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cosmokramer
Nov 1, 2004, 1:20 AM
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Hello,
I was wondering if anyone here has had personal experience with the long-term effects of steroidal anti-inflammatory injections due to/in order to remedy climbing-related injuries.
I recently received an injection into the subacromial space of both shoulders from my doc to treat the symptoms of impingement syndrome (it is a miracle treatment!), and was wondering if anyone had any information to share about their personal situation long after receiving such treatment and pulling rock in between. I have asked my doc all of the appropriate questions, but I would like to hear of fellow rock climbers' experiences.
Thanks in advance,
Mike
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cosmokramer
Nov 1, 2004, 3:04 PM
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EXCELLENT advice! Thanks!
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shakylegs
Nov 1, 2004, 3:20 PM
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Is the injection a one-time deal, or do you expect regular shots? I don't think one shot will be that devastating, but long-term usage can have some serious side-effects: osteoporosis, water retention, skin like a horny teenager, muscle loss, hair loss, etc.
I take a daily dose of prednisone, and can't really tell if it impedes my climbing, since I began climbing a couple years after starting on that drug.
A good web site for finding out about the drugs you're taking is http://www.webmd.com
Edit: Reading the below post, my info is pretty much worthless. Carry on.
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jgrierson
Nov 1, 2004, 3:37 PM
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Repeat steroid injections will lead to thinning of the rotator cuff and possible tearing subsequent to this. Be cautious and get an opinion from a specialist.
MRI imaging and then followed by arthroscopy is the way to go.
Steroids are not treating the disease, just the symptoms. If you are getting recurrent impingment it may mean that your acromial process is abnormal in shape and thus predisposing you to a problem.
Get it checked out. :D
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pablo
Nov 1, 2004, 4:26 PM
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I recently had an injection in my knee for a long-term injury. Initially, the response was great but faded over a couple of weeks. After about a month I still feel improvement but not as much. I would recommend the treatment based on my response.
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cosmokramer
Nov 1, 2004, 4:32 PM
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In reply to: Steroids are not treating the disease, just the symptoms. If you are getting recurrent impingment it may mean that your acromial process is abnormal in shape and thus predisposing you to a problem. Get it checked out. :D
My doc basically told me exactly what you are saying. He told me that the injections are used as a diagnostic tool as well as a short-term pain reliever.
He told me that in four weeks ( :? ), if all pain has subsided, then I can start PT shoulder exercises. If PT goes well, then I can get back into the gym, then back into climbing. If PT goes nowhere, i.e. the pain returns, then it will be time for MRI and other avenues.
He also told me upon examining me that years of weightlifting have caused "bone spurs," small growths of bone the protrude slightly above my normal shoulder line at the distal end of the clavicle. He told me that the amount of bone growing above (the part you can see) also grows underneath and down into the area of the rotator cuff. He said that otherwise minor traumas to the region can be amplified by the bone spur on muscle impact.
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jgrierson
Nov 1, 2004, 4:41 PM
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My doc basically told me exactly what you are saying. He told me that the injections are used as a diagnostic tool as well as a short-term pain reliever.
He told me that in four weeks ( :? ), if all pain has subsided, then I can start PT shoulder exercises. If PT goes well, then I can get back into the gym, then back into climbing. If PT goes nowhere, i.e. the pain returns, then it will be time for MRI and other avenues.
He also told me upon examining me that years of weightlifting have caused "bone spurs," small growths of bone the protrude slightly above my normal shoulder line at the distal end of the clavicle. He told me that the amount of bone growing above (the part you can see) also grows underneath and down into the area of the rotator cuff. He said that otherwise minor traumas to the region can be amplified by the bone spur on muscle impact.
Sounds like things are heading in the right direction, good luck with everything, hope the re-hab goes well :P
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climbingbetty22
Nov 1, 2004, 4:58 PM
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Yeah, you don't want to be on the shots for along period of time. They'll eventually cause negative effects to the joint as well as have the potental to decrease immunity.
Corticosteroid injections as well block the transcription of PGHS-2. By not making PGHS-2, it shuts down the cyclooxygenase pathway, preventing cells from synthesizing prostaglandins, which are the chemicals that tell your body there is tissue damage going on, and causing you to feel pain. So they work at the level of DNA. IMHO, You should always use caution with something that's going to play around with your DNA.
