Q: I just came back from the orthopedic surgeon's office where I got a shot of cortisone in my shoulder for an impingement problem. I forgot to ask what I can and can't do for activity and exercise. Now it's Friday after hours and I have the weekend ahead of me. What advice can you give me? A:
Each physician may offer different counsel to patients depending on the current problem, age, general health, and past medical history. Some surgeons may give you permission to do anything you feel up to. Others have a specific protocol they want you to follow. As a general rule, patients advised receiving a steroid injection into a joint are cautioned against any heavy lifting or exercise. But after 10 days to two weeks, they are encouraged to start gentle range-of-motion exercises and to
remain active as tolerated. "As tolerated" usually means to do whatever you want to that doesn't increase your pain and feels comfortable. Additional strengthening exercises may be added four weeks after the injection. If you are having a series of up to three injections spaced a week apart, there may be a different protocol prescribed. Since you just had the injection, there's nothing wrong with taking it easy over the weekend and contacting your physician on Monday. You will not invalidate the effects of the injection with this approach and could potentially protect the arm during the healing process. Most of the time, steroid injections into the shoulder joint to control pain and inflammation have both an antiinflammatory as well as a numbing agent. This means that some of your symptoms will be masked so you don't want to overdo it just because you can't feel it. We know that exercise is an effective tool used in regaining shoulder motion. The ideal exercise program has yet to be discovered. The program recommended here is based on evidence we have collected from a variety of studies. There is a need for further research in this area to identify the best type of exercise and timing for exercise following cortisone injections. Reference: Ji Yeon Hong, MD, et al. Comparison of High- and Low-Dose Corticosteroid in Subacromial Injection for Periarticular Shoulder Disorder: A Randomized, Triple-Blind, Placebo-Controlled Trial. In Archives of Physical Medicine and Rehabilitation. December 2011. Vol. 92. No. 12. Pp. 1951-1960.  The post rehab professional is often faced with managing the post rehab client after a cortisone injection. I just got back from teaching our first post rehab skills workshop. During one of the workshop breaks the participants asked when is it safe to begin exercise after cortisone injection. First, understand cortisone injections are an attempt to break the “pain/inflammatory” cycle associated with an injury. Once the pain cycle is broken,
exercise is used to strengthen and stabilize the area. Wait at least 24 hours before beginning any exercise after cortisone injection. The injection itself may cause pain. If the client has pain beyond the 24 hour period, wait until the pain from the injection has completely subsided before beginning exercise. Contact the client’s physician or physical therapist before you begin exercise. Start with gentle exercise and a gradual increase in intensity based on the client’s tolerance. Gentle ROM
and stretching exercise followed by light resistance activities for the first one or two sessions after the injection is my recommendation then you can gradually progress back to the levels the client was able to tolerate before the injection. Remember, the cortisone is used to break the pain cycle to allow strength and stability training. The cortisone may completely eliminate the client’s pain but the underlying pathology is still present. Progressive strength and stability training is a major
factor in the resolution of the condition. If later during the course of the post rehab program the client’s symptoms re-appear, contact the client’s physician immediately for program guidelines or possible referral for further evaluation. Dr Mike Dr Mike Skip to content
How long should you rest for after a steroid injection?Can I exercise after a steroid injection?As a general rule, patients advised receiving a steroid injection into a joint are cautioned against any heavy lifting or exercise. But after 10 days to two weeks, they are encouraged to start gentle range-of-motion exercises and to remain active as tolerated.
How long should you rest after a steroid injection?As a general rule, we suggest that you rest for a minimum of 2 days after a steroid injection. After 2 days, we would suggest that you can gradually build up your activity levels. However, this advice does vary depending on what area is being injected.
Why can't you exercise after a cortisone shot?You won't need any special attention following the injection unless you've had a reaction to the steroids. Still, your doctor might caution you to avoid high-intensity activity directly after the injection, since excess movement could cause you more pain and swelling at the injection site.
What should you not do after a steroid shot?Don't use heating pads. Not use a bathtub, hot tub or whirlpool for two days. It's OK to shower. Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.
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What happens if you exercise after a steroid injection?
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