Ultrarunning: What You Should Know Before Getting Cortisone Injections for Your Injuries

May 8, 2012

Ultrarunning: What You Should Know Before Getting Cortisone Injections for Your Running Injuries

This article is part of Endurance Planet’s ultrarunning article series. If you have questions, comments or feedback about “What You Should Know Before Getting Cortisone Injections for Your Running Injuries”, please leave it below in the comments section…

 Ultrarunners are among the elite group of athletes who will inevitably have to deal with overuse injuries. And regardless of whether or not ultrarunners practice proper exercise mechanics and form, or wear ample protective gears, or take in the right kinds of food, drinks and supplements, overuse injuries, sadly, will be a reality among those who are into this endurance sport. But the great thing is that there are a number of treatment options to choose from and one would be cortisone injections.

Just what exactly are cortisone injections?

Cortisone is a type of steroid which is released into the blood stream by the adrenal gland during stressful situations. Natural cortisone is primarily short acting, while the synthetically produced version, the kind which is delivered via injections, is designed to be more potent and thus is longer acting too.

Cortisone injections are utilized primarily to treat inflammations. The steroid is injected directly into an injured area and it instantaneously decreases swelling. Because of this, pain in and around the inflamed area then lessens as well. Cortisone injections take effect immediately once administered although arrival of relief can vary. Some experience it in as little as hours, while others only notice pain subsiding after two or three days from the steroid’s application.

What should I expect during and after the cortisone injections?

The size of hypodermic needle which will be utilized will vary. Typically, a small needle will be used during routine cortisone injections. However, a larger sized needle may be chosen by your doctor especially if fluids need to be drained from the injured area prior to cortisone administration.

Injections generally cause little discomfort especially if a small needle is used. But pain can be a possibility if your injury is particularly inflamed, or if a wider area needs to be applied with the steroid. During this case, the doctor may opt for anesthetic and may either inject it along with the cortisone or apply a topical version of the numbing medication to the injured area.

As was mentioned, pain relief brought about by decreased swelling in and around the injured area will usually take place a few hours to a couple of days after injection. And full improvement is typically noticed after about 2 to 3 weeks. Meanwhile, the full effect usually lasts for 3 to 4 months. A handful of side effects are a possibility though and which may immediately take place after cortisone administration. These are:

  • Cortisone  flare – This condition happens when the steroid crystallizes within the injected spot. Swelling and pain, normally more severe than before the injection, will be experienced. Cortisone flare, as believed by some doctors, is a positive sign as it purportedly indicates that the steroid has indeed been administered correctly into the injured area. Cortisone flare can cause significant discomfort and may last for a day or two. Icing the injected area, taking in aspirin, and getting some rest should help relieve discomfort.
  • Whitening of the skin – The area right around the injection spot may lighten a little.
  • Infection – Infection is always a possibility whenever injections to the skin are made. Sterilizing the skin with alcohol or povidone-iodine prior to injection should minimize infection risks.
  • Elevated blood sugar – Insulin-dependent ultrarunners will need to vigilantly monitor their blood sugar levels after cortisone injection as the latter can cause blood sugar spikes.
  • Tendon rupture – Repeated cortisone injections bring about weakening and potential rupturing of the tendons.
  • Loss of fatty tissues – Fat atrophy, which leads to loss of fatty tissues, is another long-term negative effect of cortisone injections.

As was mentioned, these steroid injections have long-term debilitating effects. This is why doctors advocate no more than 2 injections in a visit, and no more than 4 injections within a year. And ultrarunners need to watch out, particularly those who get multiple injections for treatment of plantar fasciitis. Repeated administration of the steroid can bring about fat atrophy which causes loss of the essential cushion of the feet making walking or running a painful activity. Worse, tendon rupture, which can sometimes only be repaired through surgery, may happen as well.

So talk with your doctor first and foremost. Learn all there is to know about this kind of treatment and make sure you are aware and feel comfortable about the potential side effects before you head out and have cortisone injections for your ultrarunning injuries.


Do you have questions about cortisone injections, or what you’ve read so far? Do you have any ultrarunning pointers of your own to add? Please leave your feedback, comments and questions below, and we promise we’ll respond.

Comments (17)

  • Becca H says:

    You don't always get told about things like Cortisone Flare at the time of the injection. It feels like acid burning around the site and hurts like hell. I finally bumped into the solution when my partner thought it must be worth an ice pack (just at the point I was desperate). It was like a switch had been flicked. Didn't need anything else, just ice. Shame no-one mentioned the potential problem ahead of time. It would have saved a very uncomfortable time.

  • Tooba says:

    Hi I am tooba tariq I was on deltacortil ( cortisone) tablets for over a year… my doc never told me about the side effects I was taking 1 a day for 5 month then 3 a day for the next 5 month then the dose cut to 2 / day now I quit taking these tablets I am having pain in all my joints and muscles cant sit and lay or stand for long need advise an early reply will b highly appreciative regard.

  • Dm P says:

    Is it supporting for running to long time stamina?

  • marilynn turner says:

    Do I have to wait any length of time after taking aspirin to get a cortisone injection?

  • Marion foley says:

    Does cortisone shots cause palpations I had one 3 weeks ago and ended up at hospital with palpations I didn’t have them before I got the shot

  • Charlee says:

    I am a middle distance runner and may have to get a cortisone injection in my foot due to inflammation of my bunion, my question is: will I have to stop running for a certain period of time after the injection or not?

  • Greg says:

    I have been training for an 90 km iltra but have now torn a muscle in my quad (vastus medialis)

    I have heard that cortisone injections can assist with the relief of pain?

    Please can you advise the following:

    • How far in advance before comrades should I have the injection?

    • This is my first comrades marathon ultra but I am in so much pain now that I cannot run at all. Will this reduce the pain totally or just a little bit?

    • Is it safe and are there any side effects?

    Is there anything else that I am forgetting to ask?

  • Dion says:

    Other anti inflammatory’s such as ibuprofine can cause catastrophic symptoms in endurance athletes, what’s the risk with cotisone? if any

  • Julie says:

    Hi, I had a steroid injection a week ago in my foot for soft tissue inflammation of unknown cause and now my foot hurts worse. Before it felt like a bruise on the ball of my foot under my forrth toe and little toe. It hurt to walk on it all day and to do my boot camp workouts, but nite 6 days after the steroid shot it feels like a wasp sting with pain running all in the ball of my feet and into all of my tues…mostly just upon standing or putting pressure on it. It doesn’t appear red or swollen and I feel fine otherwise. Any thought as to why this is happening? My doctor says it should feel better within in two days of the shot.

  • Jose says:

    Hi my name is Jose Vasquez. I wanted to know if a cortisone shot relieves pain for a long term period. I have never had one in my life. The reason I am getting one is because I injured myself while running and i was injured for about one year in a half. I love running. I also went to the doctor got the x-ray and cat-scann. The doctor said my leg was fine that all need is a cortisone shot. So someone please respond when they see this message and im 25 five years old.

  • Got a cortisone shot last Wednesday and now I’m having alot of burning. Flush red cheeks and my left leg feels like its ice cold could this be side effects from the shot?? My first time having one I had it done on left leg on the left side of my knee and it’s keeping me up half the night.

  • Joanne Sullivan says:

    I received Cort shots in back for severe pain. Been a week and pain is worse. No relief at all. What next?

  • Planet Alice says:

    I had cortisone shots in each knee last Wednesday and got the 'steroid flare' in both knees which I was told would calm after 1-2 days. The pain is still present 4 days later (!) and I am at a complete loss of what to do. Its unbearable. Any advice is very welcome!!!

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