Steroids May Improve Tendon Repair After Surgery

[liftsiron]

posted by FContact on atomicalmuscle

Steroids May Improve Tendon Repair After Surgery

Reuters Health

By Merritt McKinney

Thursday, July 1, 2004


NEW YORK (Reuters Health) - Anabolic steroids are against the rules for professional athletes, but preliminary research suggests that steroids may help repair a shoulder injury that affects many professional and weekend athletes.

In lab experiments using bioengineered tendons, researchers at the University of North Carolina at Chapel Hill found that tendons treated with an anabolic steroid were stronger than untreated tendons.

"In a highly experimental model, anabolic steroids do appear to improve the quality of rotator cuff tendon tissue," lead author Dr. Spero G. Karas told Reuters Health.

Most likely, steroids help by improving protein production in each tendon cell or by boosting the way tendon cells communicate with each other, Karas said.

But don't expect doctors to start prescribing anabolic steroids to people who have rotator cuff surgery any time soon. Karas cautioned that much more testing needs to be done.

"If enough testing can conclude that this treatment is effective, then of course we could attempt it in humans with difficult rotator cuff injuries," Karas said.

The rotator cuff is made up of the muscles and tendons that hold the upper arm bone to the shoulder. When the rotator cuff is injured, surgery may be performed to repair it. Unfortunately, healing after surgery is often incomplete and many people experience repeat rotator cuff injuries.

Anabolic steroids are known to build muscle mass and boost strength, so Karas and his colleagues set out to see whether steroids might improve rotator cuff healing.

The research involved bioengineered tendons developed by co-author Dr. Albert J. Banes. The researchers collected tendon samples from six people who were having rotator cuff surgery. Cells from these tendons were isolated and used to grow the bioengineered tendons.

Some of these tendons were treated with the anabolic steroid nandrolone decanoate, while others were not. Some tendons were also subjected to load testing, in which the tendons were stretched.

Tendons that had been treated with steroids and subjected to loading were stronger, denser and more elastic than other tendons, the researchers report in the American Journal of Sports Medicine. The steroid-treated tendons also had a more natural appearance than other tendons.

The research will not have an immediate impact on the treatment of rotator cuff injuries, but the research establishes a way to test the effect of mechanical stress and medications on tendon cells, Karas said.

"Any drug can be tested, but we chose an anabolic agent because of its successful background in treating patients with burns and other injuries," Karas said.

Another potential implication of the research, according to Karas, is that it "may permit us to manufacture a matrix of tissue that can be used to replace deficient human tissues."

Karas noted, "We are only in the embryonic phases of this work. We are a long way off, but the potential is exciting."

SOURCE: American Journal of Sports Medicine, June 2004.

 

[jarbulldog]

that is very interesting, i had shoulder surgery on jan 5 of this year and started gear in march of this year and just know coming off.

 

[hunter21]

I always thought anabolics were hard on your tendons.?? I always feel stiff while on cycle. When arnold made that last terminator movie he had rotator cuff surgery and was back making the movie after a month and a half throwing stuff around....id say he threw some HGH
in there along with everything else because that surgery take s more time to recover than that especially at his age..

 

[thetopdog]

Some steriods reduce collagen synthesis (eg. test) and some increase it (eg. nandrolone)

 

[needsize]

funny, i went to see a top surgeon about my rotator cuff damage, and he explained how anabolics actually inhibit the body's ability to heal tendons and ligaments

 

[Thammer]

I've known some guys on Anabolic Androgenic Steroids (AAS) that do seem to bounce back pretty quickly from serious injuries. They usually go to the doctor and are ahead of schedule in terms of healing time.

hunter21,

You probably always feel stiff while on cycle due to a few different reasons. Usually when on cycle people train heavier and harder therefore putting more stress on tendons due to more weight or more work. The other reason could be attributed to the "flu-like" symptoms that many get while on some AAS.

Here is a good read on the effects of Winstrol in relation to tendons etc.:

Title: Stimulation of collagen synthesis by the anabolic steroid stanozolol.

Researchers: Falanga V, Greenberg AS, Zhou L, Ochoa SM, Roberts AB, Falabella A, Yamaguchi Y; University of Miami School of Medicine, Department of Dermatology, Miami, Veterans Affairs Medical Center, Florida, USA.

Source: J Invest Dermatol 1998 Dec;111(6):1193-7

Summary: In this report, we measured the effect of the anabolic steroid stanozolol on cell replication and collagen synthesis in cultures of adult human dermal fibroblasts. Stanozolol (0.625-5 micrograms per ml) had no effect on fibroblast replication and cell viability but enhanced collagen synthesis in a dose-dependent manner. Stanozolol also increased (by 2-fold) the mRNA levels of alpha1 (I) and alpha1 (III) procollagen and, to a similar extent, upregulated transforming growth factor-beta1 (TGF-beta1) mRNA and peptide levels. There was no stimulation of collagen synthesis by testosterone. The stimulatory effects of stanozolol on collagen synthesis were blocked by a TGF-beta1 anti-sense oligonucleotide, by antibodies to TGF-beta, and in dermal fibroblast cultures derived from TGF-beta-1 knockout mice. We conclude that collagen synthesis is increased by the anabolic steroid stanozolol and that, for the most part, this effect is due to TGF-beta-1. These findings point to a novel mechanism of action of anabolic steroids.

