Table 6

Examples of injuries for which local anaesthetic should only be used in professional football, with extra caution, when the rewards are very high (as risks are also high)

Ankle sprainsMRI scan is indicated to assess the state of articular cartilage, and injection (even extra-articular) is best avoided if there is any significant articular damage
Tendon injuriesTendon ruptures are likely when a local block is performed to relieve pain arising from the tendon. In certain circumstances (particularly tendons with many agonists) this risk may be acceptable
Prepatellar and olecranon bursaInfection is a likely complication of injection of these bursae. In the case of prepatellar bursa (or any other extra-articular knee injury), documentation should be made, perhaps with a witness, to specifically note that the injection was extra-articular, in case the player suffers a serious knee injury during the game
First metacarpal and radiocarpal injuriesThe thumb and wrist are more critical hand structures and degenerative conditions should not be accepted lightly in these regions. Scaphoid fractures should always be excluded as this is a common missed diagnosis that on occasion cannot be cured surgically