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Monday, April 21, 2008
Updated: April 24, 11:50 AM ET
LET 'EM PLAY

By Eric Adelson

The dream continues.

[Ed's note: For a photo gallery of athletes using prosthetics, please go here .]

[Ed's note 2: To read related content on whether being "disadvantaged" has now morphed into an "advantage" for athletes, please go here .]

The future of sports sits in a Massachusetts basement, down the hall from a roomful of Legos. The future of sports is happening in a cavernous building in Iceland. The future of sports lies under the bed of a 13-year-old boy with no legs in Florida.

The basement: It's in the MIT Media Lab in Cambridge, and it's full of metal gizmos that surround an equation-covered whiteboard. A bilateral amputee professor named Hugh Herr works here. If anyone can predict what sports will look like in 2050, it's Herr, who lost his legs 26 years ago in a climbing accident. Herr wears robotic limbs with motorized ankles and insists he doesn't want his human legs back because soon they'll be archaic. "People have always thought the human body is the ideal," he says. "It's not."

The building: It's the home of Ossur, a prosthetics-design firm in Reykjavik. Researchers here are developing limbs that rely on Bluetooth technology to "know" how to move. While the able-bodied don't need to tell their legs to run up steps, amputees must will their prosthetics to make every movement. But just because the limbs are gone doesn't mean the remaining nerves have stopped working. Scientists want to wire artificial legs and arms into the nervous system and make them part of the body itself. Already, a below-the-knee amputee at Ossur walks uphill and downhill on a treadmill. He dances. He kicks a soccer ball. He bends it like Beckham. Soon, prosthetics wearers will be able to turn, cut and twist, motions difficult with current technology but essential in most sports. Next-gen research will shift from replacing the human leg to improving it, just as pharmaceuticals have shifted from restoring to enhancing. Why stop at a better hairline when we can make a better thigh? The boy: His name is Anthony Burruto. He's 13 and has no idea what's happening in those labs. But you can bet he wants the technology if it means his two fake legs will work as well as his right arm, which can hurl a baseball scary fast. Little League opponents agree not to bunt when Burruto takes the mound. But soon he might have better legs than any of them. Soon there will be no need to change the rules so disabled boys can play with regular kids. Soon officials will be forced to wrestle with this question: How can able-bodied kids keep up with the superabled? And when that day comes, when the basement and the building and the boy come together, sports will change forever.

THE PLATES are already shifting. On Jan. 14, the IAAF banned South African sprinter Oscar Pistorius from the Olympics because tests found that his Cheetah Flex-Foot legs, which look like J-shape spatulas, give him an advantage over runners with human legs. Sprinting on his carbon prosthetics, Pistorius looks to be bounding on springs. The IAAF study says the Cheetahs are more efficient than human legs, so Pistorius uses less oxygen than similarly fast able-bodied runners. In essence, the IAAF's contention is that running is too easy for him, so the governing body banned "any technical ... device that provides the user with an advantage over another athlete " Pistorius' Olympic dream was crushed before he had a chance to qualify at his country's trials.

Already, effects of the ruling have cascaded down: The NCAA, which used to stipulate only that the metal part of a prosthetic be covered for safety, has adopted the IAAF rule for track and field and left open the possibility for "rules more stringent than [those of] the international authority." While artificial-limbed athletes worry about creeping regulations meant to keep them at the fringe of competitive sports, the able-bodied fear a slippery slope that begins with prosthetics and ends who knows where. "Next will be another device," IAAF development director Elio Locatelli has said, "where people can fly with something on their back." Such critics see athletes like Pistorius, once inspiring, as a threat to fairness.

Sports have always been about progress: higher, faster, stronger. Technology, though, is quickly outpacing evolution, and few know how to respond. So we draw arbitrary lines: Creatine is fine, but HGH is not. Reading lips is fine, but videotaping pregame walk-throughs is not. A titanium rod beneath the skin is fine, but a prosthetic leg is not. We want our athletes to be superior, but not so superior that our children can't grow up to be just like them. It's why accused steroids users trumpet their reliance on "hard work," as if hard work and performance-enhancing drugs didn't reinforce each other like diet and exercise. We can all work hard, but drugs are a leap many won't take. One is essentially human, the other essentially technological.

The reaction to Pistorius is part support and part fear, and both are understandable. Athletes with prosthetics are admirably human and frighteningly inhuman. "Are we entering a posthuman era in sports?" asks sports ethicist Cesar Torres. "So far, the changes in the human body have been by evolution. Technology is enabling the human body to adapt in ways we couldn't dream 50 years ago."

The truth is that it's much too late to stop the technological bus. The dictionary defines a prosthetic as "a device, either external or implanted, that substitutes for or supplements a missing or defective part of the body." By that measure, prosthetics are already used in sports. A swim cap is a prosthetic; it smooths the "defective" surface of a swimmer's head, making it more hydrodynamic. So is Speedo's new LZR Racer, which makes a swimmer more buoyant. Since the suit was introduced, records have fallen like rocks in a landslide, but the sport's governing body decided it was legal. So why, exactly, is the suit okay but Pistorius' legs are not?