Discussion: I must first acknowledge that the commonly held belief is that anabolic steroids predispose an athlete to tendon rupture. This conclusion is drawn from animal studies showing that some steroids produce a larger, stiffer tendon in rats and that these steroid-induced tendons "fail" before the tendons from the control animals. The term fail refers to the breaking point.

The interesting thing about the present study is that the steroid stanozolol (Winstrol) had a different effect than testosterone. If you are a regular reader of MESO-Rx you should be well aware that not all steroids act in the same manner. And that because of subtle differences in there molecular structure they are able to elicit different responses. For example, Deca seems to act primarily through the androgen receptor (AR) where as Dianabol has effects beyond those associated with the AR.

Because synthetic steroids have differ in their chemical properties it should not be surprising that testosterone did not have the same effect as Winstrol. Winstrol increased collagen synthesis as opposed to testosterone which did not in this study. Interpreting the results of this study are more difficult than simply describing them. Other researchers have suggested that steroids cause a rapid increase in protein synthesis within tendon fibroblasts which results in fibroids or fibrous nodules within the tendon (Michna,1988). These fibroids alter the mechanical properties of the tendon perhaps predisposing it to rupture. It is also noted that during short term use of steroids there is an alteration in the alignment of collagen fibers which may also lead to rupture. Interestingly these alterations in collagen metabolism are transient with markers of collagen turnover returning more or less to baseline after 3-4 weeks of steroid administration (Karpakka,1992). These same researchers noted that low dose anabolics effect primarily muscle collagenous tissue with tendon being effected only at higher doses (i.e. 5 times the therapeutic dose) which would more closely represent what is needed by bodybuilders to put on mass.

The question remains, dose this mean that Winstrol will actually help prevent tendon injury or will it lead to bigger yet stiffer tendons prone to injury? It is difficult to take animal research and extrapolate the results to humans. Stanozolol is used therapeutically in humans to treat a variety of connective tissue and vascular disorders and its clinical effects suggest that it can modulate connective tissue breakdown in people. Despite being labeled as "ineffective" by many bodybuilders it is very popular among athletes. As with most hormones, dosage plays a role in what effects are seen, be they positive or negative. Hopefully future studies will shed light on the therapeutic effects of different steroids on tendons in humans.

References:

Michna H Appearance and ultrastructure of intranuclear crystalloids in tendon fibroblasts induced by an anabolic steroid hormone in the mouse. Acta Anat (Basel) 1988;133(3):247-50

Karpakka JA, Pesola MK, Takala TE. The effects of anabolic steroids on collagen synthesis in rat skeletal muscle and tendon. A preliminary report. Am J Sports Med 1992 May-Jun;20(3):262-6

 

[liftsiron]

Some steriods reduce collagen synthesis (eg. test) and some increase it (eg. nandrolone)

Right as well as EQ, primo and winstrol.

 

[bigdaddy22]

I have a very close friend whose doctor reccomended steroid use as a possibility post op, for ligament repair. He used deca

 

[liftsiron]

Here is the study that was referred to in the article posted by Thammer.



posted by JGUNS on CEM

J Invest Dermatol. 1998 Dec;111(6):1193-7. Related Articles, Links
Here is the actual study to the article posted by Thammer.

Stimulation of collagen synthesis by the anabolic steroid stanozolol.

Falanga V, Greenberg AS, Zhou L, Ochoa SM, Roberts AB, Falabella A, Yamaguchi Y.

University of Miami School of Medicine, Department of Dermatology, Miami Veterans Affairs Medical Center, Florida, USA.

There is evidence that anabolic steroids, which are derived from testosterone and have markedly less androgenic activity, promote tissue growth and enhance tissue repair; however, the mechanisms involved in their anabolic activities remain unclear. In this report, we measured the effect of the anabolic steroid stanozolol on cell replication and collagen synthesis in cultures of adult human dermal fibroblasts. Stanozolol (0.625-5 microg per ml) had no effect on fibroblast replication and cell viability (p = 0.764) but enhanced collagen synthesis (p < 0.01) in a dose-dependent manner (r = 0.907). Stanozolol also increased (by 2-fold) the mRNA levels of alpha1 (I) and alpha1 (III) procollagen and, to a similar extent, upregulated transforming growth factor-beta1 (TGF-beta1) mRNA and peptide levels (p < 0.001). There was no stimulation of collagen synthesis by testosterone. The stimulatory effects of stanozolol on collagen synthesis were blocked by a TGF-beta1 anti-sense oligonucleotide, by antibodies to TGF-beta, and in dermal fibroblast cultures derived from TGF-beta1 knockout mice. We conclude that collagen synthesis is increased by the anabolic steroid stanozolol and that, for the most part, this effect is due to TGF-beta1. These findings point to a novel mechanism of action of anabolic steroids.
__________________