I know some people who have had success treating patients by using ultrasound and a 10% hydrocortisone solution 3x a wk for 3 weeks.
As well, its possible to manipulate the whole process from a biochemical perspective. Cyclooxygenase uses arachindonate and oxygen to synthesize the offending prostanglandins. Arachindonate comes from arachidonic acid, which is an omega 6 plentiful in animal fat and cow diary. Cut back on these things in your diet and increasing your intake of omega 3s will decrease the amount of substrate for cyclooxygenase and therefore decrease the amount of prostaglandins produced, thereby reducing the inflammation.
I guess that's probably more than you every wanted to know. Doesn't really answer the question about how it will effect your climbing.
Were you diagnosed with TOS (Thoracic Outlet Syndrome) perchance?
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metakinjo
Nov 1, 2004, 5:01 PM
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LOL...Prednisone is mostly an anti-inflammatory. It has no effect on muscle growth because it is not an anabolic or androgenic steroid.
jgrierson: I hope that the healing process goes well and everything gets better for you. I know what its like to be out with shoulder injuries.
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cosmokramer
Nov 1, 2004, 5:06 PM
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Nope, just impingement syndrome for now. My ability to perform the physical tests he performed on me for external rotation, internal rotation, apprehension, etc. were enough for him to exclude with "95% certainty" the possibility of rotator cuff tears. In four weeks, I may be re-diagnosed based on my progress and whether or not I am in the 5%.
Thanks for the great bio-chem breakdown, by the way!
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whatsupdoc
Nov 1, 2004, 6:30 PM
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In reply to: LOL...Prednisone is mostly an anti-inflammatory. It has no effect on muscle growth because it is not an anabolic or androgenic steroid.
True, but it can cause muscle weakness, steroid myopathy as it's termed.
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shakylegs
Nov 1, 2004, 6:48 PM
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In reply to: In reply to: LOL...Prednisone is mostly an anti-inflammatory. It has no effect on muscle growth because it is not an anabolic or androgenic steroid. True, but it can cause muscle weakness, steroid myopathy as it's termed.
Yay, now I have a valid excuse for being weak. Thanks doc.
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send513
Nov 1, 2004, 7:28 PM
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I am in the middle of PT for my shoulder... I haven't gone the injection route yet, but I might... WHILE STILL doing PT.
It doesn't do any good to get rid of the pain if yyou don't get rid of why you have the pain.
The PT is fairly straight forward strenght and flexibility and I can tell its helping so much!!
DO PT, I can't stress it enough how important it is!
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jgrierson
Nov 2, 2004, 8:39 AM
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In reply to: Yeah, you don't want to be on the shots for along period of time. They'll eventually cause negative effects to the joint as well as have the potental to decrease immunity. Corticosteroid injections as well block the transcription of PGHS-2. By not making PGHS-2, it shuts down the cyclooxygenase pathway, preventing cells from synthesizing prostaglandins, which are the chemicals that tell your body there is tissue damage going on, and causing you to feel pain. So they work at the level of DNA. IMHO, You should always use caution with something that's going to play around with your DNA. I know some people who have had success treating patients by using ultrasound and a 10% hydrocortisone solution 3x a wk for 3 weeks. As well, its possible to manipulate the whole process from a biochemical perspective. Cyclooxygenase uses arachindonate and oxygen to synthesize the offending prostanglandins. Arachindonate comes from arachidonic acid, which is an omega 6 plentiful in animal fat and cow diary. Cut back on these things in your diet and increasing your intake of omega 3s will decrease the amount of substrate for cyclooxygenase and therefore decrease the amount of prostaglandins produced, thereby reducing the inflammation. I guess that's probably more than you every wanted to know. Doesn't really answer the question about how it will effect your climbing. Were you diagnosed with TOS (Thoracic Outlet Syndrome) perchance?
Ok, I'm sorry but the text in red is a load of boll*cks. Steroids do not mess around with your DNA. What they do is block certain enzymatic and protein synthesis/breakdown pathways, as you correctly stated, but they do not affect your DNA. Be cautious about over interpreting the facts and scaremongering. :shock:
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