The dark side of the force – Actovegin & Treatment of Franck Ribery by Müller-Wohlfahrt

Due to ongoing back injuries, Franck Ribéry is set to miss the World Championship 2014. This will most likely be the las chance to compete for the world cup, following the defeat in the finals of the WC 2006 in Germany. A participation at the WC 2018 in Russia is uncertain given that Franck Ribèry would be 35 years old then. A proud age for a winger.

It is no wonder that a discussion is now sparked that is concerned with the absence of the current European Footballer of the Year from the World Championship in Brazil. This time, the medical team takes centre stage. The French team doctor Franck Le Gall indirectly respectively directly accused Dr Hans-Wilhelm Müller-Wohlfahrt. Acting as team doctor of FC Bayern, the latter was accused of having treated all injuries with injections.

Franck Le Gall describes Ribéry’s treatments at FC Bayern as follows:

Franck plays at a club that indiscriminately treats all problems with injections.” the doctor said. It could be “10, 20, 25, 40 per issue, per year. We could have done the same, but we decided not to.

The echo from Munich was received in due course. Dr Hans-Wilhelm Müller-Wohlfahrt clarifies that “in the case of a treatment by him, the participation at the World Championship would have been possible”. He had this statement *published* by the media law firm Schertz Bergmann. Ribéry was in addition not terrified by syringes – he simply refused the treatment with cortisone. Regarding the statements made by Bergmann respectively Hans-Wilhelm Müller-Wohlfahrt it is more interesting that the latter admitted publicly to have treated Ribéry with Actovegin. Actovegin is an ultrafiltrate of bovine blood serum. Similar to insulin, the drug is supposed to stimulate the cellular metabolism, have a positive effect on the circulatory system and speed up as well as support tissue repair processes even following serious operations. Actovegin is in addition frequently applied to muscle injuries and therefore is a top seller within sports medicine. The effectiveness is nevertheless controversial within research and medicine. Regardless of this, Müller-Wohlfahrt has been holding this drug in the highest regards for a long time.

An interesting question is as to whether Actovegin is a doping substance. (The complete text can be found on: *Cycling4Fans*) The IOC placed the drug on the list of doping substances in 2001, yet crossed it off again only two months later. This was in particular suprising given that the drug is continuously said to have performance enhancing effects. It is for instance supposed to increase the oxygen intake capacity without causing a likewise increase in the number of erythrocytes. The drug was used repeatedly around the turn of the century in order to enhance the effect of EPO. About ten years later, experts are in disagreement and even deny any performance-enhancing effect of Actovegin.
The World Anti-Doping Agency (WADA) has in the meantime provided several restrictions regarding the usage of the drug. Only a certain amount is for instance allowed to be administered intravenously.

Even the investigation team of “Der Westen” focused on the problematic use of Actovegin by Dr Hans-Wilhelm Müller-Wohlfahrt in its *research blog*. Müller-Wohlfahrt was even back then criticised for the large-scale utilisation of injections as well as Actogevin that he publicly confirms in medical studies. An ironic side-note – during the disagreement between Pep Guardiola and Müller-Wohlfahrt at the beginning of the season, the doctor could justify his actions by the fact that players of FC Bayern only rarely suffer muscle injuries. He was able to back this by the findings of an UEFA study. In how far there is an association is nevertheless a question for medical practitioners.

De facto, the example Franck Ribèry exemplifies the dark side of sports. All legal (and illegal) options are considered and the grey area of sports is fully exploited. The player have to be fit and ready for action. Whether the vast utilisation can be justified from the perspective of medicine or sports-ethics does obviously not have a part in this story anymore. As fan of FC Bayern one can only wish for a clear positioning of the club against doping and the excessive use of medical drugs. This probably is but a lonely wish in the face of an ever-increase in the number of matches played as well as in the physical strain on the players.

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