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Cortisone Injections for Runners: Is It Safe?

Cortisone Injections for Runners: Is It Safe?

September 29, 2016 by Steve Gonser PT, DPT Prevention
cortisone, injections, runners
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You’ve gotten yourself to this point. Convinced your running-life is going to sink, you begin grasping for a life boat. Instead of assessing the situation, taking a moment, and determining if the ship is really sinking, you make the desperate decision to climb in.

You lower yourself into the water thinking you made the right decision, only to find yourself staring at the ass end of the mother ship as it sails off. In your panic you failed to realize that the threat was minimal. You rushed your decision making.

Desperate times cause for hastily decisions. Add a runner who sees their running season going up in flames and you have a serious recipe for disaster.

This article comes with frustration as I’ve seen a small but noticeable uptick in runners who just lost the next year of running (or longer). It’s nearly 100% avoidable, too. The big race is around the corner and they head off to a clinician to consult about their injury (usually a foot).

Before you know it, you’re sitting back gripping the table as a pointy syringe full of clear liquid is weaseling it’s way into the location of your pain. “Take it easy for a day or two,” the doc says in a loosely guided treatment plan, “then you can go back to normal activity.”

It happens quickly–both your return to running and the next step, which will dictate the next year of your running.

“POP and down goes Frazier.”

What seemingly felt like a gunshot has left you on the ground. You, my friend, have ruptured a tendon. The next few days will result in a surgery, while the next year (or longer) will be spent working your way back to running.

That seemingly small shot the doc sent to epicenter of your pain can pack a huge punch. Filled with corticosteroid, a potent anti-inflammatory drug, the injection eats away at your inflammation. Unfortunately, it doesn’t stop there. Your chronic, mashed up tendon wasn’t spared. The steroid injection has a strict scorch earth policy. It crushes both bad and good things alike. Corticosteroid injections drastically reduce inflammation at a cellular level by inhibiting the formation of new connective tissue, repair of collagen (a structural protein), amongst other critical pieces of tissue healing and repair.

Envision your chronic tendon injury as a frayed rope. A cortisone injection can not only have an affect at softening your frayed rope, but also can remove pain. Pain is super important because it can prevent you from further unraveling your tendon until…

You have ruptured a tendon.

The whole thing is preventable, especially if you understand the risk / reward of receiving an injection. You should work with your physician to understand the safety of receiving an injection–specifically for your injury. Much of the research advises against cortisone injections in and around tendons.

Instead of grabbing for the lifeboat, take time to properly fix and rehab your injuries. You need to 100% understand the risk:reward of receiving an injection at your injury site. Some sites are far safer than others.

NOTE: Steroid injections are deemed safe in some instances, but should always it’s always best to ask questions and discuss the risks with your physician.

You can find more on injections and their use in the treatment of athletic injuries by clicking here.

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Steve Gonser PT, DPT
Steve Gonser PT, DPT

Steve Gonser graduated with his Doctorate in Physical Therapy from Daemen College, instantly applying his knowledge of human movement and functional anatomy to his passion for running. Steve is a 2x Ironman, including a 10:41 finish in Lake Placid and a Sub-3 hour marathoner.

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