Who out there has had a steroid injection? Lots and lots of people have. I had an interesting chance in the last couple of weeks to assess someone both before and after they had an imaging guided steroid injection for sub- acromial bursitis (an inflammation of one of the bursa’s in the shoulder). Whilst the injection had pretty much resolved the tightness and restriction, and they were almost entirely pain free it was interesting to see that they were very, very weak and lacked control in the ranges of motion that they had just suddenly attained. It was unsurprising that in terms of strength and control their shoulder exhibited the same patterns both pre- and post-injection. How would an injection suddenly address a lack of stability in a joint? I mean the brain must have put the tightness there for a reason right?
So yes it is great that this person no longer had discomfort and tightness – though their shoulder had started clicking, co-incidence? – what use is a greater range of motion if you struggle to control it? Could it be possible that that this lack of coordinated control could be linked to the reason they developed a shoulder problem in the first place? I know what I think.
This is the problem with steroid injections, and also why people often end up having 2 or 3 (you typically aren’t allowed more than 3 due to the longer term detrimental affects), they don’t address WHY you have developed the problem in the first place and often end up masking the problem. It’s like taking a pain killer. People associate a problem with pain, and so if there isn’t pain there then how can there be a problem. However, it is clear to see that this person needs to work on re-stabilising and strengthening their shoulder to learn to control the movement that they have just suddenly got back or they are likely to get a similar problem somewhere down the line. And how many people do you know who's problems just keep coming back. Lots.
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