universitat Rovira i Virgili in Catalonia, also argues that because the general public is largely indifferent to the drug-regulating policies that are the bedrock of anti-doping organizations, anti-doping missionaries played up the deadly EPO myth as a way to gain sympathy from a public that has an otherwise insatiable appetite for legal and ille­gal performance- and lifestyle-enhancing drugs.

When López ran a meta-analysis of 36 academic texts that referenced the EPO deaths as evidence of the danger of EPO, he discovered a schol­arly train wreck. All the articles either referred to no source for their EPO-deaths claims or noted secondary resources that cited no source. As a result of this evidence-free conclusion making, academics came up with a shambolic number of EPO deaths, ranging from 5 to 20. The victims’ nationalities were also wildly inconsistent. While newspapers like the New York Times reported that the dead riders were Dutch, the academic researchers indicated that they hailed from Spain, Holland, Belgium, and Scandinavia. The deaths also took place during variable time frames ranging from “the 1980s and early 1990s” to “between 1997 and 2000,” to “1987 to 1991.”

López also looked at 20 academic texts that offered evidence against the claim that EPO killed a bunch of cyclists in the late 1980s and early 1990s. The articles commonly pointed to genetic heart defects as the most likely cause of the deaths. None of these studies cited EPO as a potential or actual cause. If the researchers behind the 20 papers came up with any one Grim Reaper haunting bike races and marathons around the world, it was the damaging effect of extreme and prolonged training. In sum, López concluded, the 20 studies he investigated “sug­gest that EPO is extremely unlikely to have had the effects that have been claimed in the speculation of anti-doping sports doctors, academ­ics, and journalists.”

When López performed the same analysis of coverage in the popu­lar press, he found an even bigger mess of chronology and nationality. News reports put the number of EPO “victims” anywhere from 7 to 40, from countries including Spain, Holland, Belgium, Germany, and Poland as well as generic “Europe.” Moreover, the articles cited athletes dying from EPO beginning in 1970, even though EPO was not produced for clinical trials until 1986.

When López broadened the scope of his search to include newspa­pers, magazines, blogs, and cycling websites for mentions of sudden deaths among cyclists between 1987 and early 2010, he found 49 cyclist sudden-death stories. In the time frame most often mentioned as ground zero for EPO deaths, 1987 to 1992, López unearthed news reports of 17 sudden deaths in Belgium, Holland, France, and the UK. These numbers are in line with the expected number of deaths from naturally occurring heart failures in athletes and the general population.

According to López’s research from 1995 to 2006, 180 athlete sud­den deaths were reported in Spain alone—about 15 per year. Of that total, 39 deaths were cyclists and 40 were soccer players. In other words, whether the number of cyclist deaths in Europe in the early 1990s was 15, 17, 18, or 20, those numbers do not reflect a spike, but rather a death rate entirely consistent with normal athlete sudden-death statistics in a single European country and low for all of Europe combined.

Compared to sudden cardiac deaths in both the athletic and larger population, the “explosion” of cyclist deaths that supposedly came at the hand of EPO does not seem like an anomaly; that number of deaths is normal. The anomaly was the arrival of a new, highly effective doping product. Blinded by a rising anti-doping fervor, journalists and medical researchers alike seemed to have superimposed EPO onto normal death rates and created a crisis where there was little, if any, postmortem evi­dence to suggest a correlation between EPO and fatalities. Yet the ghosts of the mythical 18 cyclists still haunt us today. As recently as 2012, an academic review of scientific studies on the effectiveness and safety of erythropoietin mentions the possible link between EPO and “18 Euro­pean professional cyclists [who] have died.”

The narrative about crime, death, and drugs was believable because—three years after the 1988 approval of EPO use in Europe—the story sounded logical. Athletes eager to win plus a potentially dangerous new drug equaled death. When I called López at his home south of Barce­lona, he told me he has yet to find a scrap of hard evidence linking EPO with any cyclist’s death in the early 1990s. With the weary sigh of a man who had discovered a truth no one wanted to hear, he told me, “Science has not produced so far—at least to my knowledge—any conclusive evidence linking EPO with sudden death.” While dozens of papers con­tinue to speculate about a link between EPO and the rash of Belgian and Dutch deaths, “they are just reproducing the myth,” López explained.

