The Weight Training Debate: What Sports Medicine Says About Building Muscle Safely

No. Steroid is given for active pain and inflammation, early in the treatment pathway. Regenerative therapies like PRP are used once the condition is confirmed chronic with no active inflammation. Combining them is counterproductive, since steroid's anti-inflammatory effect can work against the regenerative signal from the growth factors.

First rule out diabetes and thyroid disease, which account for around 30% of bilateral shoulder presentations in practice, then check for manual/overhead work. If negative, get a plain X-ray to rule out joint space narrowing and calcific tendinopathy, then trial physiotherapy (ultrasonic therapy, TENS, shoulder exercises) with a 3-week NSAID course. In this case, rheumatoid factor came back positive with MRI showing bilateral partial-thickness supraspinatus tears and subacromial bursitis — so the approach became NSAIDs, DMARDs for the underlying rheumatoid disease, a triamcinolone injection into the subacromial bursa, and physiotherapy. A repeat steroid injection should not be given before 3 months. If there is still no response, proceed to shoulder arthroscopy to debride the bursa, assess the AC joint and address the tendon tears directly.

Yes. Chronicity is labelled at 3 months, with 6 to 12 weeks as the clinical boundary. A patient should start with NSAIDs, not regenerative therapy. Only if steroid injection has also failed to control the inflammation between 6 and 12 weeks should regenerative therapy be considered, and 3 months is the ideal timing.

Around 10 to 14 ml of blood is drawn from the patient into a kit-supplied vial containing heparin, then centrifuged to separate the platelet-rich plasma from the rest of the blood. This typically yields about 5 ml of PRP solution, which is injected as multiple pricks around the tendon or ligament rather than as a single injection, to achieve the best results.

Platelets contain multiple growth factors, including PDGF and TGF-beta, that promote healing through two mechanisms: increasing vascularisation of the target tissue and stimulating cellular regeneration. One group of factors increases local blood supply, while another increases cellular activity — together they drive ligament, tendon and articular cartilage repair.

Yes, but only when properly progressed. Correctly executed strength training in younger years does directly help maintain bone strength into old age.

It describes how stress beyond a tendon or muscle's elastic limit causes it to fail, which is why progression has to be graded rather than pushed past a person's true capacity, and why gym instructors need proper training to prescribe safely.

Influencer advice commonly pushes 2 g/kg of body weight against a clinical recommendation of 0.8 to 1.5 g/kg, and overuse risks real kidney damage.

Commercial protein products carry a documented risk of anabolic steroid contamination, so dosing should be guided by a dietitian or nutritionist based on body weight and activity level.