Performance Enhancement & Health 2 (2013) 8–16

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Performance Enhancement & Health

journal homepage: www.elsevier.com/locate/peh

Developing athletic “atomic armaments”: The role of sports medicine

in Cold War France, 1958–1992夽,夽夽
Lindsay Sarah Krasnoff ∗
U.S. Department of State, Office of the Historian, Washington, DC 20052, United States

a r t i c l e i n f o a b s t r a c t

Article history: As the national and ideological battles of the Cold War moved into the sports arena, many states
Received 13 June 2012 sanctioned sports development programs to create winning athletes to represent the nation at elite
Received in revised form 27 March 2013 international competitions. For France, mired in a variety of crises during the 1960s, this meant produc-
Accepted 2 April 2013
ing athletes who could restore national prestige and honour via sports victories. Such athletic “atomic
armaments” could garner soft power through athletic success and restore the image and glory of the
Keywords:
nation. Part of the prescription for improving performances was to encourage the development of sports
France
medicine. At the same time, medical supervision and knowledge were applied to protect the health of
Sports medicine
History
the nation’s premier sportsmen and women, particularly youth athletes who represented the upcoming
Football generation of “winners.” While originally designed for the elite athlete, sports medicine trickled down
Basketball into amateur and sports-leisure ranks, thus becoming an affair of state.
Doping Published by Elsevier Ltd.

1. Introduction The French were no different, and sought to develop ath-

After the stalemate between capitalism and communism solid-
ified in the late 1940s, disputes could no longer be settled on
the battlefield. Instead, the athletic arena became a venue where
countries could face-off against their rivals and seek to assert
national reputation, influence, and self-esteem. Winning athletes
symbolized a strong, influential state, a necessary image in the
decades after the destruction of the Second World War. The drive
to win athletic victories spurred the turn to sports medicine in the
third quarter of the twentieth century to optimize performances
and produce results. For some ardent Cold Warriors in both the East
and the West, any competitive edge that medicine could provide
to athletes had to be seized upon and deployed to demonstrate the
superiority of a particular way of life. Many countries invested in
sports medicine programs in order to increase the opportunities
for their athletes to set new records, win Olympic medals, or bring
home world championship titles.
夽 All views portrayed in this article are those of the author and do not represent
those of the U.S. Department of State or the United States Government. Information
for this article was obtained from publicly available information in France, as well
as from oral history interviews conducted by the author during 2006–2008.
夽夽 The author is a historian in the Office of the Historian, U.S. Department of
State. Her book, “The Making of Les Bleus: Sport in France, 1958–2010” (Lantham,
MD: Lexington Books, 2012) examines the history and evolution of youth athletic
development (football and basketball) in France.
∗ Tel.: +1 917 450 5525.
E-mail address: Lkrasnoff@gmail.com
letic “atomic armaments” to garner soft power through sports
success and restore the image and glory of the nation. Part of
the prescription for improving performances to produce results
was to encourage the growth of sports medicine. Better diet
and nutrition were developed to improve athletic ability and
physicality. New strength and conditioning exercises were inte-
grated into training to prevent injury while increasing endurance
and aiding post-competition recovery. Greater medical supervi-
sion sought to safeguard athletes from the perceived dangers
associated with increased athleticism. Decades later, officials
believed that such measures to protect athletes from overtrain-
ing or doping was an obligation of the state (Meyer, 2008).
At a time when doping arguably could enhance athletic feats,
the French state enacted anti-doping legislation and incorpo-
rated anti-doping education into its sports medicine programs,
though it is debatable how strong or effective these measures
were.
There was a conflict between the state’s objective of wins and
its policies of greater medical supervision. A mixed message was
sent: win, but perhaps not at any cost. Sports policies and med-
ical programs were designed to produce better results. However,
efforts to obtain more immediate dividends (victories, medals) may
have come at the expense of the longer-term health, well-being,
and strength of the body despite efforts to protect it. More schol-
arship is needed on the enduring consequences of French sports
medicine programs, but the existing record provides a complex por-
trait of the different ways medicine was incorporated into athletic
preparation.

2211-2669/$ – see front matter. Published by Elsevier Ltd.

http://dx.doi.org/10.1016/j.peh.2013.04.001
 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16
Examination of medically-based measures taken to improve
results in football and basketball provide an interesting snapshot of
how France tried to rectify the image of the nation through sports
while ostensibly protecting athletes’ bodies from harm. Football
was and remains the most popular team sport in France and the
world. As such, international football tournaments like the football
World Cup confer degrees of legitimacy and respect not possible for
less-popular sports, or the Olympics (Defrance, 2003). Basketball,
a sport the French believed they excelled at as it was a “cere-
bral” team sport, was not nearly as popular as football, but had
a growing following.1 The Cold War sports rivalry between the
United States, the Soviet Union, and East Germany at the quadren-
nial Olympic Games overwhelmed efforts of countries with smaller
populations and resources. Consequently, football and basketball
events became prized as an arena where other countries could com-
pete. They were also sports most widely practiced in France, thus
many citizens at one point or another were exposed to football or
basketball, unlike sports such as fencing or athleticism. The focus
on youth sport was indicative of the desire to create the next gener-
ation of athletes who could win honours, medals, and trophies for
the nation. Sports medicine was deployed as a tool to facilitate this,
and over time became incorporated into more mainstream sports
participation. In this way, sports medicine and some of the tech-
niques and practices prescribed for elite athletes began to trickle
down to the general athletic public, thus resulting in a de facto state
supervision of the French body.
2. France in crisis
The desire to develop athletic “atomic armaments” to serve the
nation came at the height of several interconnected crises. By the
1960 Rome Olympic games, one of the first truly modern Olympiads
(Maraniss, 2009), France was in a state of existential calamity.
The disastrous campaign to maintain a French Algeria brought the
Fourth Republic to its knees in 1958, created the Fifth Republic, and
conferred wide-sweeping executive powers on new president Gen.
