It's "Hip" to do Drugs

By John McMullen

(The Phanatic Magazine) - It happens every few years, an injury pops up in professional sports that you never heard of.

You know, the sports hernia, the Lisfranc fracture and now -- the torn hip labrum in Major League Baseball.

I really started thinking about the problem after now-admitted steroid user Alex Rodriguez missed the first two months of the season with the injury. A-Rod was hardly the first, however.

Boston's Mike Lowell and Phillies star Chase Utley both underwent surgery for the same injury last year, while emerging Kansas City star Alex Gordon, New York Mets slugger Carlos Delgado and Phils pitcher Brett Myers have gone down this year.

All of a sudden it's become "hip" to have this surgery in Major League Baseball.

So what gives -- what's causing the uptick in hip problems?

Performance enhancing drugs is the easy answer but Dr. Alexis Chiang Colvin, an Assistant Professor of Sports Medicine from Mount Sinai's Department of Orthopaedics in New York, isn't so sure.

"The hip labrum isn't a big muscle injury. In fact it's more of a repetitive injury so I wouldn't say it was consistent with use (of steroids)," Colvin said in a phone interview.

One of few women in the sports medicine field, Colvin specializes in the surgical treatment of knee, shoulder, and hip disorders, and has worked with the Super Bowl Champion Pittsburgh Steelers and NHL's Pittsburgh Penguins as well as the University of Pittsburgh.

So why the spate of injuries?

"I'm not sure it's a new injury," Colvin said. "I just think we do a better job of diagnosing. I'm sure a lot of players had similar problems but it
wasn't necessarily diagnosed the same way and the treatment may have differed."

Dr. Ben Wedro, a clinical professor of medicine at the University of Wisconsin and a consulting onsite physician at the Summer and Winter Olympic Games, agrees.

"My experience with the increase in hip surgery may have to do with technology catching up to the diagnosis of labral tears and the ability to treat them," Wedro said. "Only in this decade has hip arthroscopy become available.

"New instruments and surgical techniques have been developed to work inside the joint and repair cartilage or labrum tears and clean out arthritic changes. This has lead to aggressive diagnostics of hip pain with the use of enhanced MRI images. Without the ability to fix the injuries that could be seen with MRI, there was no need to do the test."

In short, these injuries existed, they just weren't diagnosed.

"Historically, the hip joint was imaged by plain x-rays, arthrograms (where dye is injected into the joint and plain x-rays taken) and CT. These missed over 80 percent of the injuries within the joint," Wedro said. "Now, even in the non-athlete population, people with chronic hip pain have hip arthroscopy as an intermediate step to help with pain and function without having to wait until they are an appropriate age for hip replacement or hip resurfacing."

But, does that really rule out performance enhancers?

Matt Chaney, a former college football player and author of Spiral of Denial: Muscle Doping in American Football, doesn't think so.

"There is no clinical data that says performance enhancing drugs cause these types on injuries," Chaney, who has admitted taking steroids while a football player at Southeast Missouri State, said. "We believe steroids contribute but there's no proof.

"I know in the late 1970s and 80s, the increasing sizes of players, especially in football, resulted in some brutal tendon injuries, especially with the Achilles and patella. On the other hand, the word is HGH helps your tendons."

And that might be the real answer...No one really knows.

"When you abuse this stuff, you are going to have problems, Chaney said. "When you go for size, it's real simple. A lot of guys, off the record, admit it taxes your system. It's all about your dosage."

Since the ‘70s, athletes have grown in ways that evolution, competent eating habits and better training records can't fully explain. The players aren't just bigger, they are faster, stronger and quicker.

"The majority of athletes have used anabolic steroids or human growth hormone, GHB, insulin IGF-1, you name it," Chaney said. "Testing is not worth a damn."

An even harsher reality may be the general public -- they just don't care.

"I realized years ago that the public is insensitive to PEDs in sports and, in fact, that most fans love the performance and appearance of athletes on drugs," Chaney said.

Fans simply don't want to go back to the days when centers anchored the offensive line at 240 pounds or Thurman Munson won the AL. MVP award with 17 home runs. It's far more aesthetically pleasing to watch 330-pound tackles pull like bloated gazelles or 450-foot home runs.

Of course, enhancing performance is not necessarily a bad thing. If it were, we would ban all vitamins and supplements. Not to mention weightlifting and eating right.

Instead of the current witch hunt, moderation and education may be the better approach to the steroid problem, according to Chaney.

"If they are used in a therapeutic fashion, they can be helpful," Chaney said of performance enhancers "I am convinced we are in some sort of hysteria. It's the silver bullet theory that if you take it once something horrible will happen. It's ridiculous. People get in trouble when they abuse them."

The steroid era is here and has been for 40 years. We might as well embrace it.

"We are caught in a moral myth," Chaney said. "There is a thought that we can do something about it. We can't. We will never eradicate it.

"Sports should have a big disclaimer -- there are drugs here."