As López sees it, the role of the EPO deaths in the war on drugs in sport is analogous to the role fictional weapons of mass destruction played in the justification of the United States’ invasion of Iraq in 2003. “There was a war to be waged, and the people waging that war needed justification, an excuse, a solid reason,” he observed. Turning back to the EPO fiction, he said, “The best reason for waging that war is that doping kills. ‘We honest men, we must stop athletes from taking drugs because we are interested in saving their lives.’” By exaggerating and distorting the EPO story, the anti-doping establishment was able to pre­dict a dire future. And a bleak tomorrow creates incentives for stronger, better-funded anti-doping measures while also spinning far more com­pelling media narratives.

In 1906, Olympic founder Pierre de Coubertin described the Olym­pic Games as a “program of moral purification.”26 This mission carries on today as an anti-doping errand in a chemically polluted sporting wil­derness. For López, there is a link between the foundation of Olympic sports as a morally purifying, soul-cleansing experience and Olympic sports’ ongoing efforts to preserve what the WADA code formally labels the “spirit of sport.” “Well, actually,” López clarified for me, “they are interested in saving their souls, but they pretended that they were inter­ested in saving their lives.”

My own search of medical literature finds plenty of warnings about the dangers of too much EPO. And there are many examples of pharma­ceutical companies paying physicians kickbacks to overdose patients, a process that inadvertently accelerates the growth of deadly tumors. However, I found no documented instances of EPO killing already healthy humans, athletes or otherwise.

In December 2006, Danish researchers reported that 10 percent of a clinical trial group of 516 head and neck cancer patients on heavy EPO doses experienced accelerating tumor growth, even while undergoing radiation treatment.27 This confirmed studies going back to 2003, which also showed that EPO could boost cancer growth. And 10 years earlier, a 1996 study of dialysis patients was halted because patients on high EPO dosages suffered more heart attacks than a control group on lower amounts of EPO.

The deaths were not related to something that was inherently destructive about EPO. Instead, they were caused by overdosing. In 2007, Johnson & Johnson’s annual EPO sales were $3.5 billion, while Amgen moved $5.6 billion worth of the product. To attain these astronomical numbers, Amgen and Johnson & Johnson built incentive programs that financially rewarded doctors who administered heavy “off-label” doses of EPO to cancer and anemia patients. One West Coast office of six oncologists pocketed $2.7 million in incentives from Amgen in 2006 alone. The nationwide priming of the EPO pump led to a well-documented rash of heart attacks and carcinoma deaths in cancer and renal failure patients—so many that in 2007, the FDA released a report suggesting the dollar-incentivized high doses were neither improving nor extending patient lives.

That said, even massive amounts of EPO don’t automatically lead to death. A 2006 paper described two hospitalized South Korean heart-attack patients who accidentally received nearly 10 times their prescribed dose of EPO—318,000 units instead of 33,000. Both patients were smokers, and one had a history of hypertension and diabetes. After discovering the overdose, the hospital closely monitored the patients for symptoms such as elevated blood pressure, nausea, vomiting, shock, and thrombo­sis (which had already put them in the hospital). Despite the overdose, doctors reported that the two patients experienced none of the negative expected side effects from toxic levels of EPO. While known reactions to EPO overdoses make for a long, serious list—headache, muscle and joint pain, allergic reactions, nausea, itching, seizures, enlarged spleen, elevated blood pressure, and overproduction of blood platelets—the doc­tors reported that “in the course of close observation, we found none of the specific symptoms we expected as side effects of erythropoietin, and no abnormal objective findings on physical examination.” The patients were soon discharged, and their EPO levels returned to normal.

In 1993, a wheezing, clammy-skinned man showed up at a New York emergency room complaining of shortness of breath and a cough. The frail 62-year-old repeatedly told the doctors that he needed a “transfu­sion to correct anemia” and that he was stricken by “chronically low hematocrit.” The ER doctors had a delusional hypochondriac on their hands with a history of self-medicating. The victim, a retired biomedi­cal engineer, had a friend in the pharmaceutical industry who supplied him with Epogen. The arrivee had been injecting himself with EPO every day for several months (EPO is typically administered three times a week). He was also taking daily doses of a stew of other medicines, including penicillin.

