Thread by @DrJohnOrchard

Great that @CJSMonline has made our Systematic Review of the safety and use of local anaesthetic injections in sport a free view and download journals.lww.com/cjsportsmed/Fu…

Limited data, but we did find 1970 injections in 540 athletes from 10 studies in the Sports Medicine literature. Only from football codes at elite level - nothing at amateur level or outside football (where hopefully use is uncommon anyway)

Data on safety best for A/C joints injections, iliac crest, some finger injuries. However safety data not generally verified by independent study methodology

A/C joint pathology has good rationale for safety in that A/C OA not a long term likely cause of morbidity, so with some long term data to back up this theory it can be given soft ✔️in pro football

There might be a real phenomenon of rupture of the plantar fascia origin under local block “curing” the condition although much more work needed to prove this

Very little data on whether ultrasound guidance is useful, but for rib injuries it would almost seem essential given that pneumothorax is a possible complication

Given how common knee osteoarthritis is post football career, you’d need to be very very judicious about ever injecting knee to play, as the connection highly likely to get made 20+ years down the track

But....if you are talking Superbowls, Champion’s League finals, AFL Grand Finals, State of Origin games or the Olympics, maybe consider? That is why Sports Medicine is not a trivial specialty. Doing this in front of millions who will watch, as well

Knowing nerve anatomy also critical. Don’t go near lateral popliteal nerve, sciatic nerve, femoral nerve etc or you might get a player who can’t run. The risk of injection without the benefit of playing

Not an area with much published literature but a critical one. Important that (1) Sport and exercise medicine is recognised as the specialty it is and (2) the “don’t ask don’t tell” culture on injecting players to player becomes one of publication to define when it’s safe

A reminder: what it’s like to work in pro sport on TV every week....
smh.com.au/national/my-he…

A one metre putt in golf is easy, but when it’s to win the US Masters, it is the most difficult putt of your life. Sports medicine (and injecting an A/C joint with local) is easy, but on international TV, much more difficult 😳😅🏃‍♀️🧑‍⚕️⚽️🏈🏟🏉

@threadreaderapp unroll please