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C h a p t e r 8 Performance Enhancing Drugs Anabolic-Androgenic Steroids Anabolic-androgenic steroid use in athletes has been documented since the 1950’s and the effects on muscle building and performance are well known to athletes and body builders. Anabolic-androgenic steroids (AAS) are a classic performance-enhancing drug and have almost no legitimate therapeutic indications in athletes. In sport they are used almost exclusively to gain a competitive advantage. Although often called “steroids” or “anabolic steroids”, they should properly be referred to as “anabolic-androgenic steroids” because they are testosterone or testosterone-like synthetic drugs that result in both anabolic (increased muscle mass) and androgenic (develops male secondary sex characteristics) effects. Although athletes use AAS for their anabolic results, all AAS have varying amount of androgenic effects that are responsible for most of their adverse reactions. The result is that athletes who take AAS for their anabolic properties, to increase lean body mass or strength, cannot avoid the undesired and often harmful androgenic properties of AAS use. Finally, it is important to distinguish AAS from anti-inflammatory steroids that are called corticosteroids or cortisone. Corticosteroids are legitimately used to treat asthma and other medical conditions, as well as in the form of joint injections to treat inflammation. AAS can be divided into two categories: exogenous and endogenous steroids. Endogenous AAS are those that are naturally produced by the body in some amounts and can be made into drugs and consumed by athletes. The most commonly used endogenous AAS is testosterone that is made by the testes and is necessary for normal male function. Although it cannot be taken in pill form, testosterone can be injected into a muscle, absorbed through the skin by a patch or gel, or across the lining of the cheek in the form of a pellet. Studies have demonstrated that injections of testosterone in high doses can increase muscle mass. The other types of AAS are the exogenous or synthetic drugs. These are not produced by the body and are altered in the laboratory to change how a drug behaves in the body. For example, adding certain side chains to testosterone allows the drug to be absorbed orally. Other additions increase the potency of the drug or attempt to decrease side effects. The past few years has seen the appearance of “designer” AAS that were specifically developed to avoid detection by drug testing. Some of these are tetrahydragestrinone (THG), norbolethone and madol (DMT). The 1990 United States Anabolic Steroids Control Act classified AAS as a Schedule III drug and limited the legitimate therapeutic reasons for using them. Due to the 224
C h a p t e r 8 Performance Enhancing Drugs increased availability of newer AAS, the 2004 Anabolic Steroid Control Act was passed and this increased the number of AAS that were considered Schedule III drugs and tightened the definition of AAS. Included in the 2004 Act were THG and norbolethone, as well as many former dietary supplements that include androstenedione, androstenediol and 19-norandrostenedione. As of this time, DHEA is still considered to be a dietary supplement and can be sold over-the-counter. While there is no debate on the fact that large doses of AAS can increase muscle mass, the effects on actual performance are less clear. In many sports, performance is difficult to measure as it is influenced by factors other than strength alone. Despite the widespread use of anabolic steroids in athletes, there is little data to support its effects on performance. Studies have been limited to obvious targets such as weight lifting and measuring acceleration in sprinters. In addition to strength changes, there are additional AAS effects that may contribute to efficacy in athletes. Many have attributed AAS strength gains to increases in aggressiveness that encourages intensity in both training and competition. Although there are AAS receptors in brain tissue, it is unclear as to their role. Regardless of the actual mechanism, it is clear that athletes believe that AAS improve performance and have continued to use them. Any discussion of the adverse effects associated with AAS are complicated by the fact that scientific studies use doses of AAS far below what has been reported by athletes. As a result, it is likely that medical studies underestimate the full extent of side effects from AAS use. These studies do not begin to approximate the doses used by athletes that may be 10-40 times the therapeutic dose and in multiple combinations. AAS affect virtually every organ in the body and their effects can be divided into organ system effects, psychological effects, sex-specific effects and potential effects on immature individuals. The two systems that have been most studied are the cardiovascular and gastrointestinal systems. AAS affect the cardiovascular system by increasing total cholesterol, LDL (bad) cholesterol and blood pressure, while lowering HDL (good) cholesterol. When these are combined with the potential clotting effects of AAS, the risk of coronary artery disease dramatically increases and the possibility of heart attacks. Indeed, there are multiple reports of relatively young AAS users suffering heart attacks. There have also been reports of AAS-induced cardiomyopathy (heart enlargement) following continued use of very high doses of these drugs. 225
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LA84 FOUNDATION SOCCER COACHING MAN
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T a b l e o f Co n t e n t s Soccer
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C h a p t e r 1 A Philosophy for Co
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C h a p t e r 2 Managing a Soccer P
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C h a p t e r 3 Methods of Soccer T
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C h a p t e r 4 Teaching Soccer Tec
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C h a p t e r 5 Teaching Soccer Str
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