T Nation

Cortisone Shot

Has anyone gotten a cortisone shot for a tendon injury? How did it work out and did you do physical therapy right away or did you wait?

Did what the dr. said. Didn’t have the attitude that I knew more, or wanted a different answer. Otherwise, I would have went to a chiroquaker. Recently been through that, don’t let the emotional letdown of reducing working out cloud reasoning.

Thank you, quest, for the single most useless bit of advice ever posted on the training forum.

Specster- Read the article here: (delete space in link)

www.testosterone.net/ html/body_108blood.html

There’s some good info there under the heading “Cortisone Injections: Just Say No”

Thanks Tek, these Drs. never cease to amaze me. This guy was suppose to be an Expert. Didn’t listen to a thing I was saying - to busy blowing smoke up his own ass. Anyway, thanks for the cite.

Well excuse me, Dr. tek. State your credentials.

I got one two years ago after I tore my ACL. To tell you the truth my knee felt like a million bucks, I actually told my football coach that I could play, not that he believed me, but it felt that strong again. I got my shot two weeks into pre-surgery PT, and did two more weeks before the actual surgery.

I read your original post and TEK has a clear point. I’ve tried to read it over and over again and I just don’t understand what you are saying. It made no sense and one does not need credentials to see that.

I had a cortisone shot in my wrist for tendinitis. It didnt do shit. www.activerelease.com

My impression of cortisone injections (based on a lot of reading, not personal experience), is that they make you feel better so you can go out and do more damage. I think if I were in line to get the shot, I’d say no.

I got three. Two in my knee and one in my shoulder. The two in my knee did nothing, but it turned out I had chondromalagia, which is the wearing away of bone, on my patella. So it shouldn’t have done anything. The one in my shoulder did wonders. I had mild tendinitis, and I minor sprain in my rotators. I took a week off, and after the shot, it felt 90% better.

I had one, it makes you feel better, but it’s not meant to be a long term solution. It relieves some of the symptoms, but in the end if you’ve got a nagging injury you have to rest it and take care of it, possibly get further care. How was this doctor an “expert”, anyways? Did you go to your general practicioner? Did you go to a surgeon, a sports specialist, an osteopath, a radiologist, an herbal healer? I’ve found that if you want the “right” answer to your questions, you have to go to the “right people”. In my experience a general practicioner will help you with the pain and tell you to rest it, which is a pretty damn good remedy for most minor injuries, but one which some people are disinclined to take.

I have tendonitis in my left elbow. I had the shot. I did do what the doctor said, I don’t claim to know more than the doctor. Do you all claim to know more than the dr.? It is not that you DON’T understand, but rather that you “choose not to understand”. Get it now? I choose “Testosterone” as one of many good sources available for weightlifting and fitness information. You guys act like “Testosterone” is the one-and-only, and the final authority. Sorry, not the case. Yes, I scheduled the physical therapy according to the dr’s orders. I hope that clears it up. WWJD–Maranatha.

How Cortisone works.
Many of the symptoms of skin disease result from inflammation in tissues of the body. Cortisone, manufactured naturally by the body’s adrenal glands and also made synthetically, has been found to have a marked anti-inflammatory effect. Cortisone and its derivatives are steroids, among the most effective anti-inflammatory drugs known. Their use can substantially reduce the swelling, warmth, tenderness and pain that are associated with inflammation.

While steroid dosage should be kept at the lowest effective level, steroids must not be stopped suddenly if they have been taken for more than four weeks. By this time, some shrinking of the adrenal glands will occur, as their burden of producing cortisone has been relieved. If illness or injury follows, the glands may not be able to produce enough cortisone to keep one from going into shock. A slow reduction in the dosage of steroids allows the adrenal glands to regain their ability to manufacture natural cortisone.

Steroids may be given as a pill, by intra-muscular (IM) injection or may be injected directly into the skin. In very severe rashes and in cases where excessive cortisone ointment use has caused skin thinning, the skin may be “put to rest” with a single shot (or a short series of usually three shots) of cortisone (triamcinolone) in the hip or thigh. This may disturb menstrual cycles, and can cause elevated blood pressure to rise or diabetic control to worsen. These effects are very rare with an occasional shot.

Prednisone is the oral tablet form of steroid most often used. Less than 7.5 mg per day is generally considered a low dose; up to 40 mg daily is a moderate dose; and more than 40-mg daily is a high dose. Occasionally, very large doses of steroids may be given for a short period of time. This treatment referred to as “pulse steroid treatment,” involves giving 1000 mg of methyl-prednisone intravenously each day for three days.

