Intra-articular injections

Received an e-mail today by someone asking my advice on shoulder pain and the use of Deca. It was suggested to him by personal trainers and some b/builders in his gym, to inject the Deca-Durabolin into his shoulder joint.

I fully condemn this practice for the following reasons:
- Firstly, tendons and cartilage do not have good blood supply. How long will it take for the esterase enzyme to have the nandrolone molecule to be fully free? And for what reason? Nandrolone does not have the strong anti-inflammatory action of which cortisone does.. It is progesteronic and will connect to the progesterone receptors in tendon(of which tendon apparently has a lot of), to have a 20% progesteronic effect. This has no direct anti-inflammotory action as cortisone for instance does. Progesterone does have an effect on your immune system's T-Helper cells. T-helper 1 cells lead to the production of pro-inflammatory cytokines, which leads to pain. The T-helper 2 cells produce antibodies that again can reverse this reaction. It is through this response of stimulating TH-2 that progesterone decrease the production of TH1 cells pro-inflammatory cytokines. The nett effect of the progesteronic effect is more anti-inflammatory cytokines than pro-inflammatory cytokines. So, Deca through its 20% progesteronic effect, does have a very mild, indirect anti-inflammatory effect, but only 1/5'th of that of normal progesterone. But, it does have progesteronic effect of water retention, which in itself lubricates the joint space and this leads to less mechanical friction. Injecting it into the shoulder joint will not localize its effect to just that joint space though - it will have a systemic effect, irrespective to its placing.

- secondly, you run the risk of injecting an impure, underground-manufactured substance into your shoulder joint. What if you get infection from this? If you end up with septic arthritis, no Orthopaedic Surgeon will touch that shoulder for as long as two years! And you will need very high dose Antibiotics for anything from 3-6 months continuously.

One of my colleagues and personal friend, is probably one of the top shoulder surgeons in the country. He would just shake his head in disbelief if you would ask him to inject Deca into your shoulder joint.

Inject it into the shoulder joint ?? jeez Lucky he emailed you for advice,,

I actually have a friend who went to the ciro for a rotator cuff injury, eventually he asked me for Deca and later I found out that it was on the recommandation of his ciro and the dude used to inject him in the shoulder as well and used the same mentality as that it will help with the shoulder's rotator cuff. Needless to say the injury came back when the shots stopped. Dahh

That's why chiro's can't claim from your medical aid - they are not registerd to the HPCSA as Medical Doctors who may treat with medicine !