The Anabolic Answer

I fully understand the history of PED abuse in baseball and why Major League Baseball went to the extremes they went to in hopes to prevent the power trips and blatant abuse of steroids that we saw in the 1990’s and 2000’s. But there are cases where these banned substances are a necessary means of recovery for athletes. In “Major League Baseball’s Minor League Drug Prevention And Treatment Program” they have a section dedicated specifically to allowing players to take prohibited substances called “Therapeutic Use Exemption” or “TUE” which allows players to use certain substances if they really must. I believe that MLB should consider easing the process of getting an exemption and adopt a system in which post-injury evaluation system to determine if banned substances could make an impact on recovery rates.

In this system, players would have a baseline test at the start of every season. The tests would monitor their physical capabilities such as strength, speed, agility, and baseball related movements. A big part of these tests would also be drug testing before these tests to make sure players are clean for the baseline along with blood testing to determine levels of certain biological/chemical factors. Once players have a baseline test, they can be evaluated post-injury in comparison to their baseline tests. The league would have to create specific thresholds in comparison to baseline tests for exemptions. What I mean by this is that if a player experiences an injury that doesn’t completely diminish their capabilities but sets them back in a minor way, they may not qualify for use of a banned substance. Where if a player experiences an injury that sets them down quite a bit from their baseline tests, they may have a much higher chance of qualifying for an exemption. A system like this would obviously require major supervision and likely it’s own commitee but if it means improving injury recovery and keeping players on the field then it should by all means be considered.

One of the key reasons I’d like to see the MLB adopt a system similar to this is because of oblique injuries. In a study done on oblique injuries from the 2011 season to the 2015 season, 259 players at the major league level suffered oblique injuries resulting in 6,132 days missed. Batters/Position Players averaged 3 weeks missed per injury with over an 8% chance of re-injury. Starting Pitchers averaged nearly a month missed with a re-injury rate of around 5% and relievers averaged about 24 days missed with a re-injury rate of nearly 10%. The average days missed on recurrent oblique injuries is also higher compared to the days missed from the primary injury. These injuries are not a day to day type of injury and a statistical analysis of recovery methods shows that some players required injection of a corticosteroid, a legal steroid in Major League Baseball. However, administering the corticosteroid still didn’t speed up recovery process as it took players 30 days to recover post injection.

I think it’s quite interesting that players didn’t have any kind of improvement in recovery rates post injection from corticosteroids. So I decided to take a deeper dive into corticosteroids as a recovery method for sports injuries and stumbled upon a pretty informative article. The article “Recurrent hamstring muscle injury: applying the limited evidence in the professional football setting with a seven-point programme” by Peter Brukner, Andrew Nealon, Christopher Morgan, Darren Burgess, and Andrew Dunn discusses hamstring injuries among football players and the recovery methods used. They mention one player who used corticosteroids as a recovery method and here’s what they said “an epidural corticosteroid injection was performed…Postinjection the player reported a general improvement in his feeling of ‘freedom’ on the right side and felt able to swing his legs through fully…Five days later he started another pre-season game. After 5 min, he sprinted with the ball and crossed the ball with a whipping action and immediately felt some tightness in his hamstring, without an associated feeling of tearing or pain, and was thereafter unable to sprint with confidence.” Quite an interesting order of events as it seems that corticosteroids essentially mask the pain/ease symptoms but might not actually repair muscles.

Maybe corticosteroids may not in fact help with any kind of recovery, so let’s dive into the article “Taking Anabolic Steroids After a Sport Injury” by Samuel Mckenzie from the media outlet News Medical Life Sciences, which studies the effects of corticosteroids vs anabolic steroids in relation to muscle strains/contusion injuries. One specific experiment was conducted on rats who suffered muscle contusions and the results are quite informative. The article states “Initially, the corticosteroid group showed great improvements to twitch and tetanic strength, but later these improvement reversed and resulted in the degeneration of the muscle. The anabolic steroid group showed no initial improvements, but by 14 days showed significant improvements to twitch tetanic strength without the degeneration of the muscle. The authors concluded that that corticosteroids were helpful in the short-term but detrimental to long-term muscle repair and anabolic steroids could improve muscle repair and aid in the healing of muscle contusion injury.” If we know that corticosteroids don’t lead to long term healing and actually degrade our muscles, anabolic steroids need to be heavily considered for treatment. Baseball’s best players shouldn’t be off the field with injuries when we have proven remedies that are readily available to increase their recovery rates.

If we know one thing it’s that times are certainly going to forever change. With the changing of the times we learn from our pasts. I think Major League Baseball is far enough beyond the era of steroid abuse and the advances made in medicine, technology, and overall knowledge could make it so that we never see steroid abuse like we saw in the 1990’s and early 2000’s in Major League Baseball again. We’ve come to a time where we’ve essentially mastered the negatives of these banned substances so we’re probably smart enough to figure out a way in which only the positive effects are used in an appropriate manner.

References

“Epidemiology and Impact of Abdominal Oblique Injuries in Major and Minor League Baseball Christopher L. Camp,* MD, Stan Conte,†‡ PT, DPT, ATC, Steven B. Cohen,§ MD, Matthew Thompson,|| MD, John D’ Angelo,{ BS, Joseph T. Nguyen,# MPH,
and Joshua S. Dines,** MD. Retrieved March 29, 2023

“Major League Baseball’s Minor League Drug Prevention And Treatment Program.“. (2021). Retrieved March 29, 2023,

nn.“Recurrent Hamstring Muscle Injury: Applying the Limited Evidence in the Professional Football Setting with a Seven-Point Programme.” Brukner, Peter, Andrew Nealon, Christopher Morgan, Darren Burgess, and Andrew Du; British Journal of Sports Medicine. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine, June 1, 2014. .