As runners prepare for the London marathon 2019, and time ticks away, we are seeing an increasing number of patients asking us about the potential use of pain relieving injections so that they are able to continue with their London Marathon training. Many of our clients have already explored different avenues to relieve pain and inflammation connected with training or frequent exercise.
For example, physiotherapy can often work very quickly depending on the injury and we highly recommend physio to all our physically active clients before exploring steroid injections.
As you are about to take on one of the biggest challenges London can offer, we address some of the key questions which revolve around steroid injections and the pro’s and con’s this treatment can bring.
Q: How long have you had this injury?
A: If this is a repetitive injury which seems to taunt your long distance running capability, then try physio. The likelihood is you can correct your gait with a good physiotherapist which will help minimise the risk of further injury.
Opting for cortisone is a short term solution for a short term problem! (when it comes to sports injuries anyway).
Q: How long before the marathon should I have my steroid injections?
A: Steroid injections typically take 3-5 days to start working and after a steroid injection we advise people to avoid heavy exercise and training for approximately 1-2 weeks. Therefore once an injection has started to work it will typically last for around 2 months. Therefore with just a few weeks to go, if you are experiencing pain relating to your marathon training, the advice would be to have the steroid injection a minimum of 3-4 weeks before the event and ideally sooner than that so you can safely return to your training for a few weeks before the marathon event.
Q: How long do steroid injections last for?
A: Steroid injections typically give pain relief for around 2 months, therefore if you have an injection at this stage it should see you through until after the London Marathon.
Q: Is it safe for me to have an injection whilst I am training for the marathon?
A: We will discuss with you injections which may not be advisable whilst training for a marathon. We do not usually recommend injecting around a weight bearing tendon such as an Achilles tendon or a patella tendon (or any other load bearing structure) whilst you are undertaking high volumes of training or impact related sport. If you have any further questions relating to this please do not hesitate to contact us.
Q: Are there any injections I could have to avoid the use of steroids?
A: We offer Hyaluronic Acid injections as an alternative to Corticosteroid. These take around 2 weeks to work and although they are not used for severe levels of pain they can be very useful if you have low grade pain within a weight bearing joint such as a knee or an ankle and you do not have much in the way of inflammation. Again, if you wish to ask further questions in relation to this, please see our Patient Information page regarding Hyaluronic Acid.
We also offer slow release local anaesthetic which lasts around 12-18 hours, so ideally needs to be injected the day of the marathon.
Each year we provide an emergency drop-in clinic on the morning of the London Marathon where people can have a local anaesthetic injection to give them pain relief that will last throughout the marathon. In order to book for this clinic you must arrange an appointment at least 2 days in advance.
If you wish to ask further questions in relation to this, please see our Patient Information page regarding Hyaluronic Acid.
Q: What are the risks and side effects?
The majority of people have steroid injections without any significant side effects.
Generally the risk of side effects is greater with stronger doses and longer acting steroids, such as Triamcinolone acetonide and Methoprednisolone.
Other side effects are –
- Pain and discomfort for a few days in the joint
- A loss of fat and coloration where the injection was given
- If you have diabetes, your blood sugar level increases for a few days
- If you have high blood pressure, it may increase further for a few days
Pro’s and con’s to cortisone injections for runners
Cortisone injections can be a god send to all sports enthusiasts, treating issues such as iliotibial band syndrome (ITB syndrome) or shoulder rotator cuff pain, however there are some pitfalls that you need to consider before choosing steroid injections.
As cortisone is used to block pain and reduce inflammation there is a justifiable concern that continuing strenuous exercise immediately after treatment may damage the area further.
Any form of pain relief, whether it is over the counter paracetamol or prescribed anti-inflammatories can have the same negative impact as you are potentially masking the body’s reaction to pain and the body’s natural healing process.
However, steroid injections can be very useful if you have low grade pain and little in the way of inflammation.
As always, if you require any further information regarding any of the above, please do not hesitate to contact us.
Or call – 02074823875.