Charles de Gaulle. Immediately, de Gaulle contended with detan-
gling Algeria, long considered an integral part of the métropole,
from France. The Algerian War (1954–1962) smudged the nation’s
credibility, legitimacy, and prestige as reports of torture tactics
utilized by the French military against the local Algerian popu-
lace leaked to the media. This tarnished the image of the hexagone
around the world and at home. De Gaulle worked towards Alge-
rian independence (obtained in 1962), but this was not the only
predicament that confronted the nation. Stripped of its Great Power
status after 1945, de Gaulle feared the unchecked dominance of
the superpowers would consign France to international irrelevance.
Dismantlement of the empire in Indochina, North Africa, and sub-
Saharan Africa by 1960 meant that de Gaulle had to find a new role
for France in the world and rectify the nation’s perception abroad
and sense of self.
There were many ways that a nation could lead internationally
in the postwar period. Increasingly, states sought to employ soft
1
In summing up the best ways to improve for the Rome 1960 Summer Olympic
Games, the government believed that the intensification of identifying and training
“prime material” [elite athletes] must occur, that the general organization of sport in
France should be reconsidered, as well as the management and managers of French
sport. It also acknowledged the two sports that the government felt were its best
chances of obtaining “favorable” results: fencing and basketball. Not only were there
good athletes in both of these sports, but “fencing is the most intelligent individual
sport,” just as “basketball is the most intelligent team sport.” The French could excel
at “intelligent” sports because “we produce intelligent athletes,” the government
reported (Notes for the Director General of Youth and Sport on the Preparation for
the 1960 Olympic Games, undated) Center of Contemporary Archives, Installment
19780586, Article 100 “Rome Olympic Games of 1960.”
9
power, influence derived from a nation’s culture. The Americans in
the 1950s and the British in the 1960s led by cultural example as
the music and fashions of Main Street and High Street generated
capital around the world. While the French traditionally garnered
such influence through gastronomy and literature, by the 1960s it
seemed that French culture itself was under attack by a perceived
fifth column—the youth. An explosion of births in the 1940s and
1950s (the “baby boom” generation) led to struggles over the extent
of influence held by the new Anglo-American infused youth culture,
one that increasingly embraced recreational drugs, and worried
many authority figures over the loss of an identifiable “French”
culture. A perceived rise in the numbers of juvenile delinquents
as a result of increased leisure time did not ease parental anxi-
ety. The boomers’ sheer numbers strained the state’s institutions,
while youth discontent with the status quo came to a head dur-
ing the events of May 1968. Additionally, immigrant abour from
the former colonies, recruited to staff the manufacturing jobs that
postwar prosperity and consumerism needed, settled and began to
further change the demographic.
Government officials wished to use sports to improve the dimin-
ished image of the nation and ameliorate the youth crisis. This route
proved problematic, as the 1960 Rome Games demonstrated, for
France was also mired in a sports crisis. The nation’s Olympians
won only two silver and three bronze medals at that summer’s
Olympiad, an embarrassment to the nation. The poor French results
were broadcast and publicized widely to a global audience. The
inability to garner medals or tournament titles in football, the
world’s most popular sport, or basketball, the sport at which
France felt it most naturally should excel, continued throughout
the decade and contributed to the sense of crisis.2 French athletes
projected an impression of decay, hardly the way to generate soft
power through athletic prowess or restore the global image of the
nation.
To counter such depictions, sports policies and programs were
launched in the 1960s to create a new generation of sportsmen
and women who could win major competitions. The focus was
on the youth to develop future athletes and provide supervised
leisure time activity—an attempt to curb the perceived youth crisis
of the era. Encouraging the youth to play sports was also benefi-
cial for the nation’s health. Many officials believed it necessary to
strengthen the French body, which was decimated by the severe
caloric restrictions of the wartime years (Brissonneau, 2010, p. 33).
The sports crisis did not begin to ebb until the state tried to more
actively cultivate a national sports culture in the 1970s. The key was
legitimatizing sport and elite athletic preparation through national
legislation.
The October 1975 Mazeaud Law provided social and financial
assistance to elite athletes during their training period, on the
basis that, “the development of the practice of sport and physical
activities is a fundamental element of culture, which constitutes a
national obligation” (Government of France, Law Number 75-988
of October 29, 1975).3 The law provided for youth athletic devel-
opment, under the genesis that training athletes from a young age
could socialize them according to accepted notions of French iden-
tity. The Mazeaud Law sought to produce winning athletes and
teams that could restore honour and portray a rejuvenated nation.
2
At the 1960 Rome Olympic Games, France failed to win any gold medals, out-
performed by countries such as Ethiopia, Denmark, and Japan, which each won at
least one gold medal.
3
It was the first time that the French state acknowledged that sport, not just phys-
ical education, was an integral part of French culture. Furthermore, in the promise
of state support for sports development, the government pledged itself to a remark-
able new route, one previously only undertaken by the Eastern European communist
regimes in making sport a crucial element of national policy and funding.
10 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16

Sports medicine was a tool employed to help achieve results for elite footballers and basketball players than for top professional
France. players.
The 1975 Mazeaud Law helped formalize the role of medicine
in athletic preparation. It stipulated that anyone who held a license
3. Servicing the state
to practice sport needed to obtain a medical certificate. This docu-
mentation, renewed annually, attested that the athlete was in good
The notion that strong, healthy bodies could service the state
physical condition and could participate athletically (Rochcongar,
dates to the late nineteenth century. Physical education, originally
2007). To this end, doctors needed to obtain certificates in biology
perceived as a way to promote powerful soldiers to defend the
and sports medicine in order to provide medical certificates. For
nation and healthy mothers to repopulate it, was mandatory in
many elite athletes, this was the first time that they met with doc-
state schools by the 1880s. The rise in the popularity of team sports,
tors prior to being injured. This preventative supervision reflected
the growth of the Olympic Games (founded by Frenchman Pierre de
the state’s desire to create athletes who could compete with the
Coubertin), and the post-1918 channeling of nationalism into the
best in the world, rather than merely strong sportsmen and women
arena of sports competitions encouraged athletes to turn to science
(Defrance & Lim, p. 11). The change in objectives towards winning
to help improve performance by winning races, games, or setting
rather than strength demonstrates the dueling dynamics at work
records.
as the republic sought to reassert itself.
