UKC

Hi All,

Just starting on dosage of Prednisolone, they are pretty strong corticosteroids and was wondering if anyone has any knowledge (anecdotal or scientific!), as to whether or not it my increase risk of injury?

Main worry is finger pulleys and whether or not I should be cranking on stuff whilst I'm on these (9 day prescription).

Cheers,
James

In reply to jungle:

not in the short term for a short course then no except bruising really as far as i know, long term yes plenty of risks muscle wasting etc

In reply to jungle:

Only anecdotal advice really - I went on a high dosage shortly before a sport climbing trip and it totally messed me up. I got a tweaked elbow pretty quickly but far more damaging were the mental effects and general lethargy. I'd get three clips up a route and be drenched in sweat, dizzy and too scared and anxious to commit to moves. Most annoyingly the dosage was only meant to last a week but the consultant messed up and left me on it for a month, which I then had to taper off from. Didn't fix my condition either but fortunately I've recovered from the side effects of the drug.

In reply to jungle:
Prednisolone is a very valuable and potentially life saving drug. Like any drug it has potential side effects. If will only be prescribed if there has been a careful assessment of risk verses benefit. Do not stop it suddenly. Do not rely on vague personal advice from a forum. If you have specific questions or feel you need more information please make a list of your questions and contact the prescribing doctor. If he or she is not easily available and it is not your General Practitioner who has prescribed it please contact your GP for further advice.
Sorry this sounds very medically arrogant but sometimes I do feel I need to step in and be dogmatic.
David Hillebrandt
Medical advisor to BMC.

In reply to jungle:
I don't want to quote verbatim multiple paragraphs, but Dave MacLeod (he holds an MSc in Medicine and Science in Sport and Exercise, so is not just a wad with an opinion) in his book Make or Break does not view them favourably, saying: "The available research suggests the long term benefits of steroid injections are poor", and cites as evidence: Coombes, B.K., L. Bisset and B. Vincenzo, Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy; a systematic review of randomised controlled trials.

He goes on to say 'injury recurrence rates are much higher than with therapeutic exercises alone', "an even more worrying finding has been repeated reports of subsequent ruptures in tendons that have been treated with multiple steroid injections",
"there may be a case for early use when their effects of reducing tendon swelling would be important, such as in impingement of the supraspinatus tendon in the shoulder or trigger finger. However some GPs still routinely treat painful tendons at the outset with injections, perhaps because of poor awareness of recent research developments of because of their appealing short term effects on pain. If this is offered at your first GP consultation when first presenting with a new injury, it may well be prudent to seek a more specialist opinion before accepting the injection."

Hope that helps.

Lastly I encourage people to buy his latest book - it's the bible of healing climbing injuries:http://davemacleod.com/shop/makeorbreak.html

In reply to SenzuBean:

You don't know what you are talking about - corticosteroids are not injection based as the steroids are in the context of MacLeod's work.
So please don't spout shit about medical issues.


to the OP - i my experience - which should have no bearing on whether you decide to take them or not - I had few problems with them whilst taking a fairly high dose for several months and doing a high volume triathlon training at the same time. My biggest side effect was serious glucose cravings which drove me nuts as I try to eat little to no sugar and low amounts of carbs.

In reply to ClimberEd:


Actually you are the one spouting crap. Corticosteroids are given as injections, and the section I quoted is titled 'Corticosteroid injections'.

Here's another simple resource that explains it:
http://www.netdoctor.co.uk/medicines/cancer/a6524/deltastab-injection-predn...

In reply to SenzuBean:

I think it's quite clear that the OP is talking about a prescription for oral steroids rather than steroid injections. Please don't confuse the two as they will have completely different indications, side effects and risk-benefit profiles. I think the OP should take David Hillebrandt's advice above.

Out of interest have you read the paper that you mention? I've had a quick skim through it, and whilst I can't put it into the context of Dave MacLeod's book (having not bought it) I'm not sure the data supports such a bleak outlook. They find varying effects for steroid injections (notably *not* looking at any injections into joints), and only really find negative effects in elbow tendonopathy rather than in rotator cuff problems.


I assume this is from somewhere different, as Coombs et al. report a single case of achilles tendon rupture which was reported from a participant who had been withdrawn from the trial, that had otherwise favourable results of steroid injections into achilles and knee injuries.

I'm not saying there is necessarily good evidence for steroid injections, or that anything in Dave's book is wrong, but I'm not sure the study you've quoted is a particularly good one to justify your further comments.

In reply to jungle:
A short course of oral pred' should not cause any problems. Long term there could be and these are well known . This is very different from local steroid injections to specific musculoskeletal problem areas , the evidence for which , outside 4-6 months is very dubious . A debate on local infiltration is outside the scope of this question , but Australian Institute of Sports Medicine et al have plenty of studies to read.
Hope all goes well.

In reply to SenzuBean:

The normal usage of pred and corticosterioids is through oral or topical administration. The OP also said a 9 day prescription. In this case information about injection based intervention is misleading at best

In reply to jungle:

Thanks all for your responses. Have spoke with GP and pharmacist, and they pretty much said there was minimal risk of injury although side-effects vary from person to person.

The anecdotal evidence is useful to hear. What I've highlighted is, is that as it's a short-term dose I shouldn't be that troubled by it - I'm on day two atm!...I think I'll just take it a bit easy for the time-being, hard to do though as we're off to Costa Blanca for Easter, ha!

Just in case you're wondering what it's for, I've got sinus issues: congestion, no taste, no smell, polyps, wonky septum - diagnosed last week after 12 years of trying to see an ENT specialist.

I'm rattling atm...prednisolone, clarithromycin, and omiperazole!

In reply to Aly:

I wasn’t sure the OP was talking about oral administration, so chimed in to be on the safe side. I didn’t read the paper - as I only wanted the OP to be aware of it.

In reply to jungle:

thats what I said