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 steroid.
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 this study.
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.