With just a few weeks to go before the London Marathon, we have lots of patients contacting us, asking about the potential use of pain relieving injections so that they are able to continue to train and prepare for the London Marathon. The key questions that people seem to ask are – how long will steroid injections last for? Is it safe to have a steroid injection to deal with running related pain? and is there any althernative injections that they can have that will relieve pain so as to avoid using steroid. We’ve given some guidance outlined below:
Q: How long before the Marathon should I have my steroid injection?
A: Steroid injections typically take 3-5 days to start working and after an injection. We advise people to avoid heavy exercise and training for approximately 1 week where possible. Once an injection has started to work it will typically last for around 2 months. Therefore with just a few weeks to go, if you are experiencing pain relating to your marathon training, the advice would be to have the steroid injection a minimum of 3-4 weeks before the event and ideally sooner than that so you have time to safely return to your training for a few weeks before the marathon event.
Q: How long do steroid injections last for?
A: Steroid injections typically give pain relief for around 2 months or more (depending on a number of factors), therefore if you have an injection at this stage it should see you through until after the London Marathon on 28th April 2019.
Q: Is it safe for me to have an injection whilst I am still training for the marathon?
A: We will discuss with you injections which may and may not be advisable whilst training for a marathon. We do not usually recommend injecting around a weight bearing tendon such as an Achilles tendon or a patella tendon (or any other load bearing structure) whilst you are undertaking high volumes of training or impact related sport. Some of the most common Marathon injuries that are generally regarding as safe to inject include iliotibial band syndrome (ITB syndrome) and trochanteric bursa (lateral hip) pain.
Q: Is there any alternative injection I could have to avoid the use of steroid?
A: Yes, but the key is to select the correct injection for the condition. We offer Hyaluronic Acid injections as an alternative to corticosteroid when can be very effective for pain within joints e.g. knee joint or ankle joint , however the treating clinician will need to assess you at the appointment to determine if appropriate . These injections take around 2 weeks to work and although they are not used for severe levels of pain they can be very useful if you have low grade pain within a weight bearing joint and you do not have much signs of inflammation. Again, if you wish to ask further questions in relation to this, please see our Patient Information page regarding Hyaluronic Acid.
Q: Are there any other treatments that will just get me through the day of the Marathon ?
A: Yes, an often overlooked alternative that we are also very happy to offer is slow release local anaesthetic injection. This injection will give pain relief for around 12-18hours and so ideally needs to be injected the day of the marathon and is injected directly to the site of pain. Each year we provide an emergency drop-in clinic on the morning of the London Marathon where people can have a local anaesthetic injection to give them pain relief that will last throughout the marathon. In order to book for this clinic you must arrange the appointment at least 2 days in advance.
As always, if you require any further information regarding any of the above, please do not hesitate to contact us on injections@complete-physio.co.uk or call us on 02074823875.