July 2019 musculardevelopment.com MD 27Judging by the reluctance of strength
athletes to consult with doctors, these
requisites for compassionate and
knowledgeable medical care are seen by
them as lacking in too many physicians.
The disconnect is even greater when these
athletes have chosen to use steroids. A
still too large number of physicians have,
because of their lack of knowledge and/
or their perceived personal bias against
strength athletes, become untrusted by this
population. As a result, though more than half
of all strength athletes say they would like
to see physicians for issues related to their
sport, they are reluctant to do so. The majority
report that even when they are experiencing
symptoms, they avoid doctors whom they
consider at best unknowledgeable and at
worst judgmental (Cohen et al., 2007). Thus, it
would appear that unconditional acceptance
of strength athletes by physicians is perceived
as more the exception than the rule—
especially when steroids use is suspected.
But even when use is not an issue, ty pical
encounters are oft en described as having
judgmental overtones, with the strength
athlete seen as someone who has harmed
himself unnecessarily. Additionally, concerns
on the part of either physician or patient
regarding the confi dentiality of the medical
encounter can negatively aff ect the strength
athlete’s medical care. For example, when
the use of illegal substances is suspected or
actual, critical patient data related to anabolic-
androgenic steroids (AAS) may not be sought
(by physician) or made available (by athlete).
It should be clearly understood by both
physician and patient that the law protects
the confi dentiality of their medical encounter
in the same way it does any patient’s.
The suff ering of someone who has gone to
extraordinary lengths to become strong, and
whose appearance indicates extraordinary
strength, may not elicit the sympathy that
other patients bring forth, but a physician
is not called to be sympathetic; he or she
must maintain unconditional empathic and
professional regard for all patients. It is
concerning to hear or read about physicians
who have reacted to these patients’ requests
for help with some version of “It’s your own
fault” regarding their symptoms, or their
AAS dependency (Yua et al., 2015). Only two
years ago, a major medical journal published
an article in which a physician reported
recommending what amounted to going
cold turkey, a “just say no” approach, when
a patient who was suff ering in withdrawal
asked for help to end his use of AAS. This
is totally unacceptable when there are safe,
eff ective weaning protocols available to
support cessation. It is clear that both the
knowledge gap and the weak dissemination
of available knowledge have been signifi cant
obstacles to appropriate medical care for
strength athletes.
Beyond the obvious professional disservice
when a patient is stigmatized in the clinicalsett ing, a poor fi t between doctors and
strength athletes may also have contributed
to missed opportunities to investigate the
many health issues related to this sport.
Additionally, encounters between physicians
and strength athletes present valuable
opportunities to investigate in vivo the
mechanisms of action and the potentials and
limits of human strength, and how they can
be enhanced. Such learning from our strength
athletes’ experiences would benefi t other
populations whose full participation in society
may be compromised by their mobility and
strength limitations due to muscle wasting
diseases and even the aging process itself,
for example. The enthusiasm and support of
a number of medical colleagues who have
indicated interest in learning more about
treating the strength athlete validates again
for me why I have chosen this profession
(Dobs, 1999). As I close this article, I realize
that the knowledge and care of the strength
athlete is not simply “hardcore” medicine; it is
at the core of medicine itself.Stay Strong and Healthy,
Dr. OReferences:
Cohen J et al. A league of their own. J Int Soc Sports
Nutr 2007; 4:12.
Dobs AS. Is there a role for androgenic anabolic steroids in
medical practice? JAMA, Apr 14, 1999, 281(14):1326-1327.
Yua J et al. Healthcare professionals’ stigmatization of men
with anabolic androgenic steroid use and eating disorders,
ScienceDirect, June 2015.Learning from strength athletes’ experiences would
benefi t other populations whose full participation in
society may be compromised by their mobility and
strength limitations due to muscle wasting diseases
and even the aging process itself.