Shoulder cortisone shots

Patient

Q: I play baseball and had labrum repair surgery in 05. since then I have not had any pain except when I pitch (or throw hard). I started getting two cortisone shots per year in 09. Once I get them I can pitch without pain for approximatly one to two months. Today I got a cortisone shot and for some reason cannot lift my elbow in a certain direction (standing, tricep to the ceiling and hand down). I don't have pain it is just like I don't have any strength. I can move my are and should in other direction fine. Why is this and what do I do next?

Doctor

A:    Generally it is not recommended to receive more than 2 steroids shots in any joint per year. I suggest that you get a thoroughly evaluation by a orthopedic surgeon to rule out cervical spine problems and assess the status of the tendons of the rotator cuff. Maybe you are having the consequences of a Overuse or Repetitive stress injury Repetitive. RSIs are injuries that happen when too much stress is placed on a part of the body, resulting in inflammation (pain and swelling), muscle strain, or tissue damage. This stress generally occurs from repeating the same movements over and over again, as in your case pitching with a lot of throwing “hard”, with no enough healing time so they are also called “overuse syndrome”. The concept is that overuse injury is associated with repeated challenge without sufficient recovery time in any sport or activity in which you exceed the guidelines and your own limits or capacities, which might be the root of your problem here, because it is not recommended keep getting 2 cortisone shots/year if the real cause is not treatedTry to allow enough healing time, revise your equipment and technique, and learn to know when “enough” is.

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