Study: AAS may Accelerate Functional Recovery from Tendon Rupture

CFC

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I came across a study here that may be of interest to some. I've noted before on here how AAS can cause rapid recovery and thickening of the wrong type of collagen in tendons, thus theoretically making AAS-using athletes more prone to tendon rupture and injuries in future.

This study is interesting because it appears to show accelerated recovery and superior functioning in athletes who do use AAS during recovery.

Obviously they haven't studied the histological (under a microscope) composition of the tendons, and we should suspect that they are indeed thicker and more brittle from AAS use.

However from a practical, functional perspective, that may not actually matter. And for a regular bodybuilder, using AAS during recovery may actually be beneficial.

The only caveats I'd apply here are that (a) it was a tiny study, and (b) if you're a competitive lifter or athlete who pushes your tendons to the limit every time you train, the outcome might be completely different and that brittleness may well cause another tear.



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Injury. 2011 Nov;42(11):1307-12.
The effect of steroid-abuse on anatomic reinsertion of ruptured distal biceps brachii tendon.

(Pagonis T1, Givissis P, Ditsios K, Pagonis A, Petsatodis G, Christodoulou A.)


INTRODUCTION:
There is an increase in the number of anabolic-steroid (AS)-abusing trainees, who suffer from sports injuries, needing reconstruction surgery. Rupture of the distal biceps brachii tendon is a common injury in this group.

PURPOSE:
The study aimed to investigate the effect of AS abuse in the anatomic reconstruction of the ruptured distal biceps brachii tendon along with an immediate range-of-motion postoperative protocol.

METHODS:
We conducted an observation study of 17 male athletes suffering from distal biceps tendon ruptures. Six of them reported that they abused AS (group A), whereas the non-users comprised group B (n=11). Both groups were treated with the modified single-incision technique with two suture anchors and an immediate active range-of-motion protocol postoperatively. Follow-up was at 4, 16 and 52 weeks postoperatively, with a final follow-up at 24 months.

RESULTS:
Follow-up at 4, 16 and 52 weeks postoperatively showed a statistical significance in favour of group A for therapeutic outcomes concerning flexion, supination, pronation, Disabilities of the Arm, Shoulder and Hand (DASH) Disability Symptom Scores, Mayo Elbow Performance Elbow Scores and isometric muscle strength tests for both flexion and supination. Twenty-four months postoperatively, statistical significance in favour of group A was recorded in isometric muscle strength tests for both flexion and supination and also in DASH Disability Symptom Score.

DISCUSSION:
The results of our study suggest that there is a correlation between the effect of AS and the quicker and better recuperation and rehabilitation observed in group A. Nonetheless, these results must be interpreted with caution, and further in vivo research is needed to confirm these findings.




http://www.ncbi.nlm.nih.gov/pubmed/21481384
 
I came across a study here that may be of interest to some. I've noted before on here how AAS can cause rapid recovery and thickening of the wrong type of collagen in tendons, thus theoretically making AAS-using athletes more prone to tendon rupture and injuries in future.

This study is interesting because it appears to show accelerated recovery and superior functioning in athletes who do use AAS during recovery.

Obviously they haven't studied the histological (under a microscope) composition of the tendons, and we should suspect that they are indeed thicker and more brittle from AAS use.

However from a practical, functional perspective, that may not actually matter. And for a regular bodybuilder, using AAS during recovery may actually be beneficial.

The only caveats I'd apply here are that (a) it was a tiny study, and (b) if you're a competitive lifter or athlete who pushes your tendons to the limit every time you train, the outcome might be completely different and that brittleness may well cause another tear.



****



Injury. 2011 Nov;42(11):1307-12.
The effect of steroid-abuse on anatomic reinsertion of ruptured distal biceps brachii tendon.

(Pagonis T1, Givissis P, Ditsios K, Pagonis A, Petsatodis G, Christodoulou A.)


INTRODUCTION:
There is an increase in the number of anabolic-steroid (AS)-abusing trainees, who suffer from sports injuries, needing reconstruction surgery. Rupture of the distal biceps brachii tendon is a common injury in this group.

