Doctors link gym supplement misuse to surge in Avascular Necrosis cases among Indians in their 20s
New Delhi: Leading orthopedic experts have issued a grave warning about a rising public health concern: the misuse of anabolic steroids and unregulated protein supplements is causing severe and often irreversible hip damage in India’s youth, particularly those in their 20s.
At the recently concluded Delhi Hip 360 conference held in the capital, specialists highlighted a sharp increase in cases of Avascular Necrosis (AVN) and early-onset hip degeneration—conditions traditionally seen in much older adults.
Dr. L Tomar, Organising Chairman of Delhi Hip 360 and Senior Director and Unit Head of Orthopaedics and Joint Replacement at Max Hospital, New Delhi, said, “We are observing a significant surge in hip-related complaints among young patients in recent years. Every week in my OPD, I see 2–3 patients under the age of 30—many in their early 20s—complaining of persistent hip pain. Investigations often reveal 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.”
Recent studies have echoed these findings, showing that alcohol, steroid abuse, and supplement misuse are key contributors to AVN in young adults. In a related move, the Maharashtra Food and Drug Administration (FDA) recently launched statewide inspections after several protein powder brands were found laced with performance-enhancing steroids. Many such products are sold online or in gyms without proper labeling or regulatory approval.
Experts at the conference noted that the femoral head—the upper part of the thigh bone—is particularly sensitive to changes in blood supply and often bears the brunt of misuse. “Steroids, especially when taken unsupervised, directly affect the blood supply to the bones,” said Dr. Rajiv Jain, Chief Coordinator of Delhi Hip 360. “The femoral head is the most vulnerable. It starts with pain, stiffness, and limping, and eventually leads to complete collapse of the joint. In such cases, total hip replacement is the only option.”
Avascular Necrosis is both painful and often irreversible if not diagnosed early. Doctors said that hip replacement surgeries—once rare among young patients—are now becoming increasingly common in urban areas.
Data shared at the conference revealed that over the past three years, more than 30% of AVN cases reported at tertiary care hospitals in Delhi involved patients under 35. Most of these patients had a history of steroid injections, oral steroid use, or supplement misuse.
“Fitness has become a booming industry in India, but it’s largely unregulated and misinformed,” said Dr. Sharad Agarwal, Scientific Chairman of the conference. “Young people are being misled into believing that muscle gain equals health. What they don’t realize is that behind that muscle, their bones may be silently deteriorating.”
Calling for urgent policy intervention, Dr. Agarwal added, “We need awareness drives, stringent regulation of the supplement market, and orthopedic screening at gyms. Fitness should not come at the cost of mobility. The youth of India must be guided to build strength responsibly—without breaking their hips.”
Doctors are now urging fitness trainers, influencers, and gym owners to take responsibility and educate clients about the risks of shortcuts like steroid cycles and unverified protein powders.
