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Exhausting and dangerous, are infiltrations on the way out?

A prick and it starts again! There was a time not so long ago when the world of professional sport, especially football or rugby (but not only, far from it), swore only by infiltrations, these cortisone injections injected close to a painful area of ​​the organism (here a knee, there an ankle), to temporarily treat an injury and allow the player to frolic like a doe, as if nothing had happened. Finally, we say “treat”, but it would be more accurate to say “hide”. “The infiltrations done before a match absolutely do not treat the injury, they serve to mask the pain, confirms Thierry Delmeule, the Girondins de Bordeaux doctor. It is neither more nor less than a bandage on a wooden leg”.

If it can still happen that players have occasional recourse to this practice to play an important match – this was the case for example of Taylor Fritz before his final against Nadal in Indian Wells – it seems on the other hand that the time when the one piqued for a yes or for a no is over. And for good reason: “It’s the repetitive, chronic side, which has done monstrous damage to both bone and tendon. If you do an infiltration, the tendon will thin out and over time it will break. Same at the bone level, if you use it repeatedly in the same place, the corticosteroid eats away at the bone, it makes holes in it. Bellone, Amoros or Van Basten, to name but a few, experienced catastrophic end of careers or post-careers because of this, ”explains the Bordeaux doc.

Uninformed or uninformed players

The most appalling case remains that of Bruno Rodriguez, whose right leg was amputated in mid-March. If we cannot say that this is due solely to infiltrations, for him, there is little doubt. “When I was playing, I had a lot of ankle sprains (…) I always wanted to play, for the little ones as for the big games, so I was undercover, he told The Team after his operation. And it leaves traces. The cortisone that was injected into me, it is known, it eats away at the cartilage, and if there is no more cartilage, it squeaks inside. We, as soccer players, are not necessarily aware of the consequences. It is certain that if it had been explained to me, I would have said that I was letting the coming match pass… ”

This lack of information, the former French rugby player Imanol Harinordoquy has repeatedly denounced. Even today, he says he is “angry” at the veil posed on the more or less long-term risks of repeated infiltrations.

“At the time, there was no information given to the players, and I say it all the more easily as I have seen it throughout my career. Afterwards, it happened to all of us one day to play undercover before a big game. We assume the risk, there’s no problem. But I think that in some cases, if we had been aware of the risks involved, there are quite a few games of lesser importance that we probably would not have played…”

“Yet it is paradoxical because I was the first to criticize the guys who had taken a little hit and who did not want to play on the weekend, which was managed. We used to say that, “you manage yourself”… But looking back, I tell myself that they were the ones who were right. »

A lack of hindsight at the time

Conversely, former French tennis players Florent Serra and Paul-Henri Mathieu – both known to have played for many years gritting their teeth and who sometimes resorted to infiltrations – have always been informed of the inherent risks. “At home, in tennis, at least in the French Federation with Doctor Bernard Montalavan, we have always been very careful on this issue”, assures PHM. “We were always discussing the benefit/risk ratio with him,” says Serra.

Was this concealment of information then specific to collective sport? “It’s not impossible, thinks Mathieu. In co-sport, the goal of the club that recruited you and pays you is to be able to use you as quickly and as much as possible. I don’t know if all clubs think first and foremost about the long-term career of their employees. We have no choice, we are alone to manage our career, we need it to last from a financial point of view. The objective is to play as long as possible and therefore to be very attentive to the long-term risks. »

If he does not deny “a certain pressure from clubs, presidents, coaches, even players, at the time”, Doctor Delmeule also explains that all these little people also lacked information “in the 1980s, 1990 and 2000”. “At first we had good results, it’s true, but then we realized that the players who were regularly infiltrated farted or were completely disabled after their career. We therefore backtracked and realized that there were other possible supports, with which the player may miss a match at the beginning but at least he will be really healed and not just relieved . But before we didn’t know about all these side effects, we didn’t have that perspective. »

When painkillers make athletes addicted

Conscious, them, of the risks incurred by these magic injections, and because it was necessary to play well despite the pain under penalty of “being pushed out by others and no longer earning a living”, according to Serra, our two tennis players admit on the other hand, having consumed a lot of anti-inflammatories such as Voltarene or Ibuprofen. At the risk of becoming addicted. Paul-Henri Mathieu: “At some point you can’t live without it. Painkillers are like a drug, I don’t hide it. In the last seven or eight years of my career, I haven’t played a match without taking anti-inflammatories. It’s not necessarily good either, we know that. I had a fragile stomach and I had to put on gastric bandages. I even ended up in the hospital twice before big tournaments because I thought I had an ulcer because of the painkillers”.

In football too, Voltarenomania is still relevant, as explained by the former doctor of the France team, Jean-Pierre Paclet, in a long interview with our colleagues from So Foot : “It has become an addiction for some, a reassuring reflex. A bit like my grandmother who, if she doesn’t have her dose of paracetamol every day, says she hurts all over. Anti-inflammatories are almost a placebo effect for some footballers. Under cover of anonymity, another doctor told us the story of a great Ligue 1 striker of the 2000s who, on arriving in France, asked for his little injection of painkiller in the buttocks before each match.

“After a while, we put water in to make physiological serums instead of Voltarene, we gave him an injection and he told us that it did him good, until we confesses to him that it was water, that it was useless and that he had to stop. It becomes a kind of ritual in fact”. On arrival, whether we are talking about small pills or infiltrations, “the best thing is still rest”, advises Delmeule. “The goal is to heal the wound and not to hide it, otherwise it will make it worse,” he concludes. This is what we are aiming for today. In Bordeaux, infiltrations, we must do two or three maximum per season ”.

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