PURPOSE:
The study aimed to investigate the effect of AS abuse in the anatomic reconstruction of the ruptured distal biceps brachii tendon along with an immediate range-of-motion postoperative protocol.

METHODS:
We conducted an observation study of 17 male athletes suffering from distal biceps tendon ruptures. Six of them reported that they abused AS (group A), whereas the non-users comprised group B (n=11). Both groups were treated with the modified single-incision technique with two suture anchors and an immediate active range-of-motion protocol postoperatively. Follow-up was at 4, 16 and 52 weeks postoperatively, with a final follow-up at 24 months.

RESULTS:
Follow-up at 4, 16 and 52 weeks postoperatively showed a statistical significance in favour of group A for therapeutic outcomes concerning flexion, supination, pronation, Disabilities of the Arm, Shoulder and Hand (DASH) Disability Symptom Scores, Mayo Elbow Performance Elbow Scores and isometric muscle strength tests for both flexion and supination. Twenty-four months postoperatively, statistical significance in favour of group A was recorded in isometric muscle strength tests for both flexion and supination and also in DASH Disability Symptom Score.

DISCUSSION:
The results of our study suggest that there is a correlation between the effect of AS and the quicker and better recuperation and rehabilitation observed in group A. Nonetheless, these results must be interpreted with caution, and further in vivo research is needed to confirm these findings.




http://www.ncbi.nlm.nih.gov/pubmed/21481384

Which aas I glanced over it quickly but couldn't see a specific hormone so didn't bother reading it, useless article unless I've missed something
 
They didn't control it unfortunately. These were just men who said they were using cycles independently. They self-reported various AAS though including Deca, Anadrol and Test.
 
There's nothing useless about proving AAS in general may be beneficial.

Science is rarely black and white, especially stuff like this, still in its infancy. It's about recognising that despite AAS being apparently counterproductive wrt collagen deposition on a histological level, they still may be functionally beneficial. So we now have a theory to work with.

It may be increased muscle mass or innervation (caused by all AAS, not a specific compound) is what's beneficial, and some AAS may be ultimately expected to be better than others.

But getting the kind of science you're expecting (precise, specific answers) is not going to happen unless hundreds of subjects are inducted into studies. And there's simply no money (and an ethical boundary) for that to ever happen.
 
Nice little read and I'll definitely have to go over it after I wake up. I'm too much of a kid in a candy store when I read science journals that I find something little to take with me. No matter how redundant the subject discussion.

Thanks for these posts like always CFC.
 
There's nothing useless about proving AAS in general may be beneficial.

Science is rarely black and white, especially stuff like this, still in its infancy. It's about recognising that despite AAS being apparently counterproductive wrt collagen deposition on a histological level, they still may be functionally beneficial. So we now have a theory to work with.

It may be increased muscle mass or innervation (caused by all AAS, not a specific compound) is what's beneficial, and some AAS may be ultimately expected to be better than others.

But getting the kind of science you're expecting (precise, specific answers) is not going to happen unless hundreds of subjects are inducted into studies. And there's simply no money (and an ethical boundary) for that to ever happen.

There also doesn't seem to be much of an interest to do large scale studies as the AAS population is such a small demographic of people compared to any other medical research population.
 
I agree CFC but it's not very useful to us, useful for public opinion but if we don't know the difference between eq and stanzolol when it comes to repair it could cause problems is what I mean
 
No really, it is useful to us. I know you're thinking specifically about the tendon, because we know some (eg stanozolol) make the tendons grow thick and brittle. That much is true, and more studies about which are better/worse would, I agree, be great.

But when you've had a tendon rupture and reattachment, it's not just about the tendon collagen. Tendons are actually best thought of not as strong white rope-like cords that hold muscles to bones, but as amalgamated muscle-tendon units (or MTUs).

Muscle and tendon are mixed up together with nerves in such a way that they actually function as a single unit (this is what we mistakenly think of as the 'tendon'). As a consequence, the muscle and nerves also play a critical role in recovery when you've had a severe injury. If the muscles and nerves don't regrow well, and if too much scarring/fibrotic tissue forms - even if the tendon collagen recovers nicely - your recovery could still be screwed.

