Athletes Ask: What to Expect After a Cortisone Shot in Foot?
Posted by Jenn F. on Monday, October 8th, 2018
For many athletes, cortisone shots soothe the savage pain of inflammation and provide hope that they can return to a high level of athletic activity soon. Yet, you may have a few questions about this common treatment in podiatry and sports medicine, such as: what is the difference between a long-acting and short-acting cortisone shot or what to expect after a cortisone shot in foot? Podiatrists at The Center for Podiatric Care and Sports Medicine weigh in.
Short-Acting Cortisone Shots
Short-acting cortisone shots are used for three days to quickly reduce acute pain and inflammation. Betamethasone (6 mg/ml) or dexamethasone (4 mg/ml) are typically used. The danger with cortisone, in general—even short-acting cortisone—is that tendons can be weakened. So we often tell patients to immobilize and take it easy during the treatment. These shots can be administered following acute trauma. Usually, when you hear people talk about cortisone shots, they are referencing the long-acting type.
Long-Acting Cortisone Shots
Long-acting cortisone dissolves its crystalline base slowly over a nine-month period. These shots are especially effective for treating bursitis and neuritis. Patients are typically given Kenalog (10 mg/ml) or Celestone (6 mg/ml) mixed with a five-hour local anesthetic. You might feel sensitivity during the first two to seven days, as some shots produce additional short-term swelling, so we recommend icing the puncture site three times a day for the first week and twice a day the second week.
It takes three to seven days to first notice the effects, with peak effectiveness usually discovered around the two-week mark. Additional shots can be given as boosters (spaced two weeks apart) during this timeframe if you have less than 80% pain relief after two weeks. You should be able to walk without pain on a normal day. You may have mild pain and swelling, but it should be more easily managed with icing, stretching, NSAIDs, or stretching.
We take special care to avoid tendon sheaths and plantar fascia (which could result in a tendon or fascia rupture) and to avoid cortisone in cases where there is bone or cartilage damage. If you have arthritis, we are limited to five or fewer injections per year. If the shots fail to take the edge off, surgery may be the only option to repair the damage.
What to Expect After a Cortisone Shot in Foot?
Sorry. There is no running, high-intensity, or weight-bearing sports allowed for two weeks after your cortisone shot. For this reason, some athletes prefer to tough it out with ice therapy and a month of physical therapy. We like to evaluate patients after two weeks to determine the next step. Most patients require two rounds of injections, which would require them to refrain from strenuous activities for at least one month. The importance of ice cannot be overstated. It’s likely you won’t need additional shots if you follow the icing protocol carefully. After three injections, we may consider additional immobilization treatment.
Once you reach 80-90% improvement, weight-bearing activities can be resumed as tolerated. We recommend cross-training to take your activity level up a notch and lower stress on the recovering structures. We’ll ask to see you after three and six months to check on your progress.
Cortisone Shots in NYC
If you have foot pain, a cortisone shot can be a great minimally-invasive therapy and alternative to surgery. The Center for Podiatric Care and Sports Medicine offices in Manhattan and White Plains are trained to treat any ailment of the foot or ankle. Some of the most common applications for cortisone shots include arthritis, bursitis, gout, neuritis, neuromas, plantar fasciitis, tendonitis, and turf toe. We accept most major insurance plans and can treat you without a referral. Contact us to set up your appointment today.
If you have any foot problems or pain, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. Geldwert, Dr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.