Athletic development in France looked towards science for ways
The Mazeaud Law was influential in that by the late-1970s,
to improve performances.4 Since 1921, French scientists and doc-
supervision of non-elite athletes was increasingly more common.
tors worked together to develop the field of sports medicine.
Sports licenses were not given only to elite athletes; they were
Though operating with little fanfare, they made progress in advanc-
given to anyone who participated in some form of formally orga-
ing the discipline, and training more doctors (Chailley-Bert, 1962,
nized sport. Thus, the law’s requirement that every licensed athlete
p. 1). However, it was the post-1945 emphasis upon sport as
receive medical supervision promoted sports medicine across dif-
a tool of international power and diplomacy that propelled sci-
ferent levels of sport: elite, professional, and amateur/mass sports.
ence to the forefront of athletics (Magan, 2003). With it, states
Even youths in the sport-study sections (sections sport-étude) run
began to co-opt sports medicine for their political agendas. At
through the national education system and the youth formation
the forefront were the United States and the Soviet Union, locked
centers (centres de formation) run by some of the private, profes-
in the race to outperform each other during the 1950s. By the
sional football clubs were subject to this provision. In 1976, L’Équipe
1960s, French sports medicine shifted away from strengthen-
noted that medical controls for youth sport-study sections were
ing the body and towards obtaining tangible results—victories
necessary:
(Defrance & Lim, 2007, p. 7). France did not want to be left
Medical intervention must be a complete medico-educative
behind. The switch in focus was supported by the evolving postwar
monitoring shared jointly by the athletic coach, the school doctor
notion that sports promoted a healthy body (Brissonneau, 2010,
responsible for the sport-study section, and the medical specialist
p. 33). Thus, the state could now promote sports as a means to
from the Ministry of Youth and Sport (Sport-Études: la surveillance
enhance overall health while also working towards developing bet-
médicale du élèves, 1976).5
ter athletes—a different, more modern way for the body to service
The sophistication of the sports medicine programs provided
the nation.
varied. It is likely that a more comprehensive sports medicine pro-
Such efforts began to pay dividends by the 1960s, noted Profes-
gram emerged only in the late 1980s and 1990s as the increased
sor Paul Chailley-Bert, President of the Paris University Club. “The
professionalization of developing quality young footballers (and
consequence of this work,” he wrote, “is that amongst the Western
by the later 1990s, basketball players) for export to the world’s
countries, France is the one in which sports medicine is the most
best leagues stimulated demand.6 The tardy arrival of a broader
developed and produces the best results” (1962, p. 1). Given the
use of sports medicine was indicative of the influence, or lack
depth of the 1960s sports crisis, it is debatable whether French
thereof, of a national sports culture. It was only after the Mazeaud
sports medicine successfully produced the “best results.” Yet, it
Law, new youth sports programs, and the increased cultural pen-
was increasingly used to develop elite athletes, those who com-
etration of televised sporting events that a French sports culture
peted for the nation in major international competitions such as
developed.
the Olympics and the football World Cup. As such, sports medicine
Once such a culture was established, aided by the mediatiza-
emphasized the production of results at the highest levels with an
tion and consumption of sport after 1984, sports medicine assumed
eye towards the nearer-term competition.
a more important role. While attempts were made in the 1960s
Within the context of football and basketball, the situation was
to harness science and medicine to produce better athletes, most
slightly different than for other sports disciplines like track and
legislation on medical surveillance of athletes—specifically, youth
field for the line between elite and professional athletes in team
athletes—began in 1987. It coincided with international athletic
sports was (and remains) blurry. For football, which professional-
successes and the rise of youth training à la française. After a 1984
ized in the early 1930s, it was common practice for players selected
rule change, it was no longer necessary for a physician to spe-
to play for the national team, Les Bleus, to also play profession-
cialize in sports medicine in order to issue medical certificates to
ally. Basketball, although it did not fully professionalize until the
athletes. This helps to explain why sports medicine was not a preva-
end of the Cold War era, also had elite players who played semi-
lent field outside of elite athletics until the early 1990s (Barrault,
professionally. Thus there were likely fewer differences between
2006, p. 135; Rochcongar, 2007; Einsargueix, 2007; Meyer, 2007).
how sports medicine was employed to promote performance for
The renewed specialization after 1990 can be attributed to contin-
ued government legislation and desire to use medicine to promote

4
Early sports medicine was pioneered by German physicians, according John M.
Hoberman. Throughout the decade, doctors increasingly applied medicine to ath-
letic training, resulting in the evolution of the discipline. By 1928, several European
doctors formed the International Association of Sports Medicine (Association Interna-
tionale Medico-Sportive, AIMS), promoting sports medicine as a specific field, replete
with international conferences to share research and findings (Hoberman, 1992; and
“History and Purpose,” http://www.fims.org/default.asp?PageID=483889893).
5
Sport-study sections were specialized programs within the school system,
allowing talented youths to focus on athletics while still completing their schooling.
6
For football, the prime destinations were the English Premiership and Italy’s
Serie A. For basketball, the dominant league was the National Basketball Association
(NBA) in the United States.
 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16
better athletes through diet and nutrition, injury prevention, and
general medical supervision. In order for the French body to service
the state, it had to be in optimal condition. Sports training pro-
grams for football and basketball players, both at the elite and
professional levels, searched for ways to enhance performances and
obtain results.
