This is a very controversial topic but one I am asked about frequently, which is why I hesitantly decided to write this piece. Let me start by stating that I am not biochemist or an endocrinologist, nor am I any other kind of medical doctor and I do not pretend to be. This article is not to be interpreted as medical advice; it is simply an informative piece to help readers understand the functions and roles that different hormones have in the healing process.
Action sports are inherently high-risk sports. Most of the general population know them as extreme sports and for good reason, because they are extreme. Action sports push our bodies to the limit not just athletically and physically but mentally as well. I personally hate the term extreme sports because it makes me think of some gnarly surfer/skydiver/snowboarder dude from the early 90’s wearing fluoro clothes playing hacky sack on the beach talking about how extreme/radical/gnarly his last activity was…. Sorry if I have offended any one.
Action sports have evolved well beyond those early ‘extreme’ days. Now the title encompasses just about every non traditional sport including but not limited to, surf, motocross and supercross, snowboarding, skiing, wake boarding, mixed martial arts, freestyle motocross, BMX of all disciplines, mountain biking of all disciplines, skydiving and base jumping…. the list goes on. The one thing about the nature of these sports is they have to continuously progress to stay relevant and exciting. They must continue to push the limits of what is possible. This is even more so with the judged disciplines over racing. Sports like BMX park and dirt, as well as FMX and freeride MTB all have to keep pushing the limits otherwise they will get repetitive to watch. It’s pretty simple; there are two main ways to progress, through trick progressions or course design. Both of which will increase the difficulty and the level of risk involved. With the increased risk comes an increased failure rate or increased injury rate.
Action sport, like all sport, has the terrible problem that injury time is down time and can mean no income from endorsements, prizes, and performance fees. It is not like a normal job where you can have your ACL fixed, have a week off work and get back to it. Depending on the injury, athletes can be looking at up to 6 months or more of down time. Because of this reason alone athletes are always on the lookout for shortcuts to healing so they can get back on and competing sooner.
Enter steroids, I’d be lying to you if I told you that in my career as an FMX athlete I had never investigated the possibility of using them to speed up healing and minimise down time. I’m sure it has crossed everyone’s mind, the question though is does it work? In addition, is the risk worth the reward?
Let’s start by understanding what steroids are, then what they do to your body, and finally how they affect the healing process.
Most people only think about anabolic steroids when the term is used, but steroid is really just a blanket term for various hormones and vitamins found in our body. The body can make these or we can supplement them to induce some kind of effect or correct an imbalance. A substance like cortisone, which is a corticosteroid, is often used to reduce inflammation from chronic ongoing injuries. This is done by injecting cortisone directly into the injury site (this can provide relief temporarily and enables athletes to continue competing but rarely is a long-term solution). Female contraceptive pill is also a steroid and even vitamin D falls into a sub class of steroids called sterols. However, we are not here to talk about female contraception or vitamin D are we.
Anabolic steroids are one of the most demonised substances in sport. But why is this? Well in my opinion, this is because they are perceived to create an uneven playing field, giving one person an ‘unnatural’ advantage over another. Which is fine and I am not here to argue for or against the use of anabolic substances for sport performance. However, let’s talk about why they work. Anabolic steroids are essentially different forms of testosterone, the male sex hormone. There is a reason men are usually bigger and stronger than females, yep you guessed it, we have more testosterone.
Testosterone does a whole heap of things in the body; the one we are going to focus on though is protein synthesis. This is basically how your body builds muscles. You work out which damages the muscle fibres, the androgen receptors on your muscle cell pick up the testosterone, which then up regulates protein synthesis and increases muscle growth. On the other side of it, testosterone also inhibits the breakdown of muscle tissue from cortisol. Therefore, with anabolic steroids, you have more growth and less muscle breakdown meaning you can get bigger and stronger faster.
Now the question is does this help with injuries? Once again, I am not talking little scrapes and bruises. Rather, I am referring to fractures, as well as tendon and ligament ruptures.
Ligaments and tendons
I’m really sorry to break it to you but if a ligament or tendon suffers a complete tear no matter how amazing at healing you are or what you take, it’s never going to fix itself. It is going to require surgery to have it reattached. If it is a partial tear you may be lucky, but it will still need a lot of attention and still quite possibly surgery depending on the severity and location of the tear. There is a lot of promising research going into the localised use of growth factors to heal ligaments and tendons but this is still something a medical doctor would be facilitating[i]. However, what about steroids after surgery? That is sure to help things heal faster… isn’t it? Well, maybe… as far as the wounds go[ii], but who really cares about a wound fully healing in 7 days instead of 14 when you are out of action for 6 months or more. Because truth be told, the majority of the research I read indicated that reoccurrence of tendon and ligament injury was actually increased with athletes that had been using anabolic steroids[iii]. Putting the pieces of the puzzle together, I believe there are two main contributing factors to this. The first being the biological factor that, with the modified protein synthesis of steroid use, the structure of the collagen in the tendons or ligaments is changed causing them to become less elastic[iv]. This combined with the environmental factor of the athlete ‘feeling’ stronger and healed, so they push themselves too hard too early and cause re-injury… silly athletes.
Bones
There is actually a lot of research that shows in the presence of anabolic substances that bone cell growth increases which you would expect would cause an increased healing rate, and if you ever hear anyone say ‘steroids make your bones heal faster’ is probably what they are talking about. Problem is that those studies were conducted in labs, not in real people. They literally took bone cells bathed them in anabolics and watched what happened. Though research also indicates that bone healing from systemic anabolics (like when someone jabs themselves with a needle or takes pills) may be limited. There are indications from animal studies that localised[v] and systemic use of certain steroids may assist in the rate of bone healing[vi] but there is also evidence to the contrary[vii].
So where does that leave us? Well certain steroids may help with fracture healing but not ligament or tendon damage, which usually coincide with one another. At the same time, steroid use also does carry its own risks, both physically and legally. For me personally would I use them for bone healing? The answer is no, my knowledge of the body and its systems allows me to ‘hack’ the healing process in other safe and legal ways, which is the same recommendation I would give to my athletes.
To find out more about healing and recovering from injuries head over to my contact page and shoot me a message, I’d love to hear from you.
Train hard, be safe.
Your strength coach,
Cam
[i] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879239/
[ii] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1501119/
[iii] http://www.ncbi.nlm.nih.gov/pubmed/17701152
[iv] http://www.ncbi.nlm.nih.gov/pubmed/3610410
[v] http://www.ncbi.nlm.nih.gov/pubmed/23940550