When the patient checked into the ER, his hematocrit level was a through-the-roof 70.4 percent, a number that startled doctors used to finding a typical 42 to 54 percent hematocrit in adult males. While the fact that the patient was taking so many other drugs made it difficult to tie his symptoms to EPO alone, a report on the case in the American Journal of Emergency Medicine indicated that the months-long overdos­ing on EPO was causing the patient chest pain and hypertension, and it had worsened symptoms of his existing lung disease. The report pointed out that when a hematocrit level exceeds 70 percent, the amount of oxy­gen reaching the brain decreases, which in itself can be dangerous. In spite of his spectacular abuse of EPO, the patient recovered and was later released to a psychiatric hospital.

These vignettes are not meant to argue that EPO abuse is safe. It’s not. In their write-up of the case, the physicians took the opportunity to warn other doctors to be on the lookout for athletes who self-administer EPO: “It seems likely that an erythropoietin-induced increase in hematocrit, coupled with the dehydration that develops during prolonged exertion, would increase blood viscosity and cause impaired muscle perfusion and possible fatal thrombosis.” The point remains, however, that it is extremely difficult to find a case that backs up the press-supported notion that EPO was indiscriminately slaughtering cyclists in the early 1990s.

One reason European athletes may have quickly adopted EPO in Europe in the late 1980s is related to a difference in European and American patent law. Shortly after Amgen successfully cloned EPO in 1982, at least four other biotech firms and the University of Washington separately made the same breakthrough. A court battle handed the U.S. patent to Amgen. European patent law, however, is reluctant to grant patents on naturally occurring substances, and Amgen did not get an EPO monopoly on the other side of the Atlantic. As a result, Europeans had access to EPO from at least three manufacturers.

This pharmaceutical company competition, along with the buy­ing power of Europe’s national health care systems, kept EPO prices much lower in Europe. The affordability put the drug within financial reach of struggling European athletes while the drug’s distribution from multiple chemical manufacturers may have created more opportunities for gray market product leakage. According to Alessandro Donati, an Italian sports professor and doping investigator, data from the sales of performance-enhancing drugs in Italy show that of 181 million prescrip­tions studied in 2000, the best-selling ones were erythropoietin and human growth hormone. The €158 million worth of EPO sold in Italy in 2000 did not include amounts brought in from Switzerland, nor the EPO distributed by the Mafia—much of it stolen from pharmacies or obtained from illicit distributors. Donati also cites a 1999 French study that indi­cated that only one-sixth of global EPO production went to patients with pathologies, with the rest being distributed through underground mar­kets. Because there were more manufacturers of EPO in Europe than in the United States, Europe had more distribution nodes from which the drug could be bought or stolen, he says.

Interestingly, health care system differences ended up saving the lives of cancer victims in Europe compared to the United States. In 2001, Amgen released a new EPO called Aranesp. To spur product sales, the company offered $1,200 kickbacks to doctors for every prescription written. Amgen also ran a TV ad blitz that encouraged patients to ask for Aranesp as an antidote to fatigue. Prescriptions skyrocketed 340 percent in the United States, but increased only 52 percent in Europe. Across the pond, direct-to-consumer marketing is illegal, national health care systems use their buying clout to negotiate lower drug costs, and doctors in those same health care systems are immune to Big Pharma payola.

Five years after the Aranesp release, studies began to indicate that American cancer patients were dying 10 percent more frequently than European cancer sufferers. As it turned out, EPO was accelerating tumor growth; the American sales-and-marketing incentives that got more patients to take more EPO had the unintended effect of killing them off more quickly than in Europe, where patients were shielded from the pharmaceutical company’s aggressive sales-and-marketing efforts. While there is no evidence directly linking EPO to any competitive cyclist deaths in Europe, in the United States, there are ample data showing that heavy EPO use incentivized by the oddities of the American health care system was shortening cancer patient lives. This discovery lead to a sterner FDA-mandated “black box” warning on EPO packaging and a decline in American oncologists’ enthusiastic EPO prescription writ­ing.36 The scandal also suggests how EPO’s black reputation in sports as a drug of mass destruction got an assist from drug makers’ efforts to expand product sales.

