The use of local anaesthetic injections in professional football.

Local anaesthetic use in professional football is one of the greatest taboos in sports medicine. The subject is not covered comprehensively in any sports medicine textbook or review article. Most of the publications citing local anaesthetic use are legal cases from the National Football League (NFL) in which the procedure has been connected with a career ending injury. 1 2 There are some candid accounts of how commonplace local anaesthetic use is in the NFL, 3 4 and anecdotal evidence suggests that the situation is no diVerent in professional football competitions elsewhere in the world. This includes professional rugby union, in which the practice is oYcially banned. I have previously published my personal statistics of local anaesthetic injections over a four year period with a professional Australian football team, 5 6 but cannot find any similar documentation from other doctors in the sports medicine literature. The attitude of most professional football doctors may be that this practice is a necessary evil that can be performed on certain occasions, but not mentioned or justified in public. I contend that we end this hypocrisy. Either sports physicians should cease using local anaesthetics in professional football and recommend that the practice be universally banned, or we should study the procedure, speak and write freely about it, and produce guidelines for its rational use. The eVects of oYcially banning local anaesthetic use, as the International Rugby Board has done, would include an increase in injury prevalence, which is measured by players missing games. This is because players who could take the field with a painkilling injection would be forced onto the sidelines by team physicians adhering to the law. Anecdotal evidence is that the ban in rugby union has not eliminated the practice from occurring altogether. Most of the desire to take the field with injury arises from the players themselves, and if regular doctors refuse to use local anaesthetics , some players find an alternate doctor who is willing to do it in secret. For a suitable injury in a critical match, a player may be able convince his doctor to administer the injection even if it was banned, with both parties oYcially denying it. Suspending players for testing positive to a local anaesthetic in a drug test is not practical, as these drugs are regularly needed in professional football during the procedure of suturing lacerations. A ban on local anaesthetic use is …