4. Diet and nutrition
One area that could be improved, to fine–tune the health of
athletes, was nutrition and diet, which were increasingly recog-
nized as directly related to athletic accomplishments. The link
between food, nutrition, and sport was highlighted at the 1967
European Basketball Championship where French Federation of
Basketball (FFBB) President Robert Busnel spoke to Le Monde about
the French performance. Describing the team’s eleventh place fin-
ish in a sport that France traditionally excelled at, Busnel despaired
that “the nations we once fought against are now superior” (Pas
d’équipe de France sans ‘géants, 1967). The country was at a dis-
advantage, he noted, because its elite squad lacked more than two
“giant” players over two meters tall. FFBB doctor Jacques Huguet
articulated that having a “giant” basketball player was akin to hav-
ing an atomic armament. “If a nation does not possess one,” he
said, “it is an unbalanced struggle”. France set out to create its
own arsenal of athletes in part through improved diet and nutri-
tion.
Nourishment and sustenance were important elements in
constructing stronger players. Food rationing and severe caloric
restrictions, legacies of World War II, were still fresh recollec-
tions in the 1960s. Although postwar prosperity afforded greater
access than ever to food, the French wished to ensure that elite
athletes ate enough to sustain an active lifestyle. Sports and govern-
ment authorities also wanted to ascertain that the food consumed
contained enough nutrients to allow young bodies to complete
development. Although the Ministry of Youth and Sport did not for-
mally legislate medical supervision in youth sports until the 1980s,
efforts to improve athletic performances and promote the athlete’s
health through diet were investigated and discussed as early as the
1960s (Meyer, 2007; Einsargueix, 2007).
The FFBB took the lead in identifying diet and nutrition as
an important aspect of performance enhancement.7 According to
Gérard Bosc, former National Technical Director of Basketball in
France, one of the primary concerns of basketball trainers and doc-
tors by the 1960s was the need to identify taller players (Bosc,
2006). It was felt then (as it is now) that a nutritious diet could
produce healthy players and aid physical development (Guincestre,
2008).8 By 1974, dialogue within the FFBB shifted to how a more
nutritious diet could simply improve performance. Importantly,
7
In France, national sports federations preside over each Olympic-recognized
sport. The federations traditionally were subservient to the state, dependent upon
annual subsidies from the government in order to pursue their missions. Each
national federation is responsible for the welfare of their sport, the training ath-
letes of all ages and performance levels, codifying that sport’s regulations within
the country, and setting regulations for medical and training procedures. The FFBB
was never as strong as the French Football Federation (FFF), a reflection of the place
and roles of the sports within French society. Yet, in the 1960s the FFBB launched
a yearly conference at which its doctors and other professionals discussed ways to
use medicine to improve basketball performances and produce results while at the
same time safeguarding players. Other federations may have had a similar focus
on medicine and nutrition at this time; however, the records of the FFBB were the
primary ones preserved in the archives of the Ministry of Youth and Sport of this
era.
8 10
Dr. Jean-Yves Guincestre of the FFBB noted in 2008 that that height was much
more a function of genetics rather than diet. Still, he noted, the FFBB sought to recruit
boys who were 2.10 m (6 ft 9 in.) and girls who were at least 2.0 m (6 ft 5 in.) tall. “For
a basketball team that wants to win a championship title, the probability of winning
a medal correlates with the number of players over 2m10.”
11
FFBB medical professionals noted the difficulty many athletes had
eating enough calories each day and the environment in which
meals were consumed (Tenth Medical Day Report, 1974, p. 25).9
Specialists noted this was due in part to the high cost of food,
especially fresh vegetables and meats, and there were concerns
that most athletes lacked calcium (p. 30). Yet, there were few rec-
ommendations about how to make food more affordable to elite
athletes.
In comparison, the French Football Federation (FFF) was not
as concerned about diet at this juncture. According to Dr. Pierre
Rochcongar, a former doctor to the national football team, dietary
concerns for young elite football players in France did not rise to
the forefront of the sports development system until the late 1990s,
when professional dieticians were added to the staffs of all the FFF’s
youth training academies (Rochcongar, 2007).10 The tardiness, he
said, reflected the nature of football, for which “we did not have
the problem of height in selecting optimal footballers.” Selection
into the development system and national teams was and remains
a function of one’s ability, not height. Incorporation of more formal-
ized dietary guidance also perhaps reflected newer findings linking
diet and nutrition to improved athletic performance by providing
the energy necessary to run, kick, think, and compete.
There was a noticeable increase in information pertaining to
sport and nutrition in the years following the passage of the
Mazeaud Law. It was acknowledged that dietary prescriptions dif-
fered from sport to sport, reflecting the variance in exertion levels.
In 1980, it was recommended that on game days, to maximize
energy levels for optimal performance, athletes participating in
team sports such as football or basketball should observe the three-
hour rule: to eat their main pre-match meal three- to four-hours
prior to game time. Breakfast was to be eaten between 7 and 8 am,
followed by lunch around 11 am, a pre-game snack, and another
snack at half time in order to help boost energy levels (Creff &
Bérard, 1980, p. 347). Diet was found to play a significant role
in helping to prevent injury to muscles and tendons, while also
improving vigor (Durey & Boeda, 1982, p. 35). Therefore, it was
recommended that young players should eat a breakfast that con-
tained high levels of protein, such as eggs, cheese, or cold meat,
drink plenty of fluids, and get sufficient sleep.
Despite the early attention given to diet and its role in athletic
performance, dietary concerns were not regulated until 1987. Even
then, there were no specific requirements as to how much and
what young elite athletes should eat to achieve optimal perfor-
mance and nutrition. Federations could prescribe certain regimens
on a sport-by-sport basis. After passage of the law, it was up to the
doctors to decide dietary guidelines for their charges (Einsargueix,
2007).
