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Cortisone Injections... Yay or Nay?

by Nancy Shura-Dervin

Injured runners sometimes want to know of getting cortisone injections will hasten their healing process. Cortisone aka a "steriod" is a potent anti-inflammatory medication. Most of you are familiar with topical cortisone creams and ointments that when applied to the skin, relieve minor skin eruptions/irritations. Cortisone is not a pain reliever but it may relieve pain by reducing the inflammation. For injuries deep under the skin, cortisone may be injected to relieve the inflammation associated with the injury.

Cortisone injections are often used for orthopedic injuries, particularly involving the joints but can also be injected into any soft tissue injury. Cortisone injections often produce rapid symptom relief however "relief" should not be confused with "healing". While symptom relief may be dramatic and quick, complete healing may involve weeks or months of time off of the activity that caused the injury. Runners who continue to train and race after cortisone injections often "re-injure" and face the very real possibility of even more rare but serious, possibly permanent injuries. Cortisone injections can actually cause maceration or loss of tissue integrity around the medication site. Likewise, cortisone injections are associated with increased incidence of tendon rupture among athletes who continue to train with tendon injuries treated with cortisone. Other rare but serious complications may be loss of bone tissue, joint infection, and nerve damage. Less serious but more frequent complications are infection, increased pain, and fat atrophy at the injection site (a very unwelcome result for runners treated form plantar fasciitis).

When it comes to cortisone injections, one should think of it as a band aid in that it will mask the symptoms however the most beneficial response to most "over use" running injuries is... REST!

Cortisone shots are banned by the World Anti-Doping Agency (WADA) unless an abbreviated therapeutic usage exception (TUE) is obtained prior to competition. This means that virtually all athletes training for and competing in sanctioned running and triathlon races world wide, who have received a corticostoid without obtaining TUE are cheating.

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