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- When we compound for athletes we are proud to report favorable responses from patients and team personnel, along with favorable outcomes. These outcomes come from compounds such as topical muscle relaxants, transdermal gels, sprays and ointments for pain relief, ultrasound gels and iontophoresis solutions.
- These compounds can be extremely beneficial for the following specialties: sports medicine, wilderness medicine, and travel medicine. This type of compounding is nothing new. Transdermal pain gels are used throughout the country on nearly every professional sports team. In addition, they are kept on hand at USA National Karate-do Federation (USANKF) events and at TreK competitions.
Practitioners and athletes alike have found that topical compounds can be very effective in the treatment of sports-related soft-tissue injuries. In athletes that have abrasions, a popular compound that is used contains aloe vera, lidocaine and bupivacaine. “The lidocaine and bupivacaine are regional infiltrative anesthetics. The aloe, which has antibiotic properties, also acts as an antiprostaglandin to reduce inflammation, soothe injured tissue, and promote healing.” Says Patrick M. Knost, MD, a family medical physician.
Knost’s prescription of choice for treating the scrapes and soft-tissue injuries sustained during competition is ketoprofen 20% in penetration-enhancing vehicles. “In sports medicine, compounded ketoprofen cream is incredibly effective,” he said. “It provides immediate relief, and it’s very safe — I don’t know what I’d do without it. It’s an excellent treatment for contusions, sprains (especially twisted knees), strains, insect bites and crush injuries. I often give my injured patients a 10-mL syringe filled with the cream for later application. I’ve also prescribed it for patients who have trochanteric bursitis, which often afflicts weekend warriors or those who have just started an exercise program. It provides relief from tennis elbow in 10 minutes, and it’s a great treatment for osteoarthritis of the fingers. Compounds like this cream provide my patients with effective treatments that aren’t available commercially.”
- A staff member of the Clemson athletic department for more than 20 years, Danny Poole now oversees 18 intercollegiate sports programs for men and women, including football, volleyball, basketball, swimming, soccer, baseball, golf, tennis and track. Approximately 550 students who range in in age from 18 to 22 years participate in Clemson sports.Poole keeps the following compounds handy to treat injured Clemson athletes. The schedule for application and the duration of treatment vary from patient to patient.
- Ketoprofen 10%, 15% or 20% in Pluronic lecithin organogel (PLO)
- Dexamethasone 0.4% in an aqueous solution for iontophoresis
- Acetic acid 2% or 4% in an aqueous solution administered by iontophoresis
- A combination of baclofen 5%, lidocaine 10% and guaifenesin 10% or 20% in PLO
- Lidocaine 4%, epinephrine (adrenalin) 0.05% and tetracaine 0.5% (LAT) in a spray or hydroxyethylcellulose gel
- Muscle relaxants such as guaifenesin (usually 10% or 20%) in PLO or cyclobenzaprine 0.5%, 1% or 2% in PLO.
- “Compounds definitely have a place in the treatment of the injured college athlete,” said Poole. “The customized topicals that we use for sports injuries are not commercially available. Athletic trainers should work with a compounding pharmacist and a physician to devise treatments for the injuries their athletes usually sustain. They should also keep an adequate supply of those medications on hand for immediate use. It is our goal to put athletes back into their field of play as safely and quickly as possible, and compounding pharmacists can often help. They can provide us with therapeutic tools to restore the injured athlete to pre-injury fitness.”