Cortisone Injections to the Knee--Anybody have them?

Triathlon Forum
1

It seemed like my patellar tendonitis was on its way out, and then, bang, I start to get fluid in the knee joint. I may have been wearing the knee strap a bit tight and high, but I was hobbled with pain that night–personal inspection revealed a lot of fluid around the joint.

SO I am hoping to get cortisone injections to keep the training going and get me through IMAZ. Then I will do rehab and evaluate whether long distance is something I should do.

Anybody had these shots? How long do they last? Are they miraculous?

2

They should always be a very last resort. I had one in my hip and it didn’t do much for me. The problem is that you can do more damage to your knee because you don’t feel it.

3

My sports doc told me a few things on the latest ‘thoughts’ on cortisone. The larger the tendon/muscle region that is injected, the less problematic the long term effects. For example, I received a cortisone shot in my wrist. All very small tendons/ligaments, my doctor told he himself would not, and would not recommend, I get the same area injected again. That said, after about 2 weeks the pain was gone…the ‘masking’ lasted 10 weeks and then returned. Served its purpose as I had an motorcycle endurance event planned that I could not have participated in without intervention. Similar to your situation, I’d invested a lot of time and money and was willing to take some aggresive measures to insure my participation.

I don’t think cortisone has universal results, I was told the effects usually take about 2 weeks to show up, and then you’ll find out if its going to help out. The patellar tendon is fairly robust, so it shouldn’t be worrisome as far as damaging because of the injection. Finally, the bad rap cortisone received appears largely to be because of abuse, re-injected a particular region over and over again to the point where the damage (that is masked by the drug) finally brings the tissue to the point of failure.

I’m not a doctor, just passing along what I’ve been told.

Best of luck to you, I hope it helps and have a great race!

b-

4

Thanks berti.

5

If the fluid build-up is in the back of your knee…its mostly likely a Baker’s Cist…probably needs to be drained after IMAZ.
I got Cortisone shots on both my knees last year when I had some nagging outer PT pain…I was very reluctant,but, got it after I researched all the side effects of todays Steroidal Cortisones.
All info claimed that if not abused, there would be no long term degeneration of cartilage in the knee cap region.

I was treated at very well known Bone & Joint Center here in the East Coast.
My Ortho was a marathoner himself.

BUT…in retrospect…I wish I didn’t do it.
I only had this done once…so I think I’m OK…haven’t had a re-occurance of knee pain, in fact I feel so strong this season…it looks like a PR year in the making., but I attribute it more to laying off for a while and spending some serious time w/ leg strenght development.
My legs now look so different with all the muscle development…albeit,picked up some muscle weight along the way(4-5 lbs compared to last season),…but the stability I gained is worth the added weight …my 1/2 marathon time has improved by 15 mins!! WHICH IS HUGE in my book.,and my wattage on the bike is up too,which has been pretty much the same for the last 2 seasons.

With IMAZ so close…not sure what I would do if I were in the same situtation…and if you do decide to get the Cortisone shot, ask for the version that begins with the letter K…can’t remember the full product name, there are about 4 or 5 variants.

It needs a few weeks to take full hold, so get it now if you are going to do it.
The biggest Caveat , which you need to consider is that each person handles the numbing level differently, so bear in mind that if you feel real good…its a sign that you can do some REAL serious long term damage if you go too hard.

You won’t feel that until the Cortisone subsides…it could be weeks, or months.

Monk-- Good Luck though…and I wish you well -as this is a very serious matter and one I can certainly sympathize with.

PS- After the injection…ICE immediately with your leg elevated for as long as you can stand it.
This keeps the cortisone concentrated in your knee region,as opposed to standing with a ice pack taped to your knee.

…and if your HMO covers it…ask for a shot of EPO too…tell them Nina sent you! LOL

And of course you can still do long distance.
At last years IMLP…we met a 70 yr old with metal screws in both his knees,got it during the war…before any hi tech surgery.
It was his 6th IM!
The guy was larger than life! He finished under 16 hrs.

You’re a Monk for goodness sake!..just go back to the Monastery and get some of that secret wine those guys make and you’ll be good to go.

