Current men’s world No. 1 ranked Jannik Sinner sparked headlines last week with his decision to reappoint the fitness coach involved in the doping violation that led to Sinner’s 3-month ban from professional tennis.
Early this year, Sinner accepted a 3-month ban based on the detection of metabolites of Clostebol (a form of anabolic steroid) in his system during his participation in the BNP Paribas Open Indian Wells event in March 2024.
Whether or not Sinner has by reappointing his fitness coach elected to forgive, for the medical and allied health practitioners who treat professional athletes, Sinner’s case offers (another) cautionary tale on the use of supplements in sport not to forget.
Under the World Anti-Doping Code (Code), medical and other persons working with, treating or assisting an athlete participating in or preparing for sports competition are considered to be ‘athlete support personnel’, along with a host of other persons (including coaches, trainers and parents). According to the Code, athlete support personnel are expected to be knowledgeable of and comply with all antidoping policies and rules adopted pursuant to the Code and which are applicable to them or the athletes they support.
Supplements are often used in sport and training for their properties in assisting to achieve optimal conditioning, performance, recovery and injury prevention. The risk with supplements, however, is that they can contain trace amounts of banned substances.
No Fault or Negligence
In anti-doping, athletes are strictly liable for what enters their bodies, regardless of whether they intentionally or unintentionally used a prohibited substance or method.
A period of ineligibility can be quashed if in an individual case it can be established that the athlete (or other person) bears ‘No Fault or Negligence’. This is where the athlete or other person did not know or suspect and could not reasonably have known or suspected even with the exercise of utmost caution, that he or she had used or been administered the prohibited substance or prohibited method or otherwise violated an anti-doping rule.
In Sinner’s case the explanation provided was that the Clostebol in Sinner’s system was transferred to him inadvertently by his physiotherapist who was using a medical spray, ‘Trofodermin’ containing Clostebol to treat a wound on the physiotherapist’s own finger at the time he was providing massage to Sinner during the Indian Wells event. It was Sinner’s then fitness coach who purchased the spray from a pharmacy in Italy where it is available for sale over the counter. Whereas the Independent Tribunal responsible for hearing Sinner’s case determined that the evidence supported a finding of No Fault or Negligence,[1] the World Anti-Doping Authority (WADA) didn’t agree and appealed the case to the Court of Arbitration for Sport. In the end, Sinner agreed to a 3-month ban (pursuant to the Code which gives the WADA power to enter case resolution agreements in circumstances where a player admits to an anti-doping violation).
Sinner’s case is not the first example of an anti-doping suspension arising from supplement use. AFL fans will recall the widespread sanction imposed against Essendon Football Club suspending multiple players and officials in relation to the use of supplements.
Other prominent cases in professional tennis over the last 12 months involve the current women’s world No.3 ranked Iga Swiatek and Australia’s Max Purcell and Thomas Fancutt.
Iga Swiatek received a one-month ban after low levels of trimetazidine were detected in her system. Swiatek applied to have the suspension lifted on the grounds that she unknowingly ingested the banned substance after taking (contaminated) melatonin recommended to her by her doctor (who was aware that Swiatek was a professional tennis player). As an additional assurance, Swiatek instructed her fitness coach to search the product’s ingredients against the WADA list to confirm there were no prohibited substances. Despite Swiatek’s endeavours, the International Tennis Integrity Agency was not satisfied the circumstances justified a finding of No Fault or Negligence, confirming that athletes are responsible for what they ingest.[2] Swiatek’s culpability was assessed to be at the lower end of the range. However, as a result of her suspension, Swiatek missed three events and had to forfeit the prize money she won at the Cincinnati Open shortly after her positive test.
In March this year, Thomas Fancutt voluntarily entered a provisional suspension after admitting to unknowingly violating the Tennis Anti-Doping Program by receiving an intravenous infusion more than the permitted threshold. Shortly afterwards, Max Purcell accepted an 18-month suspension for a similar violation after an ITIA investigation revealed that Purcell had received two intravenous infusions in excess of the permitted threshold at a clinic in Bali and failed to check the volume of the Infusions before they were administered by the treating doctor.[3] The period of ineligibility was reduced from 2 years based on Purcell’s ‘substantial assistance’ provided during the ITIA’s investigation.
Important Lessons for Athlete Support Personnel
The above cases should serve as a cautionary reminder not just to athletes, but also the medical and health practitioners who are called upon (whether ongoing or on occasion) to treat or assist an athlete participating in or preparing for sports competition.
In the relatively short career of an athlete the consequences of a ban could be severe if not devastating. As well as ineligibility, disqualification and forfeiture of any medals and points, a ban can impact an athlete financially (for example, forfeiture of prize money, liability for costs or other financial sanctions), and reputationally.
The onus is principally on professional athletes to make themselves aware of the risks involved in any supplements and methods recommended to them for treatment (and as Sinner’s case demonstrates, knowing also what supplements their support personnel might be using when in physical contact with them). However, medical and health practitioners who treat or assist an athlete also have a responsibility to verify the prohibited status of any medication or supplement and the risks of contamination in products they recommend to an athlete, or which they themselves might use around professional athletes. Complicity in a violation, or failing to appropriately discharge professional responsibility, could lead to sanctions under the Code as well as other legal and reputational consequences.
[1] International Tennis Integrity Agency and Jannik Sinner (Sports Resolutions, SR/250/2024).
[2] Decision of the International Tennis Integrity Agency Pursuant to Article 7.14 of the 2024 Tennis Anti-Doping Programme, 27 November 2024.[3] Decision of the International Tennis Integrity Agency Pursuant to Article 7.14 of the 2025 Tennis Anti-Doping Programme, 29 April 2025.