The increased attention given to the nutritional content of meals
fed to young footballers and basketball players sought to protect
them from injury, to keep energy levels up, and to avoid exhaus-
tion. In this fashion, the state in conjunction with national sports
federations and clubs sought to create athletes healthy enough to
put in winning feats on the field or on the court and attain results for
the nation. While originally implemented at the elite level, dietary
prescriptions trickled down into professional and amateur sports
9
At the Tenth Medical Day of the FFBB, held in Paris on March 9, 1974, medical
professionals discussed the results of a study conducted after the Munich 1972 Sum-
mer Games. This study advocated that footballers should consume a total of 2792
calories per day, while basketball players should eat 5000 (male) and 2700 (female)
calories per day (Tenth Medical Day Report, March 9, 1974, p. 30).
Youth development academies are run by the FFF to identify and train the next
generation of elite and professional players. Established in the mid-1970s, today the
centers are responsible for youths as young as 13 and 14 years of age. Indeed, the
average height of French footballers falls within the 1.75 or 1.76 m range (5 ft 8.8 in.
and 5 ft 9.2 in. respectively).
12 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16
as the athletic feeder systems in France sought to reach out to more
youths.
5. Preventative training
Another way that sports medicine developed to produce players
in better physical condition to win was through the implemen-
tation of preventative training regimens. Such regimes became
increasingly routine to win tournaments and matches (Sapin, 1975,
p. 23). By 1975, the FFBB had teams of specialists, composed of
coaches, physicians, researchers, teachers, and psychologists, to
support elite basketball players. The FFBB believed that body-
building (i.e. weight lifting) could develop performances and help
prevent injury. Some of the training techniques suggested were iso-
tonic weight lifting, work with the fingers (for ball pressure), work
with medicine balls weighing between two and five kg, abdomi-
nal exercises, and work with the legs and knees (La musculation,
1975, p. 28). Such work helped to prevent knee injuries, the most
common affliction suffered by basketball players past and present
(Guincestre).
Football authorities also used medical knowledge to develop
more rational athletic training programs to enhance performance.
As early as 1965 the National Football League (Ligue National de
Football, LNF) consulted doctors to determine how they could
decrease the number and severity of injuries incurred by profes-
sional players. The LNF commissioned a study that found that most
injuries were due to long, hard practices, the use of Duralumin
cleats,11 lack of protective measures for the individual, and play-
ers running into goalposts (Étude de M. Bacharzina. . ., 1965, p.
1). The study recommended greater emphasis on medical supervi-
sion as a precautionary measure for injury prevention, suggestions
subsequently emphasized (p. 2).12
Historically, the injuries that most often plagued young football
players, according to Dr. Rochcongar (2007) were knee problems
and a host of secondary injuries, many relating to the tendons.
By 1986 tendonitis was on the rise because young athletes were
training for greater durations of time each day and week at an
age when their bodies were not fully developed (Beliveau, 1986,
p. 143). Other causes of tendonitis were improper training grounds
and techniques, which caused tendonitis in the Achilles heel and
knee (pp. 144–145). Young football players, especially the defen-
sive players and goalies, suffered higher rates of injury, mostly in
the lower body: sprains in the ankle, quadriceps, hamstring, and
groin, although problems with the knees and the Achilles tendon
were also prevalent (Le Gall et al., 2006). Boys and girls sustained
the same injuries, though girls had higher rates of inflammatory
reactions (Beliveau, p. 143). Most of these injuries were the result
of training regiments. Thus, building muscle (lifting weights) was
integrated into athletic regimens so as to protect the athlete’s
health (Durey & Boeda, p. 4).
In recognition of the fact that the anatomical development of a
13- or 16-year old was different from that of an adult, coaches and
doctors worked together to develop practice regimes for youths
to reduce injury risks. Improved training facilities were built,
there was greater emphasis on weight lifting and learning bet-
ter technique, and an increased awareness of the need for more
aerobic training. For example, it was suggested that a football
player run approximately 5–8 km, or 3–5 miles, to practice play-
ing up and down the field. (Article 2 Football Medicine, undated).
11
Duralumin is the main alloy of aluminum and is very lightweight. Many cleats
at the time were made using duralumin spikes.
12
A study released that October found that the two sports in which the greatest
number of participants sustained injury were rugby (14.2%) and football (6.12%)
(Guillebaud, 1967, p. 19).
It was hoped that development of safer athletic training regimens,
overseen by medical doctors, would improve results. As the Cold
War wore on, sports medicine turned ever more towards more
technically-focused training to avoid injury and fine-tune athletic
accomplishment. These practices gradually made their way out of
the elite and professional arenas and into more mainstream sports
programs.
6. Medical supervision
A third way that French sports medicine for football and basket-
ball players sought to enhance performance was through greater
medical supervision. It was believed that greater medicinal over-
sight helped safeguard the mental and physical wellbeing of
sportsmen and women. While medical supervision in youth sports
started in the 1970s, studies or recommendations that specifically
targeted adolescent athletes did not begin to appear until the 1980s
and 1990s, making it difficult to ascertain such issues prior to that
time. However, a few snapshots help to sketch out ways in which
medical supervision of young athletes were deployed to produce
players who could win football and basketball games and tourna-
ments for the nation.
Mandatory medical supervision of all athletes dates to the 1975
Mazeaud Law, and one byproduct was greater funding to moni-
tor the nation’s athletic bodies. The number of sports medicine
centers and volume of athletes examined grew at a time when
more Frenchmen and women took up sports, indicating that
medicine was an increasingly important component. While in 1965
there were 118 sports medicine centers, which conducted med-
ical exams on 213,841 athletes (youth and adult), by 1977 there
were 287 sports medicine centers, which examined 475,021 ath-
letes (Ministère de la Jeunesse, des Sports, et des Loisirs, 1977, 1978,
pp. 179–180).13 Such numbers underscore the notion that medi-
cal supervision of athletes was increasingly a service of the state,
just as general healthcare and unemployment insurance were state
obligations.
Things began to change during the 1980s. France’s first private
television network launched in 1984, Canal +, a paid subscrip-
tion channel that ended the government’s monopoly of television
broadcasting. From its inception, Canal + ensured that sports were
one of its core components. It was able to pay large sums of money
to sports federations, securing the exclusive rights to broadcast
entire matches live. This forced the nation’s other three channels
to compete, and infused money into the sports system.14 Canal +
was highly successful, and began to transform how sport was con-
sumed and conceived of within the country. As Bourg & Gouguet
articulated, it was the influx of money during the 1980s that caused
French sport, especially football, to become an economic activity.
