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, literally, 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 1980s, 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 one 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 (Escilene 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 bodyparts 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 these “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 muscles 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, in their muscles. 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 injected 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 subcutaneous 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.
Editor’s note: Jerry Brainum has been an exercise and nutrition researcher and journalist for more than 25 years. He’s worked with pro bodybuilders as well as many Olympic and professional athletes. To get his new e-book, Natural Anabolics—Nutrients, Compounds and Supplements That Can Accelerate Muscle Growth Without Drugs, visit www.JerryBrainum.com. IM
1 Banke, I.J., et al. (2012). Irreversible muscle damage in bodybuilding due to long-term intramuscular oil injection.Int J Sports Med. In press.