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Tendon weakening & rupture : Corticosteroids can impair collagen and slow tendon repair, increasing the risk of partial or full tendon tears (Achilles, patellar, rotator cuff) American Journal of Sports Medicine (2006) , For conditions like tennis elbow, while cortisone may offer faster initial pain relief, a study in JAMA (2013) found that patients had worse long-term outcomes (higher recurrence rates and poorer full recovery) at one year compared to those who opted for physical therapy alone, suggesting it may hinder long-term healing Bone risk : Repeated steroids have been associated (rarely) with avascular necrosis (loss of blood supply to bone)