The spectators became consumers (2007, pp. 36–37). They note that
at this point, “the athlete became a worker, the club became a brand
and sport became a product” (p. 37). While being a professional
football player was now more profitable than before, the money
involved in French football was never close to the larger sums
associated with other leagues in Europe. Still, as football became
a product in France and as the football abour market began to be
exported to leagues where there was more money, the pressure
13
One can break down the 1977 figures to reflect the attention given to young
athletes by the medical authorities that year: there were 39 doctors in youth-sport
establishments, 136 doctors who were assigned as inspectors for youth sports pro-
grams, and 36 federal medical commissions. Together they examined 2700 youth
athletes who were enrolled in the country’s sport-study sections. No statistics are
available as to the number of center of formation players that were examined during
this period.
14
In comparison, in Britain the mediatization of sport began in the 1970s with the
liberalization of television, while in Italy it began in the late 1970s.
 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16
to perform grew.15 Sports medicine was a way to help fine-tune
professional athletic performances.16
The influx of money trickled down to the youth sports systems
and added new pressures. By 1984 it was possible for some to make
a living by playing professional football and many young players
aspired to this dream.17 The motivation to be the best meant one
could sign a more lucrative professional contract, and further down
the road, possibly an endorsement deal. Certainly, the main moti-
vation for many players was their love of the game and the desire to
and the honour in playing for the national team, if selected. But for
some young players, the monetary rewards represented a chance
to help pull their families out of poor economic positions. Given
these new pressures, fears grew by the late 1980s and early 1990s
that young athletes could be exploited or pushed beyond their lim-
its. Medical supervision was perceived as a way to minimize risks
and look out for the player’s health, though it competed with the
overall objective of winning.
General medical surveillance to supervise young athletes was
one way to ensure that youth development programs in football
and basketball did not have adverse impacts on their young charges.
Oversight provided by doctors sought to ensure that young players
did not push themselves too hard, to guarantee that they did not
reach the point where they were burned out, or turned off from
sport by the burdens of constant practices, games, and pressures
of the system. “Burnout for us is very rare,” said Rochcongar, citing
the system’s medical controls as a major factor that prevented this
phenomenon. He also pointed to the psychological aspect of the
hope that most young players had of being selected to the national
team. “If you are in a center of formation18 for years, psychologically
there is a certain structure that keeps you going,” he said. While
this might be true to a certain degree, the FFBB’s Guincestre noted
that burnout does exist at certain levels amongst youth players,
although in France it is generally not referred to as such.
State medical regulation of youth sports participation sought
to protect the young. The perceived dangers of the youth sports
programs were many. In addition to mental strain, the physical
risks were multiple. An adolescent could practice or play in games
when they were not in good health and thus risk injury, which
was of special concern as the time devoted to competitions and
practices increased continuously. There were fears that a youth
might not consume enough nutritious calories or get enough sleep
to fuel his daily athletic performance. Such an under-nourished or
fatigued athlete was consequently more prone to injury. In this way,
medicine played a role in strengthening the body—not for military
service or maternity—but to win accolades for the state.
7. Anti-doping measures
On top of concerns over burn-out and a player’s state-of-mind,
there were also anxieties that the youth could succumb to the pres-
sure to succeed and turn to doping to combat fatigue or improve
performance. Such concerns led to implementation of education
15
Television also transformed football from a leisure time activity into an enter-
tainment spectacle. The increased role of television created more sports heroes
whom French youths admired. Television allowed, more than ever before, the youths
to cultivate a form of hero-worship for these athletes. The majority of the sports
heroes of the 1980s were footballers, though there was an occasional basketball
player who generated acclaim and attention.
16
There is little literature that addresses how television changed French basketball
and its popularity. Yet, basketball began to follow a similar trajectory to football by
the late 1980s, albeit without quite as much success or money.
17
While football in France was professionalized in the early 1930s, it was not until
the liberalization of media and sport in 1984 that being a professional football player
began to be a somewhat profitable profession.
18
The center of formation was a training academy first pioneered by the FFF which
sought to select and develop the best youth talent in the area.
13
about doping agents, controls, and legislation. Doping regimens in
the West grew in numbers and level of prominence beginning in
the 1960s when athletics became a Cold War tool. As the French
looked about to other examples on which to base their athletic
preparations, there were initially few concrete ones to follow. In
the 1950s and 1960s when the republic first sought to utilize the
soft power of sport, the main influence was the American model
(Brissonneau, 2010, pp. 35–37). Run primarily out of the U.S. uni-
versity system, American athletes trained and received coaching,
support, and medical supervision through their academic institu-
tions. By the late 1960s, the French were increasingly influenced by
the East German model (Brissonneau, pp. 35–37).
The GDR, in its quest to out-influence the Soviet Union and
gain recognition and honour abroad, cultivated a pro-doping cul-
ture to achieve assured athletic victory. The GDR was successful in
gaining international acclaim and influence through the extensive
doping programs that were integral components of its totali-
tarian sports training programs. The hormonal treatments that
comprised the daily routines of many East German athletes were
sanctioned by the state in an effort to win. One of the most well-
known examples of the GDR’s doping initiative was within its
famed swimming schools (Ungerleider, 2001). Despite the undis-
puted success of the GDR system, according to available sources,
French athletic programs never instituted a systematic program
of doping to win, despite the problems of the nation’s sports cri-
sis. This extended to the realm of team sports. While the GDR
system influenced the structure of French youth football centers
of formation instituted in 1973, the East German focus on win-
ning at all costs was not the most useful model for football or
basketball.19
Doping arguably provided a way to obtain better athletic results
and help one’s athletes remain competitive in the global market-
place. The growth of doping in the third quarter of the twentieth
century illustrates that for many countries, sports medicine was a
means to apply medical knowledge of the body and pharmaceut-
icals to achieve athletic victories, rather than seeking to safeguard
the athletes’ health (Defrance & Lim, 6).
