The primary purpose of using anabolic drugs, such as testosterone,
steroids and growth hormone, is to trigger added muscle beyond what is
attainable naturally with training and diet. Of course, athletes who use
anabolic drugs also train intensely and go on diets to change body
composition, frequently to lose fat. Using anabolic drugs under dieting
conditions, where calories are often cut back severely, can spare muscle
that might otherwise be broken down; however, the drugs also promote
muscularity that is beyond genetic limits. The situation is clearly
apparent when athletes get off the drugs. Their newly acquired muscle
bulk often seems to melt away with each passing week.
For some athletes the added size they get with drug use isn't enough.
Because of fierce competition, they want to dwarf their competitors, so
they resort to techniques that temporarily--or not so
temporarily---boost muscle size beyond even what can be produced with
any drug. The genesis of "local site enhancement," as it's known,
probably began in the early 1980's, when some bodybuilders began
injecting themselves with a mediocre anabolic steroid drug called
Esiclene, generic name formebolone. Compared to other anabolic steroids,
Esiclene didn't produce the often dramatic size effects, but it did
have one property that made it attractive to competitors. It tended to
produce a localized inflammation of muscle that lasted about a week.
Experience soon showed that Esiclene use was best for smaller muscle
groups, such as the biceps, deltoids, and particularly the calves. The
localized inflammation induced by Esiclene often boosted muscle size by 1
to 1 1/2 inches after a few days. In larger muscle areas, such as the
chest, back, and legs, however, it tended to produce a lumpy effect
that looked like tumors. It was also said to make the muscle look
harder. Likely many contests have been won by competitors who gained a
last-minute edge by using Esiclene.
Esiclene became increasingly hard to get over the years, however, and is
no longer made or sold at all, even on the black market. The notion of
producing overnight gains in mass was for many too attractive to pass up, and so, in the early '90s German bodybuilder
Chris Clark devised a concoction that he called "Pump & Pose." It
was often advertised as a "posing oil," but its real purpose was to act
just like Esiclene, boosting muscle mass quickly. The more common name
was Synthol, and it consisted of 85 percent oil, usually medium-chain
triglycerides; 7.5 percent lidocaine, a local anesthetic, to blunt the
pain of injection (Esiclene also contained lidocaine for the same
reason); and 7.5 percent alcohol to keep the solution sterile. The
notion of injecting oil into the body for cosmetic purposes wasn't new.
Back in 1899 some folks were injecting paraffin, a type of oil, into
body parts that appeared deformed. Oddly enough, it soon became apparent
that many of those who used Synthol produced deformities.
Since the development of Pump & Pose, a number of other brands have
been introduced, including Syntherol, Esik Clean, Nuclear Nutrition Site
Enhancement oil, Cosmostan and Liquid Muscle. They all are expensive,
so many resort to using sterilized sesame or walnut oil injected
directly into muscle. In reality, many injectable anabolic steroid drugs
contain sesame oil as an injection vehicle.
The idea behind the "site enhancers" involves stretching the
connective-tissue sheath that surrounds muscle tissue. This fascia, as
it is called, is thought to be a major impediment to maximum muscle
growth, so stretching by regular injections of oil would "make room" for
additional muscle growth. The typical application protocols involve
frequent injections of one to two milliliters daily in various locations
within the target muscle for either several weeks or up to six months
or more. Injecting into distinct areas of muscle and then massaging the
areas afterward are thought to produce a more natural look and prevent
the development of scar tissue. The body tends to produce scar tissue
around anything that is put into it that it views as foreign. That
includes breast implants. Popular areas for injection include triceps,
biceps, delts and calves.
In truth, it's often painfully obvious when athletes have used Synthol
or other oil injections in a bodybuilding contest because they have
unnatural-appearing lumps on their muscles. When the calves are
involved, it's comically obvious. More insidious is the possible damage
to long-term health that can come from oil-based site injections. While
30 percent of the oil is immediately metabolized, most of it forms cysts
in muscle that can last three to five years or longer. That makes the
oil injections far different from Escilene, which produced a local
inflammation that lasted only a few days.
Injecting oil directly into muscle can produce some serious side
effects, which include a pulmonary embolism if the fat injection is
wrongly injected directly into a blood vessel. The fat becomes an
embolism and travels in the blood to the lungs. One elite pro
bodybuilder nearly died a few years ago after his girlfriend injected
him with Synthol and mistakenly shot it directly into a blood vessel.
Luckily, he survived. Other possible side effects of Synthol include
nerve damage if it's injected into a nerve, infections and strokes. A
few published case studies of bodybuilders who have used Synthol have
documented oil-filled granulomas, or nodules. Others have shown ulcers
and cysts. Some who may be allergic to sesame oil get an allergic
reaction involving an inflammation of blood vessels. Overenthusiastic
use frequently results in a muscle appearing droopy or deformed.
Not many cases of problems involving site-enhancement injections have
been published in the medical literature. Those that have often involve
injection of straight oil, such as sesame or walnut oil, and subsequent
infection and formation of oil and fat cysts. By far the most serious
case of problems experienced after an oil injection was published
recently.1
A 40-year-old man described as a "semiprofessional bodybuilder" showed
up at a hospital complaining of multiple painful swellings, redness and
elevated temperature in his right upper arm that had begun two months
earlier. The swelling had increased over time. He felt so sick that he
hadn't trained in more than two months. A previous medical exam had left
him with the incorrect diagnosis of "ruptured muscle fibers." The
doctors told him to rest and take anti-inflammatory drugs, which didn't
help. The man had injected himself with sesame oil for eight years,
until four months before his trip to the hospital. He'd inject two
milliliters of sesame oil at 20 intramuscular locations, which resulted
in an upper arm measuring 27 1/2 inches!
An MRI revealed more than 100 intramuscular and sub-cutaneous cysts of
up to seven millimeters each, with no sign of obvious infection in his
left upper arm, both shoulders, both legs and chest.
Those happened to be the most frequently used areas of his site
injections over the years. His right brachialis showed that the muscle
mass was completely obliterated, replaced by oil cysts. The entire right
biceps and the long and lateral heads of his triceps had been replaced
by scar tissue, and the tissue was vastly swollen. The only muscle left
in his arm was the medial head of the triceps, and that also contained
oil cysts and scar tissue. Since he appeared to have an infection in his
arm, he underwent surgery to remove the infected tissue. Sure enough,
his muscle was infiltrated with pockets of pus and abscesses. When the
oil he used was analyzed, it showed no traces of bacteria or fungi. His
muscle loss was so extensive that it was considered irreversible.
A year later the bodybuilder was still suffering pain great enough to
prevent him from training. Interestingly, the loss of muscle was most
extensive in the areas he had either not injected or had injected
lightly. Still, he had lost no size on his arms since the surgery. After
three years he continued to suffer from pain and weakness but did some
training. More than 90 percent of his upper-arm muscle had been replaced
by oil cysts and scar tissue. The ongoing inflammation in his arm may
have set him up for future cancer, as cancer is associated with chronic
inflammation.
In his effort to attain superhuman muscle size, this bodybuilder
literally destroyed his muscles, and the effect was not reversible. It's
obvious that the notion of injecting oil into muscle is just idiotic,
and those who do so may pay dearly for it.
1 Banke,I.J., et al. (2012) Irreversib le muscle damage in bodybuilding due to long-term intramuscular oil injection.
Int J Sports Med. In press.
