Tonight’s televised Lance Armstrong interview is being advertised as the saddest, final chapter in one man’s incredible, but now tainted, athletic career. But for many sports fans, it’s just another episode in an ongoing, tiresome saga.

From Canadian sprinter Ben Johnson losing his 1988 gold medal after a positive steroid test, to Mark McGwire, Sammy Sosa and others awkwardly testifying before Congress about performance enhancing drug (PED) usage in baseball—and now Armstrong—it’s almost commonplace to view record-setting or historical athletic performances with a jaundiced eye at this point. For some fans, it’s the only way they’ve ever known sports.

But why? Why do athletes who are undisputedly at the top of their professions feel the need to gain this edge? Is it the money, the fame? Or is it a frustration that training, nutrition, equipment changes, etc. have taken them as far as they can possibly go, yet they wish to climb even higher? Have we reached the pinnacle of what a human being can accomplish without artificial assistance?

Our Sports Doc panel weighs in:

David Rubenstein, M.D., Main Line Health Lankenau Medical Center, Team Orthopedist for the 76ers: “I think the purest way to measure this is to look at the sports with the longest history of [PED] abuse—cycling, track & field, swimming. These are pure sports. Just looking at women’s track and field, the most prestigious world records were all set over 20 years ago. There wasn’t nearly as much testing back then, so a lot of women today are competing with records that may have been established under enhancement.

So we’re training better, athletes are eating better, they have the finest coaching, top-of-the-line equipment… but these records aren’t going anywhere. I think that tells us that yes, we’re getting close to our limits. I don’t see a whole lot of room for further improvement without the use of other means.”

Peter F. DeLuca, M.D., Rothman Institute, Head Team Physician for the Eagles and Head Orthopedic Surgeon for the Flyers: “The last 16 years, I have had the opportunity to attend the NFL Combine. I have seen these athletes get bigger, faster and stronger over the span of these 16 years. All of these players are tested for performance-enhancing drugs and a few per year actually test positive, the rest are naturally gifted. I’m sure 50 years ago physicians wondered if the athletes of their day have reached their full physical potential.

My concern is as these athletes get bigger, are we going to see more injuries? Our bones, ligaments and tendons can sustain a certain level of tensile stress before they break, and that stress is related to mass and acceleration. So as the players get bigger and faster we will see high impact collisions that will exceed the failure point for these anatomic structures.

Some people may argue that as the athlete gets bigger; their ligaments, bones and tendons get stronger. In my experience there is not much difference in the size of the ACL in a 6-foot-6, 300 lb. offensive lineman compared to a 5-foot-7, 170 lb. soccer player. I believe we will see more injuries before the performance of athletes plateau.”

Robert Cabry, M.D., Drexel University School of Medicine, Team Physician for U.S. Figure Skating and Associate Team Physician for Drexel Athletics: “The use of performance enhancing drugs dates back to the ancient Greeks. The desire to be the best in your sport will always drive some athletes to seek success regardless of cost. Being the best can mean being eternally remembered but also a college scholarship, the Olympic gold medal or the big NFL contract.  Even though the cost may be high, the potential gains are irresistible.

Many athletes, if given the choice, would take 20 years of fame and wealth even knowing they may have to give up the Hall of Fame. Also, as a society, we can’t resist the desire to see more records broken and to see the athlete perform beyond the imagination. There’s no better feeling than to see your favorite hitter crush the ball into the upper decks or to see your favorite cyclist make fools of the other riders.  Because of our desires, the era of performance enhancement will continue to grow and become more sophisticated.  

The only way to save sports is to enforce strong monetary sanctions so there is no financial motivation to cheat. Don’t just take away his trophy, take away his wealth. Only then, might we not call into question every new athletic accomplishment.”

Michael G. Ciccotti, M.D., Rothman Institute, Head Team Physician for the Phillies: “With everything that’s happened from a professional sports and Olympic perspective—people can’t help but be skeptical with respect to future accomplishments. But I don’t believe our athletic achievements have reached a plateau. I believe that there will be records broken by athletes who are ethical, who adhere to their training. Unfortunately, the environment is such that these athletes may still be questioned.”

Joel H. Fish, Ph.D., Director of The Center For Sport Psychology in Philadelphia, Sport Psychology Consultant for the 76ers and Flyers:  “I believe that it is human nature to want to smash world records and to strive to be the best that we can be. In an honest way, athletes will continue to try to accomplish what no other athletes have accomplished before them. With significant improvements in healthy training and conditioning methods, as well as with advancements in sport psychology in order to improve mental skills for peak performance, I believe that athletes will continue to run faster and jump higher than ever before. When it is clear that it is being done in an honest way, fans will be able to cheer wholeheartedly for their heroes once again.

Lance Armstrong has become another record-setting hero who has disappointed his fans by his admission of cheating and performance enhancing drug use. In the short-run, I think that fans will reserve judgment on record-breaking athletic performances.  This is because our trust in athletes has been tarnished by the revelations in recent years that many of our Olympic champions and elite athletes have used performance enhancers to help them achieve their record performances.    

In the long-run, though, if strict testing methods are instituted by our professional leagues and at the Olympic level, I think that fans can rebuild their trust in the athletes that we so admire.”