In the midst of its sport crisis, in 1965 France became one of
first countries to enact national legislation penalizing sportsmen
and women who doped.20 Law 65-412 of June 1, 1965 stated
that “anyone who previous to or during a sporting competition
knowingly uses any substances which are intended to artificially
raise his physical abilities for a short time and is likely to harm
his health,” would be subjected to fines ranging from 500 to 5000
francs, and even jail time of up to one year for the offense (Loi
65-412 du 1er juin 1965 tendant a la repression de l’usage des
stimulants. . ., 1965, p. 4531). It was supplemented by the decree of
June 10, 1966 (Decree 66-373), which banned specific substances
from athletic competitions, mostly amphetamines (Décret No
66-373 du 10 juin 1966. . ., 1966, p. 4753). Enforcement of these
new requirements rested with the Minister of Youth and Sport,
the Minister of Social Affairs, and the Minister of Justice. Yet, there
was a difference between enacting such legislation and enforcing
it (Hoberman, 2009, p. 100).
For France, the issue of doping and the measures taken against it
are interesting in that they contradict the nation’s desire to project
power abroad through athletic triumphs. One might think that
France would not have undertaken such an ardent, anti-doping
19
The original objectives of the French football formation centers were to create
better players who would win games and tournaments, while also creating “whole”
humans. The football club was designated to serve as a paternal protector of the
young players, and served to help them learn what it meant to be a “good” citizen. See
Krasnoff (2011) chapters three, four, and six for further information on the objectives
of these systems as well as how they changed over time.
20
Belgium also enacted similar legislation at this time.
14 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16
position so that they could harness the power of medicine and
pharmaceuticals to gain gold medals and other titles. But perhaps
the anti-doping lobby reflected the still lingering ideals of ama-
teurism that so heavily dominated the discourse of the sports crisis
during the 1960s (Krasnoff, 2011). Perhaps it was also linked to the
continued influence of de Coubertin and ideas of sport’s primary
utility as building a well-rounded human, not just a winner.
The anti-doping approach embraced medical knowledge of the
body to teach athletes how to best perform. Medical supervision
thus included education about doping agents, their impact upon
the body, the legal risks involved, and how doping could end one’s
stay at youth training centers. It was an effort to protect athletes
from the perceived dangers of doping. Many programs adopted a
no-tolerance policy in which a youth player who tested positive
for a banned substance without a doctor’s note was automatically
dropped from the program. Education and prevention were the cat-
echisms of the day, but they did not eliminate the problem. For
France, just as in other countries with anti-doping legislation on the
books, anti-doping since the 1960s has consisted of education, test-
ing, and penalizing those found guilty (Mcnamee & Moller, 2009, p.
7). It is questionable how effective the anti-doping education was
when the laws were rarely enforced (Hoberman, 2009, p. 100).
There was a general code of silence surrounding doping and
young athletes. Some argued that there was silence surrounding
the issue as it was a non-issue. Dr. Gilles Einsargueix of the Min-
istry of Youth and Sport disagreed. “Everyone says that there is no
doping in their sport,” he said, “but it is in all professional sports,
even if there is less money involved than in football and tennis,”
the sports that traditionally have had the most money in France
(Einsargueix, 2007). Dr. Véronique Meyer, also of the Ministry of
Youth and Sport and an anti-doping expert, added that prior to the
late 1980s, “nobody spoke of doping in football. . .but it was there
in the sports where there is a lot of money” (Meyer, 2007). The odds
of doping not trickling down to a sport’s up-and-coming generation
were slim if it was a problem in the adult version of the game.
The government tried to bolster its anti-doping rhetoric. In May
1987 the Ministry of Youth and Sport launched an anti-doping cam-
paign (“Doping, Get Lost!”) to try to combat the growing problem.
Part of the motivation was the increased number of positive test
results after 1985. That year, 1656 tests were undertaken for ath-
letes (youth and adult) across 17 sports, with only 13 positive cases,
under 1%. This number doubled in 1986 (Giraudo, 1987a, p. 20)
when, out of 2453 exams, there were 56 cases that were positively
identified for doping substances (Giraudo, 1987b, p. 12).
By 1989 the French government codified its updated sports
doping regulations. Law 89-432 of June 28, 1989, was first time
the state instituted a mandatory information campaign to edu-
cate all athletes, especially adolescents and youths, about the ills
of doping. This program was to be undertaken not only by tea-
chers and coaches, but also by sports doctors (Loi 89-432 du 28
juin 1989. . ., 1989, p. 8147). Other measures called for by this law
were the institution of medical studies to learn about the immedi-
ate and long-term effects of doping agents, the establishment of a
medical bureau for elite athletes to monitor their developments,
the creation of a National Commission Against Doping, charged
with dispersing information on the anti-doping campaign, and the
elaboration of doping controls and tests.
It is difficult to unearth information pertaining to doping con-
trols or studies of young athletes in France prior to the late 1970s
and 1980s, as there are very few public records of regulations of
them (if they existed). Thus, it is hard to judge the effectiveness of
such measures. However, by the late 1980s and early 1990s there
was the perception that doping was spreading to young elite ath-
letes. A study conducted under the direction of Patrick Laure in the
late 1990s and early 2000s found that many general practitioners
had limited knowledge of doping in sports, despite encountering
the issue on a day-to-day basis (Laure, 2003, p. 335). The lack of
concrete knowledge led some general practitioners to unwittingly
prescribe doping agents to athletes for performance-enhancing
purposes. “In our previous studies of French general practitioners,”
wrote Laure,
Thirty percent of respondents stated that they had been asked
to prescribe banned drugs to athletes, or to explain how to use
them. . . 87% of French GPs considered that doping is a pub-
lic health problem, and 92% thought that they have a leading
role to play in doping prevention, even if most (83%) considered
themselves poorly trained in this domain.
