• June 25, 2022

Did A Cortisone Shot Lead To Howard’s Torn Achilles?

Frank Fitzpatrick of The Philadelphia Inquirer wrote a piece over the weekend about the events leading up to Ryan Howard’s torn Achilles which brings some interesting new information into light.

In the weeks leading up to Howard’s injury, the slugger had been battling some pain in his left heel. The pain become significant enough that the Phillies decided to give the first baseman a cortisone injection to treat the injury in hopes that his discomfort would fade away, and the former All-Star would be in top condition for the playoffs.

Just a few weeks after receiving the injection, Howard suffered his torn Achilles on the final play of the NLDS, which raises questions about whether or not the team took a major risk by allowing one of their most valuable players to take a cortisone injection.

Fitzpatrick writes “Ample medical evidence suggests cortisone can damage surrounding tissue, fray the Achilles, even trigger a rupture. According to one recent survey of orthopedic physicians – many of whom unhesitatingly prescribe cortisone for tennis elbow or rotator-cuff problems – two-thirds would not use it to treat an Achilles injury.”

“Because the drug masks pain instead of addressing its root cause, some fear it encourages patients to overuse the significant weight-bearing tendon, risking additional damage. Dr. Karim Khan, a researcher and professor at the University of British Columbia, told the New York Times in 2010 that cortisone injections may actually “impede the structural healing.”

While hindsight is 20/20, it seems as though the Phillies took an insane risk by giving Howard a cortisone shot so close to his Achilles tendon; a risk that has come back to haunt them.

The medical evidence that Fitzpatrick described suggests that applying cortisone to a sensitive area of the body, an area that is going to receive a great deal of physical stress, is just asking for trouble. The drug may have done a lot more harm than good if it masked all of the pain Howard was feeling, allowing his leg’s condition to gradually decline until it became a full-blown Achilles tear.

Fitzpatrick goes on to write more about the risks involved with a cortisone injection so close to the Achilles.  “In 1996, even though the San Diego Padres’ medical staff initially balked at injecting the drug so close to his Achilles, Tony Gwynn had at least one cortisone shot near the tendon. A year later, Cincinnati’s Barry Larkin had two injections. Both players ended those seasons with a partially torn Achilles.”

There you have two examples of a couple of former stars that suffered the same fate as Howard shortly after receiving cortisone injections near their tendons. The Phillies had plenty of evidence in front of them to suggest that a cortisone shot near the Achilles tendon is a recipe for disaster, but they chose to do it anyway.

Ruben Amaro Jr. responded to the story, saying “The cortisone shot was treated for some (other) issue he had. It was not part of the Achilles’ injury. We didn’t feel it was an issue. That was resolved by the time he had his injury. One thing had nothing to do with the other.”

While Amaro may say that the Achilles injury had nothing to do with the cortisone shot, can we actually trust what he says? This is the same guy that told us there was nothing to worry about Chase Utley’s “routine soreness” in each of the last two years during Spring Training, only to ultimately reveal that the second baseman would be out for an extended period of time. To be fair, you can’t expect the general manager to come out and admit that they made a serious mistake by giving Howard the shot. That would be a major black eye for the organization, and their medical staff.

Could Howard’s cortisone shot have set the table for his eventual tear? Or is it just a coincidence? We’ll likely never know the truth. However, it seems to me as though they took a short-sighted gamble (ignoring all known medical risks) to get their star at his best for another World Series run, and their decision may leave them with a power hitter that will never be what he once was again.

Denny Basens

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  • It’s very unlikely any connection to this..Howard was trying to get out of the Batters Box in his and the Teams’ final At-Bat last October verus the Cardinals, and his Achilles Tore, plain and simple as that..

  • Do we really need to find someone/something to blame for this? These things happen every day. I just hope this doesn’t turn into another team vs player thing.

  • I had some heel pain recently and went to my foot doc to get some help – I frequently have tournaments where I am on my feet running all day – and when I went in before with some plantar fascitis type problems, he hooked me up with cortisone right away to stop the pain, and then of course sold me some good orthodics – haven’t had a problem since – but probably the end of January I went to see him with heel pain… and we had this very discussion as to why he didn’t give cortisone shots near in that area.. sent me away with a heel lift and some prescritpions for some anti inflams…

    not sure if that is the cuase of Howard’s issue – but damn! Thanks doc!

  • classic paulman, finally an article with scientific, peer review like substance, and paulman dismisses it out of hand because it is not the type of information he relies upon, “per my(always unidentified) sources…….”

  • but back to the article, there is something decietful in the way the phillies seem to control, process information, in the past with Gillick even wade things were pretty much transparent, phillies turning into eagles sorry to see

  • jake – funny part is the other article on this site (another knock off of a Philly dot com article) is how the eagles are trying to change their PR method

  • i was just going to say eagles now more like phillies, the times they are a changin

  • I do not get overly angry when this site takes aarticle from another site. People come to this site to blog and keep up with philly sports news. I get the Philly daily news everyday but sometimes dont get a chance to read until the following day or sometimes the weekends. I mean this site has def dropped off since 08-09 but they do hit the topics that people like to voice their opinions over. I would like a few more articles from G about the team with his opinions.

  • Frank – I hear you and I don’t think anyone get’s overly angry about it. However, I do think it’s worth noting to people who think this site is a source for original news. Some just don’t “GET IT”. The discussion forum is uniquely special on this site – no doubt – but I think it’s wrong to view it as a news source or even something Garry himself takes seriously….

  • The only Orignal News here is Songs with his Vaccine Conspiracies..ha

  • @ Schiller – I hear ya. Angey was not the right word.

  • angry

  • Im an Orthopedic surgeon, let me state that ALL Orthopods know that injecting cortisone near a tendon places that tendon at increased risk for rupture. The Achilles tendon is probably THE MOST notorious for risk of rupture. It was my understanding that one should almost NEVER inject near the achilles tendon…..Period.

  • rastadoc – did you ever have an experience with a patient with the type of infections Howard went or is going through

  • We got eagle has landed as our resident head doc – now we got rasta doc as our resident bone crusher –

    but question doc – Most orthopods don;t have a problem doing to cortisone in places like the shoulder (my girl had an inflammed RC tendon that goes thorugh that narrow passage) or elbow – why does it not weaken/seem to hurt those – my foot doc had no problem with that tendon in my foot –

    is it the stress and wieght bearing? If someone has heel pain – can they just play through the pain or does the pain indicate the tendon is comprimised? Don;t bill me – just curious!

  • Paulman equals jackass, just read the literature about Achilles rupture and cortisone injections, discount everything this jackass posts, unless it’s per his sources, doubly discount

  • Phils are 1-3 in “Paulman’s 23 Game Stretch to Define the 2012 Season”..
    Keep living in the past Jakedog as it pertains to the Phils, the rest of the NL has moved forward while the Phils are going backwards…
    6 games Win streak against the bottom feeders of the NL are a distant memory

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