Be Good

Fish

6

Cortisone is a Faustian bargain for sure. I had three in my elbow, each 3 months apart, to mask medial epiconditis and get me through a year of races. Short term - no pain during the races. Long term - did me no good, maybe some harm. Would I do it again? Probably not, but ask me again right before a big race…
:slight_smile:

7

Thanks fish–thanks everybody who has responded. Sorry to hear it takes a few weeks to take hold–can you train through that? We are down to the wire. Things were going very well until this happened.

8

I would RestIceCompressionElevation as much as possible in between workouts, perhaps back off from really higher threshold/lower cadence work that might be even more taxing then the regular training you’re doing. My mobility wasn’t restricted at all immediately following the injection, perhaps different for different locales, but I’d be surprised to hear that you’re not allowed to train…the couple of weeks to effectiveness is a rough guide, while there is appears to be a lot of science and investigation into the perils/pros of cortisone, it also appears that ‘results may vary’ is a fairly standard disclaimer.

b-

9

Running has been such a good thing for me, I would be very sad to have it be over. So many sad things. Much greater than this, but this freed my mind from the sad things.

10

Last year - unemployed and miserable - I was relying on training to get me through (ease the stress); but within three weeks my ITB stopped me cycling and then I was told I needed a knee operation to remove a cyst!

Needless to say, I was fairly down in the mouth after that. Sorry about the knee, brother.

11

I have not and probably won’t have one as my “big” races are behind me. I have had several friends who got them before Ironman, Boston Marathon ect. I think as a one shot (no pun intended) deal it is probably ok, because I also have some old college and pro football friends that got multiple shot and pretty much wasted their knees or shoulders.
As a short term solution they are antinflammitories and do that very well. They are usually work well for acute inflammation, but don’t removed the cause … You may want to reevaluate and do some serious rehab when you get back from New Zed. Best wishes and sorry to hear you have a crumby problem this close. G

12

bump
.

13

I did in August, the injection cut the pain down by 50% but I could not run on it for another two months. Time is the greatest healer.

Dave in VA

14

Did it stop the water on the knee thing?

15

look at it this way you’ll have plenty of time to post photo shop cut ups on slowtwich.

16

good luck my friend whatever you decide. perhaps I will open a store where a person can buy replacement robotic parts for their hands, knees, hips and such. I’ll let you know when I have the grand opening and that knee will be a thing of the past.

meow.

kittycat

17

Back in 1991 I fell on a bridge grate at the nine mile mark of the Chicago Marathon. Nasty cut on the knee, along with swelling etc. I had the ortho doc look at it a few days later. Rest/Ice/NSAID. He then sent me for physical therapy for the fluid buildup/swelling that was present. I went religiously for weeks, did the ultrasound, everything. Wasn’t helping much at all. Couldn’t really do any of the sports without pain. 6 weeks after first seeing him he gave me a shot of cortisone in the area. 3 days later I was fine. Fluid gone, no pain etc. Not saying, I’m just saying…

I don’t know if I would do it very often, and everyone tolerates things differently, but it worked and I have never had a problem related to that area again.

18

Thanks Mark–I have been working RICE, and Chiro, and stretching and strengthening the little muscles around the knee (which don’t seem to be strengthened by running/biking). Sounds like we both tried to do it right. I hope I have your results.

19

Thinking with you on this…My doc (runner) put me on 1,200 mg of Advil daily for a week for a neuritis. Of course it was not the patella tendon. We talked cortisone and he said 50/50 chance of working. RICE of course. If you’ve got swelling inside the knee seems like you may need a tap. Outside the joint…no experience there.

Symtoms come with running and cycling?

20

Unless it was a true once-in-a-lifetime opportunity like the Olympics, I would not get a Cortisone injection to train or race through pain. Personally, I do triathlons for fun and fitness so the idea of potentially damaging my body while training for a race, even my annual “A” race, is not acceptable.

I vote for dropping out of IM AZ, re-evaluating your racing schedule for this season, sticking with RICE, and taking some Yoga classes from a good Yogi who is experienced with athletes who have knee problems.

IM races can be life changing in many ways. One way is that you can truly break your body training or racing for them and end up being out of competition for years. Knee problems can stick with you for a long time, so I’d be extremely prudent.

-Marc