Limit cortisone injections to three in the lifetime of a specific tendon sheath to avoid adverse effects.

“what do you use as a rule of thumb for how many times you'll put three three at three in the lifetime of the joint three in the lifetime of that tendon sheath unless it's very very broad usually you don't see someone back 10 years later who needs another injection but if I did I'd be willing to do that again because everything has normalized physiologically at that point”