A cortisone injection delivers a corticosteroid, a potent anti-inflammatory medication, directly to a localized area of pain or inflammation. This treatment suppresses the immune response, reducing swelling and providing pain relief. Success relies heavily on proper post-procedure care, particularly resting the treated area. Exercising too soon can disrupt the medication, potentially negating the positive effects. Premature strenuous activity increases the risk of further damage, especially to vulnerable tendons.
Immediate Post-Injection Protocol
The first 24 to 48 hours following the procedure require strict rest for the medication to begin its anti-inflammatory action. Patients should minimize weight-bearing and avoid strenuous movement involving the treated site. This stillness allows the corticosteroid and the local anesthetic to remain localized and maximize their effect.
One common reaction during this immediate period is a temporary increase in pain and inflammation known as a “corticosteroid flare.” This flare occurs in a small percentage of patients when the crystalline corticosteroid medication irritates the tissue before dissolving. This discomfort typically begins as the local anesthetic wears off and can last for up to 72 hours.
To manage the temporary pain of a flare, applying an ice pack to the injection site can help calm localized swelling. Over-the-counter pain relievers like acetaminophen are recommended for managing discomfort. Consult the prescribing physician before taking nonsteroidal anti-inflammatory drugs (NSAIDs), as some providers prefer to avoid them immediately following the injection.
Gradual Return to Light Activity
Once the initial 48-hour resting phase is complete and discomfort has subsided, a transition to light activity can begin, often around day three. This test phase maintains mobility without stressing the healing tissues. Light activity must be non-impactful and performed completely within a pain-free range of motion.
Acceptable activities include gentle walking on flat surfaces, slow stationary cycling with minimal resistance, or light range-of-motion exercises prescribed by a physical therapist. The goal is to prevent stiffness and promote healthy circulation without attempting a return to full exercise intensity.
The guiding principle for this gradual return must be the absence of pain; any activity causing discomfort should be stopped immediately. If pain returns, the activity level is too high, and the individual must revert to greater rest. Monitoring the body’s response is more important than adhering to a calendar timeline during this recovery phase.
Factors Determining the Full Recovery Timeline
A universal timeline for returning to strenuous exercise is impossible because recovery depends highly on the injection location and the specific underlying pathology. The injection site determines the mechanical stress placed on the tissue during activity and the risk of complication. A full return to high-impact activities, such as running, jumping, or heavy weightlifting, must be approached with caution.
Injections administered directly into a joint space, such as the knee or shoulder, generally allow for a quicker return to full activity, often within one to two weeks. The corticosteroid targets the joint lining to reduce synovial inflammation, and the surrounding structures can typically tolerate increased load sooner. However, premature loading can compromise the longevity of the treatment effect.
Conversely, injections into or around tendons and ligaments require a much longer, more conservative waiting period due to the risk of structural failure. Corticosteroids can temporarily weaken the collagen fibers within these tissues, increasing the possibility of a tendon rupture if subjected to significant strain. For areas like the Achilles tendon or the rotator cuff tendons, a full return to heavy loading or high-impact exercise may require a four-to-six-week period to ensure tissue integrity.
Ultimately, the specific underlying injury and the prescribing physician’s instructions override any general guidance. The medical professional who performed the procedure is best equipped to set the final timeline for a full return to strenuous activity. This timeline is often coordinated with a physical therapy program designed to strengthen the area as inflammation subsides.
Recognizing Complications
While complications are uncommon, patients must be vigilant and recognize signs that post-injection symptoms extend beyond normal discomfort. The temporary pain of a corticosteroid flare is localized and subsides within a few days. Persistent or worsening pain, particularly if accompanied by systemic symptoms, warrants immediate medical attention.
Signs of a possible infection at the injection site include spreading redness, increased warmth, significant localized swelling, or any pus-like drainage. Systemic symptoms such as a fever or chills are particularly concerning and suggest the need for urgent contact with the healthcare provider. Infections, though rare, are serious and require prompt treatment.
Other complications involve potential nerve irritation, which may manifest as new or increased numbness, tingling, or weakness far from the injection site. These symptoms, along with severe, unmanageable pain, indicate an adverse reaction that should be reported to the physician immediately.