Prednisone is an extremely effective drug and may be necessary for control. Although many patients do not need to stay on steroids continuously, those with severe disease may require long-term steroid treatment.

With long-term use, some of the more common side effects of steroids include changes in appearance, such as acne, development of a round or moon-shaped face and an increased appetite leading to eight gain. Steroids may also cause a redistribution of fat, leading to a swollen face and abdomen, but thin arms and legs. In some cases, the skin becomes more fragile, which leads to easy bruising. These take weeks to begin appearing.

Psychological side effects of steroids include irritability, agitation, euphoria or depression. Insomnia can also be a side effect. These changes in appearance and mood are often more apparent with high doses of steroids, and may begin within days. Injected triamcinalone (see above), or oral dexamethasone seem to cause these changes less, but they stay in the body an undesirably long time, rendering them second choices.

An increase in susceptibility to infections may occur with very high doses of steroids. Prednisone may also aggravate diabetes, glaucoma, and high blood pressure, and often increases cholesterol and triglyceride levels in the blood. In children, steroids can suppress growth. These effects are reversed once the steroids are stopped.

Other side effects that may be caused by the long-term use of steroids include cataracts, muscle weakness, avascular necrosis of bone and osteoporosis. These usually do not occur with less than four weeks of treatment.

Avascular necrosis of bone, usually associated with high doses of prednisone over long periods of time, produces hip pain and an abnormal MRI scan. It occurs most often in the hip, but it can also affect the shoulders, knees and other joints. Caught early, the joint can be saved by “decompression” by an orthopedic surgeon. Once full developed, avascular necrosis is painful and often requires surgical joint replacement for pain relief.

Steroids reduce calcium absorption through the gastrointestinal tract that may result in osteoporosis, or thinning of the bones. Osteoporosis can lead to bone fractures, especially compression fractures of the vertebrae, causing severe back pain. Calcium, at least 1500 mg of the calcium carbonate form or equivalent, should be taken. There are new medications (Fosamax in particular) that also may help to prevent osteoporosis.

There is also a relationship between steroids and premature arteriosclerosis, which is a narrowing of the blood vessels by fat (cholesterol) deposits. In general, there is a close relationship between the side effects of steroids and the dose and duration of their use. Thus, a high dose of steroids given over a long period of time is more likely to cause side effects than a lower dosage given over a shorter period of time.

I got one for tendonitis in my right wrist extensor tendon. It felt great for 5 or 6 weeks. I didn’t work it hard for the first two weeks and gradually increased the workload after that. It started coming back after pruning a tree. Those angles on the wrist and the sawing really got it pissed off. I went to go see an ART guy then. He’s working on it now. Two treatments so far and it feels better. He thinks it might take about 4 more but you never know. Cortisone is great for a one time quick fix if you don’t plan on ever using the body part again. It reduces pain and inflamation but slows tendon healing, which is slow enough already.

That was very interesting. In high school I hurt my knee, and got a cortisone shot every Monday for eight straight weeks (my dad was my coach). After the playoffs I had surgery (lateral release) and ended up with a staph infection. I’m allergic to penicillan and vancomycin (sp?) and came with a couple of days of having my leg amputated six inches above the knee. About 13 hours before the amputation my white blood cell count started to drop. It sounds like the cortisone maybe played a role in the infection.

Redman and others,

This Dr. was refered to me by my primary care Dr. who said he was and expert and the best in the area (Boston, which is rife with Drs.). He “squeezed” me in (a 1 week wait to see him). I arrived, he had 8 people waiting to see him. He saw them all within 1 hr.
I told him I have had sholder soreness for years and it only hurts when I exercise. I had 3 tramatic events on the sholder doing jui jitsu and the 3rd I had to go to an emergency room after. When I move the arm over my head it sounds like I am pouring milk of rice crispys.
He moved my arm through the range of motion for less than 90 seconds and said I should have a cortisone shot - that it was tendonitis. I disagreed and said I had tried many different treatments - PT, layoff periods, chondroitin, anti inflamtaries - to no avail.
In the end I opted for the shot, which he said could “cure” me. If the pain persists I am suppose to call him in 3 weeks for an MRI. I have been dealing with this with what now seems like forever. It is screwing up me training big time. I want to get it over with ASAP.

Hey specster…looks like it’s been a while since your post and I was wondering how it all turned out. I just got a cortisone injection in my shoulder yesterday, and I’m wondering what to expect. I went to different orthopedists, and they both recommended the cortisone. The first guy came at me with the needle aiming for the wrong shoulder, hence the second doctor!

Seems to be working for now…wondering if it’ll come back though.