How a steroid injection can get you back on the road to fitness

YourGP’s Dr Turnbull is a big fan of keeping fit – from cycling and running, to weightlifting, squash and skiing. So he knows firsthand how frustrating it can be when a sports injury stops play. However, he also knows just how transformative a steroid injection can be in terms of settling inflammation, reducing pain, and getting patients back on the road to fitness. Read on as he describes the most common sports injuries he treats in the practice and offers a few words of wisdom to anyone embarking on a fitness journey…

Describe some of the benefits of regular exercise
The benefits of regular exercise cannot be overstated. Exercise not only builds muscle, strengthens the heart and burns fat, but also helps with mental wellbeing. It builds self esteem, provides time and headspace away from work and home, and destresses to help improve mood and lower anxiety levels. Many forms of exercise get you out into nature and fresh air and sport can teach important skills and values such as working as part of a team.

What are your favourite ways to keep fit?
I love many sports including road cycling, road running, lifting weights, squash and skiing. Work and family responsibilities these days mean that I find it difficult to do any of these regularly! Instead, I now keep exercise as simple and close to home as possible. I love running with my dog, Rhubarb, I cycle to work when I can, and I have a makeshift home garage gym leftover from the COVID lockdown years that I can sneak away to after bedtime. This also avoids expensive gym memberships!

What are the most common sports injuries you see at the practice?
Shoulder impingement and arthritis. The shoulder joint is a fantastically mobile joint but unfortunately this comes at the cost of being easily injured. Thankfully a steroid injection can often help to reduce swelling and settle inflammation.

What are the most common causes of these issues?
Usually getting older! In our teens, twenties and early thirties our bodies are extremely resilient and heal well. After this point you’re going to have a good amount of natural wear and tear going on and the body doesn’t heal as well so you’re inevitably going to start picking up injuries. With family and work commitments at that time of life you get less time to sleep, stretch, eat well and recover.

What would happen if a patient ignored the pain and continued with their fitness plan?
It depends what the underlying problem is. Many things might slowly get better with time and not be an issue. Anything with a vicious inflammation cycle like shoulder impingement will likely get worse, incur more damage and possibly permanently calcify.

How can a steroid injection help?
It can offer a very effective reduction in pain and disability for a few months for many joint problems. For many conditions such as shoulder impingement, De-Quervains or trigger finger, it can fix the issue.

Describe the patient journey
I’ll have a chat with you first to understand the issue you’re having and how it’s affecting you. I’ll examine the offending bit of you and offer a diagnosis and advice on how to treat it which may include stretching or strengthening exercises, anti-inflammatory tablets or I might recommend a steroid injection. The injection takes around 10 minutes and can often be done in the same appointment if it’s a straightforward issue. The injection, whilst not pleasant, is usually no worse than a blood test. I use the same size of needle or smaller depending on the part to be treated.

How many injections will a patient require?
Often a single injection does the trick and I never hear from the patient again, save from the thank you card! Unfortunately, joint issues tend to be chronic problems that wax and wane and so it’s not uncommon that the issue returns. In these cases, you can repeat the injection as often as it flares up with a minimum of 3 months in between. On average I would say my patients with chronic joint issues requiring steroid injections come to see me every 6 months.

How soon should a patient feel results?
Steroids work their anti-inflammatory magic usually at 24-72 hours rather than instantly, but their effects persist for 8 around weeks.

How soon can they return to exercise?
Usually within a week or two.

What is the best advice you would give to someone starting their fitness journey?
If you’re young (<35) then just go for it hell for leather. Enjoy it! If you’re older, then you do need to be a bit careful not to overdo it and injure yourself as the materials you are made up of are a little less durable, less elastic and don’t heal as quickly. If you’re struggling with motivation then ensure you make it part of your weekly routine (eg. every Tuesday and Thursday evenings) so you can’t make excuses to yourself or join a club to make it more sociable and distract your mind from the pain of cardio!