Modern medicine, PEDs: Are they different?

May, 13, 2011
5/13/11
6:45
PM ET
There are many things a baseball player can do to improve his performance:

1. He can practice more.
2. He can learn a new pitch or a new hitting technique.
3. He can get in better shape, either by losing weight or getting stronger by lifting weights, or just eating better.
4. He can learn to mentally prepare better for the rigorous demands of his sport.
5. He can watch video or pay more attention to scouting reports or hustle more.

I don't think anybody has any issues with those methods of improvement. Or these:

6. He can get contact lenses to improve worsening eyesight, or maybe get laser eye surgery.
7. He can have surgery to fix a bum knee or a torn rotator cuff or some other injured body part.
8. He can get shot up with cortisone to deaden the pain of a sore elbow or ankle.
9. He can attempt to steal signs by sneaking a peak at the catcher or having a teammate send you a signal.

The last one is part of the game, right? No problem there. But then we start getting into more gray areas:

10. He can cork his bat or scuff the baseball.
11. His team could employ some illegal method of sign stealing, such as a guy sitting in the center-field scoreboard.
12. He could take amphetamines.
13. He could take HGH.
14. He could take steroids or some other new, undetectable performance-enhancing drug.

Hmm, seems like most people frown upon those, although bat-corkers and scuffers don't seem to garner the same levels of animosity as steroid users.

OK. But what about these methods:

15. A player with perfect 20/20 vision undergoes laser eye surgery to make his eyesight even better?
16. What about players who claim they have attention deficit order, allowing them to get medical clearance to use medications like Ritalin?
17. What about Tommy John surgery, in which the ulnar collateral ligament in the elbow is replaced by a tendon from elsewhere in the body (forearm, hamstring, knee)?
18. What about a pitcher with years of injuries who undergoes a surgery that involves removing bone marrow stem cells, which are then spun in a centrifuge to separate it from blood material, and then injected along with the pitcher's own body fat into the injured elbow or shoulder to help repair the damaged ligament or muscle?
19. What about a player who uses HGH only while rehabbing from an injury?
20. What about a bionic ligament?

Of course, No. 18 revolves around the procedure conducted on Yankees starter Bartolo Colon. The doctor who performed the surgery has admitted to using HGH on non-athlete patients, but denies using it on Colon.

So my question: Where do you draw the line? Is transplanting a ligament from your thigh to your elbow natural? Many pitchers rehab from Tommy John surgery throwing harder than they ever did before (although some will argue that's merely due to the rehab involved). If the goal is get injured players back on the field (or to keep them there), why is cortisone (a steroid hormone) allowed, but using HGH while trying to come back from an injury not allowed? Even if Colon was given an HGH injection, does that really improve his performance any more than Tommy John surgery or laser eye surgery?

And what about the first pitcher who damages his elbow and is given a bionic ligament? The 6 million dollar man come to life.

Where do you draw the line? Is this about cheating or legality or medical ethics or keeping a level playing field or about baseball players using only their God-given abilities and bodies? Are performance-enhancing medical procedures OK, but not performance-enhancing drugs?

Where do you draw the line? The blurred message between medicine and PEDs will only get more and more difficult to see through.

Follow David on Twitter: @dschoenfield. Follow the SweetSpot blog: @espn_sweet_spot.

David Schoenfield | email

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