Even more surprising, USA Track & Field has worked with Nike to test carbon-sole shoe implants that harness energy normally lost when a runner's foot pushes off. Americans wore the shoes in the Sydney Olympics, meaning able-bodied sprinters have already used the type of carbon-infused prosthetics that got Pistorius banned. What's the difference between carbon shoes and carbon tibiae? Fashion? "It's a borderline case," says USOC sports technologist Peter Vint. "We're continuing to ask if that's legal or not."

The bottom line is this: Sports do not need knee-jerk segregation, they need rational and fair regulation. Every organized sport begins the same way, with the creation of rules. We then establish technological limits, as with horsepower in auto racing, stick curvature in hockey, bike weight in cycling. As sports progress, those rules are sometimes altered. The USGA, for instance, responded to advances in club technology by legalizing metal heads in the early '80s. In Chariots of Fire, the hero comes under heavy scrutiny for using his era's version of steroids: a coach, at a time when the sport frowned upon outside assistance. So if we can adjust rules of sports to the time, why not for prosthetics? Create a panel of scientists and athletes, able-bodied and disabled, and ask them to determine what's fair. One example: We know the maximum energy return of the human ankle, so that measurement could be the limit for the spring of a prosthetic ankle. That type of consideration is much fairer than simply locking out an entire group of athletes. "Not allowing someone to compete who is using his own power is a big thing to say," says Steve Novick, a U.S. Senate candidate from Oregon who has a prosthetic left hand. "You are denying the right to the pursuit of happiness in a fundamental way."

Many will disagree with this line of thinking. Some will complain that only the disabled have access to prosthetic limbs, while everyone can lace on space-age shoes. (Everyone who can afford them, that is.) Others will fret that some athletes might cut off a limb to gain a prosthetic advantage. And they just might. Young pitchers, after all, have already started opting for preemptive Tommy John surgery because it makes tendons stronger. Tiger Woods also went the elective-surgery route to gain an edge on the links: LASIK surgery, to be exact, which can improve vision beyond 20/20. Anthony Gonzalez, meanwhile, is an undersized receiver for the Colts who sleeps in a hyperbaric chamber to saturate his blood with oxygen and gain fourth-quarter stamina. Is any of this fair?

Advocates for the able-bodied will say that these athletes don't have fake parts; their advantages are natural, unlike those offered by prosthetics and performance-enhancing drugs. Never mind that testosterone, produced naturally in the body, is a steroid. Never mind that some athletes produce more testosterone and so have more steroids than others. And never mind those other "unnatural" aids that we accept. Like contacts. And screws in knees. And titanium hips. And cochlear implants.

But those are all restorative measures, some might say; they do not confer an unfair advantage. But what is a prosthetic knee for the war vet — who was born with legs — if not restorative? What's the difference between an amputee with a prosthetic and a lineman who has lost and regained use of his limbs? Or a point guard with a pacemaker? If a right wing loses an eye, would we make him wear a patch on the ice even if a mechanical eye allowed him to see off of it? "When you replace somebody's bone and it's under the skin, you can't even tell," says Penn State sports science professor emeritus Charles Yesalis. "What are we going to do, start X-raying people?"

Prosthetics technology doesn't threaten sports, in part because advances can be regulated to ensure fairness. What does threaten sports is injury. If we resist body-enhancing technology, will we outlaw prosthetic ACLs when science produces them? If Bills tight end Kevin Everett could play again with a prosthetic spine, would you tell him no? Think long and hard before you answer.

Bioethicist Andy Miah predicts that one day, "it will be an imperative, and the responsible course of action, to reinforce one's body through prosthesis when competing at an elite level." In other words, all pros will have engineered body parts. History will view the steroids witch hunt as a silly attempt to keep athletes from using technology to help regenerate after a season of pain. "In many ways, we're facing the advent of the bionic man," says MLS commissioner Don Garber. "It's something our industry has to start thinking about." And if practical medical need doesn't push the envelope, money will. Colleges and team owners will welcome ads slapped on prosthetic limbs, just as Nike slaps a swoosh on shoes. Keep an eye on the USA amputee hockey team fighting for Paralympic status — it's sponsored by Aetna.

Keeping the disabled out of mainstream sports will hurt only sports itself, just as ignoring steroids hurt baseball. Thousands of vets will return to the U.S. without limbs, and they will want the best replacements. Both the government and the private sector will oblige, and those vets will take their prosthetics to the blacktop and the field. Disabled athletes will get only more competitive. Soon, an amputee will want more than to try out for the Olympics; she will want to play for pay. And while Pistorius fights the IAAF with only a lawyer's help, Anthony Burruto, or someone like him, will have Jerry Buss or Theo Epstein or Mark Cuban on his side. "I can tell you the bottom line is business, nothing else," says Indians GM Mark Shapiro. "If we thought [a disabled person] would help us win a championship and is of good character, well, sure."

The future of sports is on its way fast, from MIT and Iceland and Orlando. Shed a tear for the "disabled" today. Tomorrow they might pity you.