Steroids, protein powders behind alarming rise in hip damage among urban youth, warn experts

Indian Express

15-05-2025

A group of orthopaedic experts have raised a serious public health concern, stating that the misuse of steroids and unregulated protein powders is severely damaging the hips of young gym-going individuals in their 20s.
This warning came during the 'Delhi Hip 360' conference held in the national capital, where orthopaedic specialists highlighted the alarming rise in cases of Avascular Necrosis (AVN) and early hip degeneration in youth, conditions traditionally seen in older adults.
Dr L Tomar, the organising chairman of the conference, said, 'We are observing a significant surge in hip-related complaints among young patients in recent years. Every week in my OPD, I see two to three patients under the age of 30, many in their early 20s, complaining of persistent hip pain.' 'Investigations often reveal Avascular Necrosis (AVN), a condition where blood supply to the hip bone is compromised, leading to bone death. In over 70% of these cases, there is a history of anabolic steroid use or excessive consumption of unverified protein powders,' said Dr Tomar, who is the unit head of orthopaedics and joint replacement at Max Hospital, Delhi.
Recent studies have indicated a rise in hip issues among youth and how alcohol and steroid use were key contributors to AVN among young adults, he said.
More recently, the Maharashtra FDA launched statewide checks on protein powders after several brands were found to be spiked with performance-enhancing steroids, many of which are freely available online or at gyms without proper labelling or approvals.
Youth, especially those chasing rapid physical transformation, are unknowingly damaging their bone health, particularly the femoral head of the hip joint, which is uniquely sensitive to blood flow changes, Dr Tomar pointed out.
There is a thriving underground online market for performance-enhancing drugs and muscle-building supplements in India.
Dr Rajiv Jain, senior orthopaedic surgeon, said that steroids, especially when misused or consumed unsupervised, directly impact the blood supply to the bones.
'It (AVN) begins with pain, stiffness, and limping and in many cases, leads to complete collapse of the hip joint. Hip replacements are required for patients whose condition can be treated using medications,' Dr Jain stated.
The condition, AVN, is not only painful but also often irreversible if not diagnosed early. In extreme cases, the only treatment is total hip replacement, a complex procedure typically meant for older patients. Orthopaedic experts say this is becoming disturbingly common in India's urban youth.
Another observation presented by orthopaedic researchers at the conference revealed that over 30 per cent of AVN cases seen in Delhi's tertiary hospitals over the past three years involved patients under 35, and most had a history of either steroid injection, oral steroid abuse or supplement misuse.
Dr Sharad Agarwal, scientific chairman of the conference and senior orthopaedic surgeon, said that fitness has become a booming industry in India, but without proper regulation and education.
'What they don't realise is that behind that muscle, their bones might be silently deteriorating. We urgently need awareness drives, regulation of supplement markets, and basic orthopaedic screening at gyms,' Dr Agarwal said.
Doctors have urged fitness trainers, influencers and gym owners to educate their clients about the risks of shortcuts like steroid cycles and unverified protein supplements.