- Keith Lawhorn, MD specializes in sports medicine and practices out of our Fair Oaks office.
In a recent article in the Washington Post, it was reported that the Washington Nationals third baseman, Ryan Zimmerman received a cortisone injection for his aching right shoulder.
Cortisone is rarely used today. In fact there are better preparations that are longer acting. Corticosteroids are potent anti-inflammatory agents. These steroids however do not have a “numbing” or anesthetic effect. These injections are often mixed with an anesthetic to make the shot itself less painful and to provide immediate pain relief. It generally takes a number of days for the effect of the steroid medication to be noticed by the patient clinically. The downsides to these steroid medications are that they do inhibit collagen synthesis temporarily. Collagen is the core tissue responsible for the composition of tendon, bone, cartilage and ligament.
Our tissues are dynamic meaning that there is a constant breakdown and repair going on all the time. Steroids inhibit the repair process temporarily and this inhibition is the reason why repeated injections over a short period of time can be damaging to the tissues. Steroids do not enhance any healing process but simply arrest the inflammatory process associated with injury and degeneration.
In the end, it is likely Ryan Zimmerman will undergo a simple procedure with a high success rate to fix his shoulder problem. For now, the steroid injection can help control symptoms to get him through the season.