Back in New York, I joined the Midtown Y and fell in with a crew of hard-hat bruisers – vice cops and garbagemen in chalk-smudged Speedos and calf-high wrestling boots. I thought they were giants until the day in June when the real size kings walked in. Two of them, Tommy and Spiro, had chiseled trunks and the complicated, quasi-Cubist planes that give away hardcore juicers. But it was the third one, a mocha-skinned guy named Angel, that I couldn't pry my gaze off. When he doffed his Puma jacket and burned through upright rows, I saw the kind of vascular, strand-on-strand rhomboids you find in Da Vinci studies. There was art in what he did and art in what he made: muscle from a fourth dimension. I gathered my flimsy nerve and said hello.
The aim of this study was to evaluate the effects of repeated steroid injections into the subacromial space. Thirty rats were injected either 3 or 5 times with triamcinolone in a dosage equivalent to that given to human beings or 3 or 5 times with saline into the subacromial space. One rat received no injection. The supraspinatus and infraspinatus tendons were evaluated macroscopically and microscopically. Two different staining methods were used on each sample including hematoxylin eosin and Miller's elastin/van Gieson's solution. After 5 steroid injections, we found focal inflammation, necrosis, and fragmentation of collagen bundles in the tendon in 4 of 7 rats. The tendons of the controls showed a normal structure (P < .05). There were no pathologic changes among the rats that were injected with triamcinolone 3 times. These results show that repeated subacromial injections of triamcinolone may cause damage to the rotator cuff of the rat. This finding may indicate cautious use of subacromial steroid injections in human beings.