Table 5

Injuries for which local anaesthetic could be used in professional football with routine caution—that is, where the benefits will usually outweigh the risks

Acromioclavicular joint sprainBlock is usually very successful. There may be an increased risk of needing distal clavicle resection at end of season, which is not usually a significant threat to a player's career
Phalangeal injuries (toes and fingers) and metacarpals 2–5Block is easy to perform. Vasoconstrictors should not be used. Some injuries may lead to degenerative arthritis of interphalangeal joints, although in most cases this is acceptable to a professional footballer. The major factors to assess are loss of range of motion and whether the player has any pursuit outside football that involves fine use of the hands, such as playing a musical instrument
Rib and sternum injuriesBlock is usually successful when rib injuries are lateral or posterior. Sternum, sternoclavicular joint, and anterior injuries to high ribs are very hard to block adequately. Pneumothorax is a possible complication, but usually occurs in conjunction with acute injury
Bruised iliac crestBlock usually provides major relief from this very painful but self resolving injury. The only common complication is sensory nerve block (lateral femoral cutaneous nerve)
Chronic plantar fasciitisInjection is very painful. Rupture of the plantar fascia origin is likely but this may, in fact, “cure” the chronic condition