What's he done this time?

Allegations published by Der Spiegel as part of the latest wave of Football Leaks revelations claim that a urine sample provided by Ramos in the wake the 2017 Champions League final tested positive for dexamethasone.

Separately, it is also claimed he obstructed anti-doping officials after a match against Malaga earlier this year. 

Let's start with the positive test.

What is dexamethasone?

A type of steroid with anti-inflammatory effects that is usually used to aid an athlete’s rehabilitation and as a means of pain relief. 

Does it enhance performance?

Sometimes. There's been a lot of misinformation on this point. The Independent, for instance, outright say it's not performance enhancing, but that's not true -- various research studies have shown that it can have enhancing effects for endurance-based exercise. 

So is it banned, then?

Only when taken in certain ways.

It's on the World Anti Doping Agency's list of substances that are prohibited in-competition (which is the list used by UEFA), but only when it's administered via intravenous (directly into the veins), intramuscular (directly into the muscle), oral or rectal routes.

And how did Ramos take it?

According to the report, he received an intra-articular injection -- that is, an injection directly into the joint. Intra-articular injection is not one of the banned methods for administering dexamethasone.¹ 

So what's the problem?

It wasn't properly disclosed.

When undergoing anti-doping testing, players are required to fill in something called a doping control form. This essentially provides additional information to be considered as part of the testing process. An important element of the form is the Declaration of Medication section, in which players are required to list all recently received treatments, medication and supplements. Players theoretically have responsibility for this form but, in practice, will be assisted by team doctors in completing it.

Ramos's doping control form made no mention of dexamethasone. Instead, it said that a very similar substance, celestone chronodose (better known as betamethasone) had been administered. When the urine sample returned a finding of dexamethasone, this presumably sent alarm bells ringing.

Why did his form list the wrong substance?

Human error, allegedly. This is probably the most dubious part of the story: it's claimed that the team doctor simply confused the two substances in the heat of the moment, caused by the ecstasy of Real Madrid's victory and the locker room chaos which no doubt ensued. 

Having said that, there's little to no benefit to having listed betamethasone instead of dexamethasone -- they are both in the same category of substances (glucocorticoids) under the rules, and are treated in exactly the same way. It's not clear how Ramos would gain from pretending he'd taken one instead of the other, so perhaps the human error excuse is plausible.

I see his point: the timing certainly seems inconvenient. Why was Ramos tested straight after winning one of the biggest matches of his life?

Yeah, peeing into a tiny bottle in front of a bunch of doctors probably isn't how most people picture spending the moments after  winning the Champions League.

In UEFA competition, in principle, two players and two reserves from each team are selected for sample collection after each game. Any player on a UEFA competition match sheet must remain available in the stadium until 30 minutes after the end of the match to undergo sample collection. Der Spiegel's article states that Ramos remained in the stadium for testing until past midnight on the night in question. 

It's in some ways reassuring to know that, even in amongst the undoubted chaos that would have been taking place, the officials did their job. Then again, the stakes don't get much higher than a Champions League final, which makes the imperative to ensure all participants are clean even greater. 

So did Ramos break the rules in this instance?

He likely failed in his broader duty to ensure his doping control form was accurate, but this does not itself constitute an anti-doping rule violation (these are the doping offences specifically listed at Article 3 of the Anti-Doping Regulations).

If Ramos or Real were to be punished for their carelessness, it would be more likely to come via the overarching UEFA Disciplinary Regulations in the form of a fine or warning. It seems UEFA has already done this to some extent: Der Spiegel noted that UEFA wrote to Real upon concluding the case to ask that they exercise more caution in future.

Right, so: the Malaga thing. 

How exactly did he obstruct officials?

It's alleged that Ramos obstructed anti-doping testing by showering, against the orders of the anti-doping officers.

Why does it matter that Ramos took a shower?

The urine sample provided by the player should be the first urine passed by them after they are notified that have they been selected for testing, so they'll usually not be allowed to shower until after the sample is collected. 

In general, from the moment a player is informed they will be subject to testing, their actions are highly restricted. Often they will be intercepted immediately after a game and chaperoned to the doping control station (usually a designated room within the stadium). This is to minimise the risk of the player manipulating the outcome of the test. 

Will he get in trouble?

In terms of punishment, realistically that ship has probably sailed.

This allegation, if true, is the one more likely to have constituted an anti-doping violation: Article 3.01(e) specifically deals with tampering, which covers "obstructing, misleading or engaging in any fraudulent conduct to alter results or prevent normal procedures from occurring". But, given that Der Spiegel's piece mentions that Ramos showered "in front of" the official (undermining any claim that his conduct was actually obstructive) and that the Spanish national anti-doping agency investigated and took no further action, punishment at this point seems unlikely.

***

Footnote:

(1) Somewhat confusingly, Der Spiegel's article later states:

"According to the response sent to Sergio Ramos and Real Madrid, [UEFA's anti-doping unit] consulted an "expert" who confirmed that two intravenous [emphasis added] injections of 1.2 milliliters of dexamethasone would produce the rough equivalent of the dexamethasone concentration found in the sample of the player's urine. UEFA took note of the club's explanation. It was "very likely" that the player and the doctor had committed "an administrative mistake."