Corticosteroid Treatment for NFL Hamstring Injuries
June 28, 2000 -- National Football League players who sustain
hamstring injuries recover faster and safely after being treated with
intramuscular corticosteroid injections, according to a recent study. These
injections, however, are only effective in specific cases and in elite
athletes, stresses lead author William N. Levine, MD.
Hamstring injuries are common in athletes who participate in
sports that require high acceleration and high deceleration, Levine tells
WebMD. Typically, this includes sprinters, football players, soccer players,
and sometimes water skiers.
The usual treatments for hamstring injuries consist of rest and
physical therapy, along with ice compresses, massage, ultrasound, electrical
stimulation, and the use of nonsteroidal anti-inflammatory medications such as
aspirin and ibuprofen to reduce inflammation of the affected muscles.
For this study, which appears in the latest issue of the
American Journal of Sports Medicine, Levine and his colleagues treated
players from one NFL team who suffered hamstring injuries over a 13-year
period. They treated 58 players who suffered second- or third-degree injuries
with intramuscular injections of a commonly used anesthetic agent and a
These injuries were severe, and when they occur, the athlete
may actually hear an audible 'pop.' The muscles are either partially or
completely torn, and the athlete is unable to use the affected muscle.
After receiving the injection into the affected muscle, all of
these players returned to full practice after an average of a week. All of them
returned to play at their previous level of performance, according to the
authors. The average training-room treatment time, which consisted of ice
packs, deep massage, electrical stimulation, ultrasound, and whirlpool baths,
was 24 days.
There were no decreases in muscle strength, power, muscle tone,
or size. The typical complications that are seen with such injections, given
directly into the muscle, include infection, hamstring rupture, and repeat
injury, and none of these were seen in any of the players who were treated in
Levine, who is director of sports medicine at
Columbia-Presbyterian Medical Center in New York City, says that in order for
these shots to be effective, the injury to the hamstring must be palpable,
which means that it can be felt and identified using the fingers -- by both the
injured patient and the doctor. Such injuries make up only a small percentage
of the hamstring injuries that occur, however. It is only in these specific
cases, notes Levine, that these injections can be effective and safe.
Levine is also quick to add that, just as these recommendations
don't include most hamstring injuries, they also do not extend to most
athletes. "This is an elite group of athletes, so we don't mean to suggest
that these results [can be extrapolated] to recreational, college, or high
school athletes," he tells WebMD.
"My personal experience with this is that the athletes do
feel better, and they also tend to do better," says John Xerogeanes, MD.
"I have seen cases of re-rupture following steroid treatment -- it happened
twice when we were treating John Elway. I'm not saying that the risk of
re-rupture is higher; I use this on Georgia Tech athletes fairly commonly. I'm
just saying it is something you need to be concerned about." Xerogeanes is
the chief of sports medicine at Emory University in Atlanta.