And what this study does is demonstrate that an anabolic stimulus improves the overall MTU outcome. We can assume it's because the beneficial impact on muscle and nerve tissue growth (and possibly reduced scarring) and the greater force the MTU can consequently handle, outweighs any functionally negative impact on collagen.

As for your specific issue, one day they may also find out which AAS are best/worst specifically on collagen regrowth, although we already do know that to some extent from laboratory studies (DHT and derivatives appear the worst).
 
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There also doesn't seem to be much of an interest to do large scale studies as the AAS population is such a small demographic of people compared to any other medical research population.

Yes that too. Ultimately there's no money in researching this area when it affects such a tiny number of people.
 
Thats interesting CFC.... having multiple injuries, and several major surgeries I have noted recovery appears to be accelerated but over the longer term tendons do seem to tear easily, and frequently..
 
Yeah that would be my general suspicion GF - that over the long term all that faulty collagen accretion would come back to bite an athlete. Also, these people are undoubtedly doing sub-maximal training. I'd never personally want to risk AAS for recovery if I was into very low rep training or competing/powerlifting/strongman etc.
 
Seems to have sped up recovery of my finger it's supposed to take 6-8 weeks where as it's been 3 and I can move it and stuff now
 
Estrogen cushions the joints. I know many forums that believe that running deca makes the joints feel better. Deca increases synovial fluid to the joints as well.

Crashing estrogen does the opposite. You have creaky bones and knees literally break from light squatting. (My mate crashed his estrogen with letro. He dried out but when he was squatting 225, his knee gave out).
 
Estrogen cushions the joints. I know many forums that believe that running deca makes the joints feel better. Deca increases synovial fluid to the joints as well.

Crashing estrogen does the opposite. You have creaky bones and knees literally break from light squatting. (My mate crashed his estrogen with letro. He dried out but when he was squatting 225, his knee gave out).

Nandrolone negatively impacts cardiovascular health over the longer term, I suppose you can't have everything...
 
Nandrolone negatively impacts cardiovascular health over the longer term, I suppose you can't have everything...

Oestrogen increases the viscosity of joint hyaluronic acid (the main compound in synovial fluid). So any aromatising AAS should be helpful.
 
Oestrogen increases the viscosity of joint hyaluronic acid (the main compound in synovial fluid). So any aromatising AAS should be helpful.

Could it be estren acting in AR having the impact on joint fluid that makes nandrolone seem superior to say test?
 
Could it be estren acting in AR having the impact on joint fluid that makes nandrolone seem superior to say test?

What makes you think of estren?

Nandrolone has direct oestrogenic activity (it's classified as an oestrogen and an androgen) but also a pretty strong affinity to the progesterone receptor (unlike testosterone). Some of it's main metabolites (ethinylestradiol and 7-a-methyl-ethinylestradiol) are also very potent oestrogens.

So it could be simultaneous interactions between the AR, ERa/b and unusual affinity for the PR that moderate the anabolic effect on joint HA and chondrocyte activity and enzymes. This differential could account for much of the variation in effect between test (and metabolites) vs deca (and metabolites).
 
Could it be estren acting in AR having the impact on joint fluid that makes nandrolone seem superior to say test?

Are you referring to a statement from Peter Van Mol (Big Cat).. Where he describes nandrolones estrogenic response via AR:

Estren is a metabolite of nandrolone through the 3α-HSD enzyme, estren was capable of activating estrogen specific constructs in the DNA through the androgen receptor.
 
Yeah that would be my general suspicion GF - that over the long term all that faulty collagen accretion would come back to bite an athlete. Also, these people are undoubtedly doing sub-maximal training. I'd never personally want to risk AAS for recovery if I was into very low rep training or competing/powerlifting/strongman etc.

Yeh.. disappointing being constrained by injury(s).. It definitely seems to restrict future growth potential (if I have any at my age).. I've found keeping weights low on some exercises whilst performing eccentric to a 4-6 count is my best option, to avoid further reoccurring injuries...
 
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