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Thread: Cortisone Shots

  1. #1
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    Default Cortisone Shots

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    Hi Coach,

    Just want your clarification/opinion on this. I have ongoing ac joint pain that just wont settle. We spoke about this on a different thread a year or so back. Just been told that I will likely be given a cortisone shot into the ac joint to try and settle the inflammation as nothing else seems too. NSAID work a bit but thats all. I said "but Rip says no" as this will damage surrounding tissue ( I also had one a year back into the subacrimoal bursa when they thought that was issue...did nothing) Med person said......"He's kinda right but only if you are injecting into a tendon, this will be into the space in the joint and so wont affect surrounding tissue and is completely safe". They also said the bursa one was safe too. Are they wrong or did I misunderstand? Are all cortisone shots bad regardless of where they go or only in certain circumstances?

    Thanks.

  2. #2
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    Why would it be safe in the joint space but not in the tendon? What does cortisone do, and how does it work?

  3. #3
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    Quote Originally Posted by mattjames View Post
    Hi Coach,

    Just want your clarification/opinion on this. I have ongoing ac joint pain that just wont settle. We spoke about this on a different thread a year or so back. Just been told that I will likely be given a cortisone shot into the ac joint to try and settle the inflammation as nothing else seems too. NSAID work a bit but thats all. I said "but Rip says no" as this will damage surrounding tissue ( I also had one a year back into the subacrimoal bursa when they thought that was issue...did nothing) Med person said......"He's kinda right but only if you are injecting into a tendon, this will be into the space in the joint and so wont affect surrounding tissue and is completely safe". They also said the bursa one was safe too. Are they wrong or did I misunderstand? Are all cortisone shots bad regardless of where they go or only in certain circumstances?

    Thanks.
    I can tell you that the press worked for me and for my kid. My shoulder burned like fire. Took nsaids. Pressed a broom stick, which I could not even press overhead, and went up from there. I never had the surgery or a shot.

  4. #4
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    Quote Originally Posted by Mark Rippetoe View Post
    Why would it be safe in the joint space but not in the tendon? What does cortisone do, and how does it work?
    I only know what I found on the net. Its an anti inflamatort and works by shutting down collagen production in the tendon cells. As a result, when you get a cortisone shot, your tendon tissue stops making new collagen ( not clear if this is permanant or temporary effect). Over time, repeated injections may weaken tendon tissue, and have even been known to cause tendon ruptures.

    The other bits also only mentioned tendons and make it sound like its only an issue if you have repeated shots in the same area. I am guessing from your reply that you disagree however.

    novicejay - I tried to press through it for some time but eventually it got so bad I was unable to move my arm due to the inflammation. I still press but now I have to take NSAIDS to settle it enough to do day today stuff.

  5. #5
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    How close is the joint space to the tendons? Does the cortisone somehow know to leave the adjacent tissue alone? See?

  6. #6
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    Quote Originally Posted by novicejay View Post
    I can tell you that the press worked for me and for my kid. My shoulder burned like fire. Took nsaids. Pressed a broom stick, which I could not even press overhead, and went up from there. I never had the surgery or a shot.
    I second this. I fell on my shoulder snowboarding 20 years prior to ever doing the press. After about a month of pressing I’d fixed what I thought was a lifelong injury as well as a more recent neck injury. You may want to chill on the bench, though, if that’s causing some flare ups. Just redo your LP on the bench in a few weeks if your shoulder starts feeling better.

  7. #7
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    Quote Originally Posted by Mark Rippetoe View Post
    How close is the joint space to the tendons? Does the cortisone somehow know to leave the adjacent tissue alone? See?
    Thanks coach. Its a fair point and about what I thought you'd say. I just wanted to check in case I had misunderstood something. Out of curiousity, is there any injury or pathology for which you would consider the shot acceptable? I am mostly at this point as a year of various therapy hasnt done anything to settle it and trying to train through it just isn't working. Docs dont want me to keep on using NSAID as only Naproxen touches the pain and they seem to dislike prescribing it.

  8. #8
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    Did you try Google? Use the word cortisone along with keywords like tendon, bursa or whatever. So in Google Search you'd enter- cortisone tendon
    This article is 10 years old but it's interesting and possibly relevant to you- Are Cortisone Shots for Tendon Injuries Worth It?
    And there's also Google Scholar if you want to find studies and research.

    I don't get asking a strength coach about medical advice.

  9. #9
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    Quote Originally Posted by mattjames View Post
    I have ongoing ac joint pain that just wont settle. ...
    Thanks.
    It will probably eventually settle, as you get stronger and add mass. Did for me. I still need to sometimes be a little careful, but I’ve added ~ 70lbs to my press since the original irritation.

  10. #10
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    Quote Originally Posted by mattjames View Post
    Thanks coach. Its a fair point and about what I thought you'd say. I just wanted to check in case I had misunderstood something. Out of curiousity, is there any injury or pathology for which you would consider the shot acceptable? I am mostly at this point as a year of various therapy hasnt done anything to settle it and trying to train through it just isn't working. Docs dont want me to keep on using NSAID as only Naproxen touches the pain and they seem to dislike prescribing it.
    What is the diagnosis?

    Quote Originally Posted by Uselesscamper View Post
    I don't get asking a strength coach about medical advice.
    Yeah, it's pretty stupid.

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