During a conversation with López over Skype, I mentioned Michele Ferrari’s infamous statement about EPO and orange juice. López said that Ferrari had dared to tell a truth that violated an anti-doping article of faith, one that firmly established itself after the IOC took its more aggressive anti-doping stance in the wake of the 1984 Los Angeles blood-doping episode: If it’s a performance-enhancing drug, it must be categorically destructive to health and the spirit of sport. In the severe catechism of anti-doping thought that was hardening after Los Angeles and the 1988 Ben Johnson scandal in Seoul, there was no room for a fact-based argument like Ferrari’s. Performance-enhancing drugs must be evil—end of story. For challenging the anti-doping missionaries’ creed by suggesting that the abuse of drugs is harmful, not drugs in and of themselves, Ferrari was immediately exiled.

“You cannot say Ferrari,” López observed. For his orange-juice com­ment, “he has been condemned. He is in hell and you cannot rehabilitate Ferrari’s image or respectability because received wisdom says that Fer­rari is the devil.”

López was not justifying Ferrari’s acts. The Italian doctor repeatedly broke the laws of the land and sports, and he conspired to give certain athletes an illegal performance advantage that others did not share. He was banned for life by the U.S. Anti-Doping Agency for his involvement with Lance Armstrong’s doping and for administering and trafficking in performance-enhancing drugs. Even in 1994, he was up to no good. However, what interests López is how journalists who write about doping, and the agencies that create and enforce doping codes, can condemn Ferrari for speaking a truth about EPO when they have used the EPO-kills fabrication as a justification for a steadily growing anti-doping infrastructure.

López is not optimistic that journalists or anti-doping agencies will hold themselves accountable about the true health risks of doping any time soon. Doing so would be to spit in the soup that feeds them. It would also suggest that our responses to drugs are based more on per­sonal bias than on hard data. “People are not interested in listening to other versions” of this colorful, body-strewn doping history, López told me. Excising the “doping kills” fable does no good for the anti-doping evangelists’ cause because the falsehood has self-justifying utility. As López put it, the EPO-kills story is useful as an anti-doping foundation myth. Like Knud Enemark Jensen’s “death by amphetamines,” the tale is factually ignorant but practically useful for the media and anti-doping bureaucracy’s “general condemnation and refusal of doping.”

As for the inherent ethical contradiction in the twisting of truth by anti-doping activists in order to return athletes to “true sport,” López does not think sinister motives are at play. Anti-doping agencies, sci­entists, and journalists are reluctant to discuss the fictional nature of drug-death stories because these tales serve a moral good that is a descen­dent of Coubertin’s quest for purity. The EPO-kills story “was useful for the anti-doping campaign,” López explained. “So it didn’t matter if the evidence was good enough or not because it was conducive” to the anti-doping missionaries’ goal of imposing a new purity on sports. In fact, López feels that anti-doping campaigners are acting in good faith, rather than willful hypocrisy. “I don’t think that they lied on purpose,” López told me. “But what they did was create a truth out of circumstantial and scattered evidence. And they believed in their own creation.”

Author
About the Author

Mark Johnson is a sportswriter and sports photographer. He has covered cycling and endurance sports as a writer and photographer since the 1980s. His work often focuses on the business of pro cycling—a topic that frequently intersects with the sport’s long history of doping. Along with U.S. publications like VeloNews andRoad, his work is published in Cycling Weekly in the UK, Velo in France, Ride Cycling Review andCyclingNews in Australia as well as general-interest publications including the Wall Street Journal.

VeloPress published Johnson’s first book, Argyle Armada: Behind the Scenes of the Pro Cycling Life, in which Johnson was embedded for a year with the Garmin-Cervélo professional cycling team. A category II road cyclist, Mark has also bicycled across the United States twice and completed an Ironman triathlon. A graduate of the University of California, San Diego, the author also has an MA and PhD in English Literature from Boston University. His other passion is surfing, which he does frequently from the home he shares with his wife and two sons in Del Mar, California. Learn more at www.ironstring.com, and follow Johnson on Twitter, Facebook,Instagram.