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Paper short abstract:

Elite sport bio-therapy practices are analysed in three primary aspects: commercialisation/corporatisation, evidence based medicine (EBM), and local medical cultures and beliefs. Ethical implications are drawn out.

Paper long abstract:

The high-pressure environment of elite sport is increasingly biomedicalised and scientised. A range of biological and regenerative cellular therapies such as stem cells and 'platelet-rich plasma' (PRP) is being debated, and in some cases these are being used therapeutically to treat injury and accelerate 'return to play'. International producers of regenerative products address sports medicine markets, for example as 'orthobiologics'. The paper draws on data from a current UK-focused research project, specifically using sociological and anthropological conceptual approaches, to analyse the emergence of bio-therapies in three primary dimensions of elite sport: commercialisation/corporatisation, evidence based medicine (EBM), and local medical cultures and beliefs. In spite of modest 'evidence' for efficacy, and widespread conservative medical policies, some innovative and controversial biotherapies are increasingly used, sometimes as intended, sometimes to counter or acquiesce to club/team and performer pressures. A strong conflict is seen on the one hand between EBM-style medical and physiotherapy practices, and on the other hand, athlete or manager-driven referral to practitioners who can be seen to have qualities of the shaman, witch doctor or faith healer. This analysis raises ethical conflicts for participants, such as medical accountability, reputation and trust, and short term return to play versus long term athlete welfare.

The project data include observation of sports medicine conferences, and interviews with sports medicine leads at English Premier League football clubs, orthopaedic surgeons, physicians and physiotherapists in cycling, sports association medical officials, and bio-therapy companies. Football (soccer) and professional cycling are the two main sports researched.