How long do I need to rest after having a steroid injection?

Many people often ask us how long before they can do their sport again or get back to their regular activity. The rest period required after having a steroid injection can vary.

In reality the answer always depends on the individual, but there are a few common pieces of advice that might help you decide when to have a steroid injection.

After any injection, whether it is Hyaluronic acid (HA), Platelet Rich Plasma (PRP) or steroid (cortisone) we recommend you rest for a minimum of 2 days. This is to allow your body to adapt to what we have injected. Occasionally, some people will have a flare after an injection. This is where you will have more pain or discomfort around the injection site as certain structures may have been stretched with the introduction of more fluid, or may be irritable by the substance now in the tissues. This is a normal reaction in up to 1/5 people. You must ensure that if you do have a flare that you rest until it completely settles. This could take up to 1 week.

How long you rest after the initial 2 days depends on a few factors.

What was injected and where:

There is evidence that a steroid injection can cause a weakening of soft tissue structures like tendons for the initial 2 week period after an injection around a tendon. Therefore if you have had an injection around a tendon, in particular a large weight bearing tendon like the achilles, we suggest you should rest for 2 weeks before loading it again. Injections into joints require a shorter rest period and we usually advise 5-7 days as an optimum before loading again.

Loading may mean different things to different patients too. Gentle walking is absolutely fine following a steroid injection to the knee, unless you were not doing much walking prior to having the injection in the first place. So your “pre-injection” activity level will be taken into account when we advise on how long to rest before you can begin some activities.

If you plan on returning to running, then an upper limb injection should only cause you to rest for 2-5 days, whereas a lower limb injection could require 7-14 days of rest before you run again.

If you have had a Hyaluronic acid injection then your rest period could be as little as 2 days. There is no steroid in this type of injection and therefore it is safer to load sooner. It is important to understand that this type of injection will not usually give fast relief of symptoms, however as peak benefits are often reported 3-5 weeks post injection.

Having a PRP injection may require more time off activity as it is considered a “pro-inflammatory” treatment. This means that we are trying to induce an inflammatory response in the joint or tendon so it will need time for that inflammation to runs its course to have the desired regenerative effect that is required.

In general joint injections will require less time off activity before you can return to your activities. Tendon injections involving steroids will usually require longer periods of rest.

If you have not been very active prior to the injection then we would not encourage you to return to activity too quickly as things can become aggravated again easily.

A useful guide might be the longer you have had the condition and limited your activities, the longer it will require to build back up to your regular activity levels again.

In summary:

If you are planning on having a steroid injection, you should time the injection around your training schedule. This means if there is an event or activity that you would like to be involved in, make sure you allow enough rest period prior to the event to maximise the results of your injection.