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Self-Reported Anabolic-Androgenic Steroids Use and Musculoskeletal Injuries: Findings from the Center for the Study of Retired Athletes Health Survey of Retired NFL Players

Horn, Scott DO; Gregory, Patricia MD; Guskiewicz, Kevin M. PhD, ATC

American Journal of Physical Medicine & Rehabilitation: March 2009 - Volume 88 - Issue 3 - pp 192-200
doi: 10.1097/PHM.0b013e318198b622
Original Research Article: Musculoskeletal

Horn S, Gregory P, Guskiewicz KM: Self-reported anabolic-androgenic steroids use and musculoskeletal injuries: Findings from the center for the study of retired athletes health survey of retired NFL players.

Objective: The relationship between musculoskeletal injuries and anabolic-androgenic steroids is not well understood. The purpose of our study was to investigate the association between self-reported anabolic-androgenic steroids use and the prevalence of musculoskeletal injuries in a unique group of retired professional football players.

Design: A general health questionnaire was completed by 2552 retired professional football players. Survey data were collected between May 2001 and April 2003. Results of self-reported musculoskeletal injuries were compared with the use of anabolic-androgenic steroids using frequency distributions and χ2 analyses.

Results: Of the retired players, 9.1% reported using anabolic-androgenic steroids during their professional career. A total of 16.3% of all offensive line and 14.8% of all defensive line players reported using anabolic-androgenic steroids. Self-reported anabolic-androgenic steroids use was significantly associated (P < 0.05) with the following self-reported, medically diagnosed, joint and cartilaginous injuries in comparison with the nonanabolic-androgenic steroids users: disc herniations, knee ligamentous/meniscal injury, elbow injuries, neck stinger/burner, spine injury, and foot/toe/ankle injuries. There was no association between anabolic-androgenic steroids use and reported muscle/tendon injuries.

Conclusions: Our findings demonstrate that an association may exist between anabolic-androgenic steroids use and the prevalence of reported musculoskeletal injury sustained during a professional football career, particularly ligamentous/joint-related injuries. There may also be an associated predisposition to selected types of injuries in anabolic-androgenic steroids users.

From the Department of Physical Medicine and Rehabilitation (SH, PG), The University of North Carolina at Chapel Hill; Department of Exercise and Sports Science (KMG), The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

All correspondence and requests for reprints should be addressed to Scott Horn, DO, 20 Porters Glen Place, Durham, NC 27713.

This work was part of a research presentation for the University of North Carolina Physical Medicine and Rehabilitation Residency Program. Some of these results were published in an abstract form and poster presentation at the 2008 Association of Academic Physiatrists Annual Meeting, Anaheim, CA, February 20, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.