Recovery or strengthening?
The Mitchell Report and other sources have suggested that athletes turn to banned drugs as much to bounce back from injuries as to build strength. So it's not hard to imagine the appeal of Huard's methods.

Given that the patient would receive an injection of his or her own cells, detection would be difficult.

Some even theorize that by injecting stem cells into healthy muscle, athletes could replicate the growth and strengthening effects of steroids and human growth hormone. Such injections often have no effect in the lab, Huard said, but that doesn't mean no one will try.

Stem cells could be dangerous because they're similar to cancer cells. Huard doesn't have hard data but said he worries that patients who receive improper injections could face elevated cancer risks.

Perhaps his research will revolutionize the standard practices in sports medicine. Or perhaps outlaw doctors will try to use it to boost performance and, instead, hurt their patients.

It's too early to tell. (Huard estimated that his research might apply to sports medicine in 10 years.) But the fact that anti-doping officials have their eyes on his work illustrates the bizarre climate of modern athletics, one in which every scientific breakthrough related to muscle growth has a potential dark side involving performance enhancement.

"It is strange," Huard said. "But it tells me we've been pretty successful."

Similarly, Howman said doping officials must work with the pharmaceutical industry so they know which new drugs are ripe for abuse.

Pharmaceutical companies have begun trials for drugs that would inhibit myostatin, a protein that moderates muscle growth. The drugs are intended for muscular dystrophy patients and others whose muscles are wasted by disease. But the bodybuilding community is already excited, because if the gene can, in effect, be turned off, workouts could lead to much greater muscle growth.

Testing is not enough, doping officials agree. Commonly used substances such as hGH are undetectable in the urine tests of most U.S. sports leagues. And forget about the latest designer drugs, which might evade even the most sophisticated tests.

Enforcing the law
That's where law enforcement comes in. Most of the American athletes flagged for hGH use have been caught in crackdowns on Internet pharmaceutical rings. Similar crackdowns will be key to stopping doctors from performing illegal genetic procedures, Howman said.

"If you rely solely on science and the collecting of samples, you'll never totally get on top of it," he said.

What lies ahead might be as much a philosophical reckoning as an attempt to stay ahead of the latest quests for performance enhancement.

It's possible that we will face a new normal, one in which gene therapy and stem cell treatments are part of routine health regimens. If such physical enhancements pose no medical risks, will there be a moral imperative to prevent them?

Already, we accept athletes taking cortisone shots and receiving laser eye surgery because we perceive these procedures as simply getting them back to normal levels. More broadly, we accept plastic surgery as a means to build self-esteem and raise prospects for professional success.

'Genetic cocktail'
"If, in 50 years, people are receiving a customized genetic cocktail instead of vaccinations, the minute you do that, you are changing their performance throughout their lives," Sweeney said. "Who wouldn't want that if it's safe?"

Given the vast array of possible enhancements, Howman said, anti-doping officials have to wage a philosophical and moral war.

"We really have to think about what we want sport to be," he said. "We have to educate the athletes of the future so they don't want to go down paths their predecessors have gone down. And we have to hope that more and more of them boo those who do go down those paths."

childs.walker@baltsun.com