Intramuscular corticosteroid injection for hamstring injuries - A 13-year experience in the national football league

The purpose of this study was to assess the safety of intramuscular cortico steroid injection in selected, severe hamstring injuries in professional fo otball players. Clinicians have been reluctant to use corticosteroid inject ions in or around muscle-tendon units because of concern of incomplete heal ing or rupture, We retrospectively reviewed the computer database of one Na tional Football League team for all hamstring injuries requiring treatment between January 1985 and January 1998. We found that 431 players had suffer ed such injury, We developed a clinical grading system to identify hamstrin g injury severity and to stratify players for treatment. Fifty-eight player s (13%) sustained severe, discrete injuries with a palpable defect within t he substance of the muscle and were treated with intramuscular injection of corticosteroid and anesthetic. There were no complications related to the injection of corticosteroid. Only nine players (16%) missed any games as a result of their injury. Final examination revealed no strength deficits, no rmal muscle bulk and tone, and the ability to generate normal power. We bel ieve that the grading system we developed can assist in selection of injury type for injection. Although lack of a control group limits statements of efficacy of injection, our impression is that intramuscular corticosteroid injection hastens players' return to full play and lessens the game and pra ctice time they miss.