By now most of you know that Texas native Lance Armstrong, once the most decorated and honored professional cyclist in the world, has been stripped of his seven Tour de France titles amidst mounting evidence of doping.

His name has been removed from the record books and Armstrong has been banned from professional cycling. Athletic clothing and footwear company Nike — which did not drop Tiger Woods from its list of sponsored athletes after the golfer was unmasked as a multiple philanderer — severed its longstanding endorsement deal with Armstrong estimated to be worth more than $7.5 million a year. Other sponsors also cut ties to Armstrong and he voluntarily stepped down as head of the Lance Armstrong Foundation, also known as Livestrong, the cancer charity he founded in the mid-1990s.

Armstrong has never publicly admitted to doping – to gaining an athletic or performance advantage by using banned substances. But he also chose not to fight the allegations in the 1,000-page dossier that provided exacting details alleging when, how and where Armstrong cheated.

Cheat. Not world-class athlete. Not champion. Not inspirational cancer survivor. Cheat is the term that more than likely will haunt Armstrong for the rest of his days.

Yet despite the consequences, and despite the crackdown by all professional sports and the NCAA, the lure of quick results and shortcuts is tempting athletes in what should be one of the most pure areas of all competition – high school.

According to a study by Texas A&M University nearly one-third (32 percent) of high school seniors and juniors reported they had purchased performance-enhancing drugs. Nearly 2.3 percent of high school athletes are using those drugs — a figure the study’s researchers believe is underreported.

As a pain management physician I work with a lot of young athletes, helping them to recover from injuries hopefully without the need for surgery. I know the pressure many of them feel to be bigger, better, faster and stronger at an age when their bodies just aren’t developed to compete at the level they want.

Sometimes they push themselves. Other times they are pushed by coaches or family members. And they all want an edge.  Proper diet, exercise and commitment to a training regimen just aren’t enough for some of them. They scour the Internet looking for tips on what drugs will give them the results they desire, and they can get tips from other cheaters on how to make it work to its maximum effect.

Some young athletes think they are playing by the rules but still wind up cheating. Plant extracts and so-called “all-natural” supplements may contain banned hormones that can get you into trouble. Yet these dietary supplements aren’t all-too-often unregulated. Just because you can get it in a health store doesn’t mean it’s safe, effective or legal for a competitive athlete.

We all cheer the winners but forget about the honor and integrity it takes to be a fair and good loser. The athlete who comes in last after giving it his or her all deserves as much adulation as the one who broke the tape at the finish line.

Which brings us back to Lance Armstrong. If the allegations are true, he knew full well he was breaking the rules to win. He may have tried to justify it to himself because, reportedly, doping is rampant in professional cycling (as it may be in too many other pro sports). Yet even if none of the allegations ever surfaced, he would know he didn’t win based on his God-given physical talent, strength of mind and strength of character.

Some people can live with that knowledge. I just don’t know how they do it.

Stay focused. Stay true. Play hard. And play fair.

On a totally different note, I’m happy to have been asked to once again serve as Tournament Physician for the 2012 USTA National Women’s Intersectional Team Event. I have been honored to volunteer my services for the past two years and am looking forward to being part of this year’s event.

Some of the best women tennis players ranging in age from 35-89 will square off at McFarlin Tennis Center (1503 San Pedro) from Nov. 12-18 for this Hardcourt Championship. Proceeds from the tournament will benefit the non-profit Texas Tennis and Education Association, which promotes health and education through tennis in Texas.

I hope to see you there.