Frequently, multiple injections are required for comprehensive treatment of the patient. Typically, patients have multiple trigger points, and 3 sets of injections are required; however, it has been this author's observation that administration of up to 10 rounds of trigger point injections may be necessary. Each week, the patient may return with a new "worst spot. Tendon and joint injections generally are limited to no more than 3 in 1 joint per calendar year because of the potential for mechanical disruption of the joint space and structures.
Awareness and educational efforts are working to help prevent anabolic steroid abuse in schools and communities. The Adolescents Training and Learning to Avoid Steroids (ATLAS) and the Athletes Targeting Healthy Exercise and Nutrition Alternatives (ATHENA) programs, funded by the NIDA, and supported by the Oregon Health & Science University programs is teaching athletes that they do not need steroids to build powerful muscles and improve athletic performance. These programs provide weight-training and nutrition alternatives, increase healthy behaviors, less likelihood to try steroids, and less likelihood to engage in other dangerous behaviors such as drinking and driving, use of marijuana and alcohol , and and improved body image. Bother Congress and the Substance Abuse and Mental Health Services Administration endorsed these model prevention programs. 4