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Technique Ultrasound-guided approach (preferred) Local Corticosteroid Injection at tendon sheath under Ultrasound guidance (see Shoulder Ultrasound) Approached in-plane to linear Ultrasound probe (probe short axis to anterior Shoulder - home position) Do not inject within tendon (and avoid circumflex artery within groove) Technique Landmark-based approach Images Landmarks Identify bicipital tendon in bicipital groove (proximal Humerus) Mark point of maximal tenderness over groove Injected with sterile technique (with Betadine preparation of skin) Direct needle parallel to bicipital groove (vertically oriented) Needle enters skin at 30 degrees oriented superiorly Do not inject bicipital tendon Infiltrate area around groove, but not into tendon Flow resisted when needle is inside tendon Withdraw needle slightly and retry Continue to withdraw until not in tendon Complications Bicipital tendon rupture Associated with intratendinous injection Do not inject bicipital tendon References

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But virtually all of them are overhyped at this point. There are promising results popping up in petri dishes (in vitro studies) and in animal models, but human data is very limited at this point. Norton says hes cautiously optimistic about the true potential of peptides, but given that less than 50% of animal study findings carry over to humans, these compounds really should be vigorously tested in human trials before being marketed to the public. The digestion process may make many of these peptides biologically inert, as digestive enzymes can break them down, though there are some measures that can be taken to protect them during this process