 

[liftsiron]

Here is another interesting read that easto posted at premiermuscle


How to increase collegen synthesis!! (i.e. - strengthen those tendons and ligiments)

--------------------------------------------------------------------------------

originally posted by AnimalMass on competitivemuscle.com

While injecting test increases protein syntesis by roughly 50 times, depending on dose and time, most bodybuilders forget that it will reduce collagen synthesis by more than 50% -- more like 80%, giving you the collagen synthesis rate of a senior citizen. Since collagen makes up tendons, bros are very prone to injury if they continue to lift very heavy, unless they cycle off T and let their collagen synthesis get back to normal. It's like having the skeletal muscle of a gorilla with the tendons of a very old man.

Winstrol increases collagen synthesis. It will give you bigger tendons. However, your body compensates for this by making them more brittle, weaker, and more prone to injury. I can't tell you how many bros work out anaerobically and become injured while on winstrol. Guys who lift in the 1-5 rep range while on winstrol, to baseball players who sprint all out from a stationary position -- winstrol should be the LAST drug they choose. Most of them like winstrol because they don't get the weight gain from it but it is very detrimental to bros who train for any sport anaerobically. Tendons tear easily on it.

Also, the drugs I mention increase collagen syn while also increasing collagen cross-linking integrity, making for a much stronger tendon.

Winstrol, on the other hand, will dramatically increase collagen syn, but ironically it decreases collagen cross-linking integrity, thus making a much weaker tendon.

You can plan a cycle of Anabolic Androgenic Steroids (AAS) which will increase collagen synthesis and skeletal muscle growth at the same time. The key is the drug(s) you choose.

Deca, Equipoise, Anavar, and Primobolan will ALL increase skeletal muscle while at the same time dramatically increase collagen syn and bone mass and density, leaving you with a substantially reduced chance of becoming injured than if you choose to use Anabolic Androgenic Steroids (AAS) like sus, cyp, or enth.

While testosterone will increase bone mass and density, even at supra-physiological levels, the result is weaker tendons due to inhibition of collagen syn.

To plan a cycle where the goal is to increase skeletal muscle mass/strength while at the same time increase joint/tendon/ligament strength, enough to keep up with the dramatic increase in skeletal muscle, you must choose drugs like Eq, Deca, Anavar, or Primo as the base of your cycle. Testosterone and its esters can be added to your cycle to keep levels within a 'normal' physiological range (ie, 100-200 mg/wk) but must not go above this. Since drugs like eq, deca, anavar and primo will reduce endogenous, natural levels of test, these levels may be maintained with exogenous test in the 100-200 mg/wk range. Test at this dose will not inhibit collagen syn, but paradoxically, will help increase it. It is when exogenous testosterone is used > 200 mg/wk that collagen syn is inhibited.

Deca @ 3 mg/kg a week(about 270 mg/wk for a 200 lb male) will increase procollagen III levels by 270% by week 2. Procollagen III is a primary indicator used to determine the rate of collagen syn. As you can see, deca is a very good drug at giving you everything you want -- an increase in collagen syn, an increase in skeletal muscle, and increases in bone mass and density. The one thing it does not give you is wood

Primobolan, @ 5 mg/kg, will increase collagen synthesis by roughly 180% -- less than deca and equipoise but still substantial.

Equipoise @ 3 mg/kg will increase procollagen III by approximately 340% -- slightly better than deca.

Oxandrolone has over a hundred studies documenting its effectiveness at treating patients needing rapid increases in collagen syn to enhance healing.

These drugs have longer half-lives than most other AAS, so this should be considered when timing your post cycle clomid use. Here they are:

Deca: 15 days Equipoise: 14 days Primobolan: 10.5 days

Anavar has a half-life of only 8 hours so it should not pose a problem.

GH is probably the most remarkable drug at increasing collagen synthesis. It increases collagen syn in a dose dependant manner -- the more you use, the more you will increase collagen syn. It has also demonstrated this ability in short and long term studies. From what I've read, hGH at 6 iu/day increased the collagen deposition rate by around 250% in damaged collagen structures. This result indicates that the increased biomechanical strength of wounds to collagen structures treated with biosynthetic human growth hormone was produced by an increased deposition of collagen in the collagen structures.

Eq, primo, anavar, and deca are all good -- they increase several biomakers of collagen syn -- ie, type III, II, I, procollagen markers. GH just seems to do so most dramatically.

Use of any of these drugs @ supra-physiological levels with a maintenance dose of test will increase collagen syn while at the same time increase skeletal muscle mass. Skeletal muscle mass gains will not be as dramatic as with large testosterone doses but you have to weigh the risk/reward basis for yourself. Also, these drugs do not satisfy the libido like testosterone, but that is not the point of this thread. It is only to demonstrate that you can increase skeletal muscle and collagen syn at the same time with certain Anabolic Androgenic Steroids (AAS) -- the decision is up to you.

AnimalMass
__________________

 

[kbrkbr]

Great thread!