Revista de Medicina Desportiva (English) July 2018 - Page 12

surgical wound is expected to be healed and the edema is decresead 6 . During the second and third weeks, the passive and active-assisted flexion and extension of the elbow is initiated 6 (limit of 30° extension for 6-8 weeks). 8 After the 8 th week there should be gradual progression to more intense activities and only between the 3 rd and 5 th month the return to really heavy activities are allowed (according to the progres- sion of the rehabilitation). 6 It is wise to mention that the diagnosis of AAS consumption is not always easy, requiring clinical suspi- cion. It is important that the doctor is aware of the alarm signals that may indicate the use of steroids 1,5 , notably: muscular hypertrophy with weight gain, changes of the behavior, acne, signs of feminization in man and virilization in women, increased blood pressure unexplained and analytical changes. 1,5 Surveillance medical visits can be useful to find out the complete list of medications, the free-selling products and nutri- tional supplements that patients may be taking and, finally, to edu- cate them about the risks involved, highlighting the Importance of good nutrition and practices of physical exercise without the consumption of AAS. 1 Figure 5 – The X-ray after surgery for control 10 july 2018 www.revdesportiva.pt Conclusions Bibliography The avulsion (or rupture) of the distal biceps tendon occurs in the during an unexpected extension force applied while the muscle is under contraction, where a weak- ened and degenerated tendon exists (due decrease vascularization, local impingement and/or continued ongoing medication consumption) or by a violent blunt trauma applied to a flexed limb. The clinical history and the physical examination are usually enough to have a correct diagnosis. Early surgical repair is essential to return to daily life activi- ties without deficits or pain, and it is associated with a high rate of thera- peutic success on the short, medium and long term. Finally, the consumption of AAS and other ergogenic supplements is also a troubling reality. Due to the current facility to obtain, to the mis- leading advertising and to the lack of information about the side effects, its consumption is becoming more frequent. In this way, it is important for health professionals to be sensi- tized to this problem and to quickly recognize the main indicators of abuse in order to be able to intervene quickly in the prevention and treat- ment of possible complications. 1. Rocha, M.; Aguiar, F.; Ramos, H. O uso de esteroides androgénicos anabolizantes e outros suplementos ergogénicos – uma epidemia silen- ciosa. Rev Port Endocrinol Diabetes Metab, 2014; 9(2):98-10. 2. Hartgens, F.; Kuipers, H. Effects of Androge- nic-Anabolic Steroids in Athletes. Sports Med, 2004; 34(8):513-554. 3. Achar, S.; Rostamian, A.; Narayan, SM. Car- diac and Metabolic Effects of Anabolic-Andro- genic Steroid Abuse on Lipids, Blood Pressure, Left Ventricular Dimensions, and Rhythm. Am J Cardiol, 2010; 106(6):893-901. 4. Autoridade Antidopagem de Portugal. Luta contra Dopagem no Desporto – Dados Estatísticos de 2014. Disponível em: http:// www.adop.pt 5. Casavant, Marcel J. et al. Consequences of Use of Anabolic Androgenic Steroids. Pediatr Clin N Am, 2007; 54:677-690. 6. Sutton, K.M. et al. Surgical Treatment of Distal Biceps Rupture. J Am Acad Orthop Surg, 2010; 18:139-148. 7. Ward, J.P.; et al. Ruptures of the Distal Biceps Tendon. Bulletin of the Hospital for Joint Disea- ses, 2014; 72(1):110-9. 8. Ramsey, M.L. Distal Biceps Tendon Injuries: Diagnosis and Management. J Am Acad Orthop Surg, 1999; 7:199-207. 9. Ryan, M.; Florian, E.; Peter, J. Distal Biceps Tendon Injuries: Current Concept Reviews. J Bone Joint Surg Am, 2010; 92:2128-2138 10. King, J ; Bollier, M. Repair of Distal Biceps Tendon Ruptures Using the EndoButton. J Am Acad Orthop Surg, 2008; 16:490-494.