To combat doping, the FFF instituted a program to educate about
recreational and doping-related substances. Dr. Jacques Lienard,
an anti-doping expert and head of the FFF’s Anti-Doping divi-
sion, stated that while technically the FFF’s anti-doping program
began in 1970, it became more full-fledged in the early 1990s
Lienard (2007). In 1994, the FFF began to test for amphetamines
and steroids, and worked more closely with the World Anti-Doping
Agency after its 1999 creation.
The French program of education on and controls over doping
agents was on paper the result of the desire to produce healthy
athletes who were protected from sport’s harsher aspects. Doping
agents, from amphetamines to steroids to hGH, all posed risks to the
health of an athlete. In some cases, they caused death or permanent
injury as the athlete did not recognize that they passed beyond the
point of exhaustion or his/her own physical limitations. In order to
induce players away from doping, the official face of French sports
medicine tried to provide greater surveillance of doping substances
and advocated for improved training techniques. According to Lien-
ard, as a result of the efforts to fight doping at the youth level, “they
[federations and coaches] have greatly improved training. Now, one
does more physical preparations at the youth level. . . the period
of development and medical supervision, combined with athleti-
cism and academics all combine,” to form the products of the youth
athletic training centers.
But questions arise as to whether such anti-doping measures
were successful or not. From the information available in the Min-
istry of Youth and Sport archives and in the press, it is difficult to
ascertain how effective anti-doping education, controls, and med-
ical supervision of youth athletes were in preventing them from
doping. Lack of studies, testimony, or documentation covering the
pre-1992 period makes it hard to gauge how much of a prob-
lem doping was. The omerta or code of silence that surrounds the
subject, while broken here and there in recent years, further com-
plicates the issue. Based on what we know today about practices of
the 1990s and 2000s, one can deduce that doping was a problem for
elite athletes of varying ages, thus calling into question whether the
attempt to create athletic “atomic armaments” came at the price of
the athletes’ health.
8. Conclusion
France’s multi-pronged approach to applying medical knowl-
edge to help create better players produced a variety of results,
including winning teams and star athletes by the time the Cold War
ended. The emphasis on enhancing sports performances through
the development of athletic “atomic armaments” by a focus on
diet and nutrition, preventative training, general medical supervi-
sion, and anti-education paid some dividends. In 1984 the national
football team won the European Championship and a different
constellation of players won the Olympic football tournament.
By the 1990s, French football players were exported abroad and
won the 1998 World Cup and 2000 European Championship titles.
French basketball players won the silver medal at the 2000 Sydney
Olympics and became an increasing presence on the courts of the
 L.S. Krasnoff / Performance Enhancement & Health 2 (2013) 8–16
NBA by the late 1990s and early 2000s. The bigger question, how-
ever, is whether the state’s effort to create winning athletes came
at the expense of the health and strength of French bodies, despite
attempts to protect and safeguard it.
What emerges from available sources is a snapshot of a nation
that sought to regain international prestige from football and
basketball success by harnessing medicine to fine-tune athletic
performance. Sports medicine, especially at the youth level, was
developed to produce better players. This dovetailed with the
desire to help protect young players from the rigors and poten-
tial dangers of elite athletic training. When young athletes started
to endure longer and more frequent practices, there were concerns
about how this might impact their health. The anti-doping move-
ment’s emphasis on physical wellbeing foreclosed some options
in the quest to obtain the “best” results from athletes—a contra-
diction in French objectives. Moreover, there are serious concerns
as to how successful the anti-doping component was, or could be.
Still, the shorter-term impact was the trickle-down effect of sports
medicine from elite athletics into broader segments of society.
Rather than constructing athletic “atomic armaments” to resurrect
the nation’s reputation abroad and domestic sense of self, French
sports medicine programs by the end of the Cold War revived the
discipline and stimulated demand. Originally designed for the elite
athlete, sports medicine trickled down into professional, amateur,
and leisure sports ranks after the late 1970s as more French men,
women, and youths participated in athletic endeavors. This was
especially true within the realm of team sports, which exposed
a greater percentage of the population, notably the youth, to the
state’s mission to promote healthy bodies and encourage develop-
ment of a national sports culture.
Acknowledgements
I am indebted to the many people who shared their knowledge,
experience and observations of the history of sports medicine in
France, particularly Drs. Joël Coste, Gilles Einsargueix, Jean-Yves
Guincestre, Jacques Lienard, Véronique Meyer, and Pierre Rochcon-
gar. I would also like to thank Evelyn Ackerman for her never-
ending support and her assistance in shaping the main points.
Methodology: There are few works that trace the historical
evolution of sports medicine and performance enhancement tech-
niques in France. This article seeks to lay a foundation that others
can build upon to reexamine, amplify, and/or complicate the history
of postwar France. While it relies on materials found in the archives
of the Ministry of Youth and Sport for 1958–1980 (the archives
were closed for material post-1980), this work is heavily informed
by press accounts and oral history interviews with medical experts
who have witnessed the discipline’s evolution.
Oral histories were conducted in France between April 2006 and
July 2008, in accordance with the Graduate Center of City University
of New York (CUNY)’s proscribed Institutional Review Board stan-
dards. The interviews were part of IRB study # 06-02-0951 “State
Sponsored Youth Sports Training in France, 1958–1992.” All sub-
jects were briefed on the objectives of the study, and signed consent
and release forms.
Appendix A. Average height of basketball players at the
1967 European Championship
Height Height Weight Weight
(m) (feet) (kg) (lbs)
General average 1.92 6 ft 4 in. 83.4 183.5
East German average 1.98 6 ft 6 in. 89 195.8
USSR average 1.96 6 ft 5 in. 90.7 199.5
Czechoslovakian average 1.92 6 ft 4 in. 90.5 199.1
French average 1.92 6 ft 4 in. 82 180.77
15
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