HOW TO INJECT

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HOW TO INJECT

All oil based and water based anabolic steroids should be taken intramuscularly. This means
the shot must penetrate the skin and subcutaneous tissue to enter the muscle itself.
Intramuscular injections are used when prompt absorption is desired, when larger doses are
needed than can be given cutaneously or when a drug is too irritating to be given
subcutaneously. The common sites for in tramuscular injectons include the buttock, lateral
side of the thigh, and the deltoid region of the arm. Muscles in these areas, especially the
gluteal muscles in the buttock, are fairly thick. Because of the large number of muscle fibers
and extensive fascia, (fascia is a type of connective tissue that surrounds and separates
muscles) the drug has a large surface area for absorption. Absorption is further promoted by
the extensive blood supply to muscles. Ideally, intramuscular injections should be given deep
within the muscle and away from major nerves and blood vessels. The best site for steroid
injections is in the gluteus medius muscle which is located in the upper outer quadrant of the
buttock. The iliac crest serves as a landmark for this quadrant. The spot for an injection in an
adult is usually to 7 1/2 centimeters (2 to 3 inches) below the iliac crest. The iliac crest is the
top of the pelvic girdle on the posterior (back) side. You can find the iliac crest by feeling the
uppermost bony area above each gluteal muscle. The upper outer quadrant is chosen
because the muscle in this area is quite thick and has few nerves. The probability of injecting
the drug into a blood vessel is remote in this area. Injecting here reduces the chance of injury
to the sciatic nerve which runs through the lower and middle area of the buttock. It controls
the posterior of each thigh and the entire leg from the knee down.
If an injection is too close to this nerve or actually hits it, extreme pain and temporary
paralysis can be felt in these areas.
This is especially undesirable and warrants staying as far away from this area as possible.

FOR INTRAMUSCULAR INJECTIONS:

If the gluteal region cannot be injected for some reason, the second choice would be the
lateral portion of the thigh. Usually, intramuscular injections in the thigh are only indicated for
infants and children. The vastus lateralis muscle is the only area of the thigh that should be
injected intramuscularly. This site is determined by using the knee and the greater trochanter
of the femur as landmarks. The greater trochanter is the bony area that you can feel where
the femur joins the pelvic girdle. The mid portion of the muscle is located by measuring the
handbreadth above the knee and the handbreadth below the greater trochanter. Injecting into
the front of the thigh or inside of the thigh is extremely unwise. These areas contain nerves
as well as a number of blood vessels.

WHAT TO USE FOR INJECTIONS
It is important to choose the proper syringe for the administration of injectable anabolic
steroids. The principle components of a syringe include a cylindrical barrel to one end of
which a hollow needle is attached, and a close fitting plunger. The most acceptable syringe
for injecting anabolic steroids is a 22 gauge 1 1/2" or 23 gauge 1" apparatus with a 3 cc case.
This length allows for penetration to reach deep inside the muscle tissue. Shorter needles,
5/8" or 1/2" are usually not sufficient for intramuscular injections and occasionally leave a
portion of the Injection in a subcutaneous area which will cause a swell between the skin and
muscle as well as impaired absorption. The gauge size of a syringe represents the
needle\rquote s diameter. The lower the gauge number, the wider it is. A 27 gauge needle is
very thin. An 18 gauge is quite wide; it is often referred to as a cannon. The 22 and 23 gauge
needles are not so large that they are difficult to insert, yet are large enough for solutions to
easily be propelled through them. The use of insulin needles is not acceptable; they are
simply too small. Usually, insulin pins are 25 to 27 gauge and only a 1/2" long with a 1 cc
case.

INJECTION PROCEDURES
There are a number of steps that should be understood in order to complete a safe and
proper intramuscular injection. First off, before handling any needles or vials, the user should
take a thorough shower. Next, an alcohol swab should be used to clean the injection site and
another alcohol swab should be used to clean the rubber stopper on top of the vial which will
be drawn from. Then, take a brand new syringe out of its wrapper, remove its plastic top,
draw about 2 ccs of air into it and insert it into the vial. Inject this air into the vial; this creates
pressure within the vial and makes it easier to draw out oil based preparations. Then, turn
the vial upside-down and slowly draw out the oil until you\rquote ve overdrawn at least 1/4
cc. For example, if someone was going to take a shot of 1 cc, they should pull out
approximately 1 1/4 to 1 1/2 ccs of liquid, then tap the side of the case to help get the air
bubbles that were drawn into the syringe to come to the top. At that point, the excess 1/4 to
1/2 cc could be injected back into the vial and the needle removed. Then, hold the syringe
needle-side-up and continue to tap it to encourage all the air bubbles to come to the top of
the syringe. Now, take another clean syringe, remove it from its sterile package and unscrew
the needle from the syringe. Exchange the brand new needle for the one that has just been
injected into the stopper. By using two needles for every injection, you can take advantage of
using the full sharpness of the pin. The needle does suffer some dulling when it is pushed
through the firm rubber stopper on a vial. It is important not to touch this needle before the
injection. It should not come into contact with a counter top, your fingers, nor should it be
cleaned with alcohol. This needle is sterile and should not be touched. At this point, once
again swab the injection site with alcohol, then press the stopper of the syringe holding it
needle-side-up, until the slight air bubbles that are at the top are pressed out. Once a bead of
oil has appeared at the top of the needle, allow it run down the surface of the needle which
provides lubrication. At this time, take the syringe and hold it like a dart. Use the other hand
to stretch the skin at the injection site and simply push the sharp clean needle in. After
inserting it deep into the muscle, pull back on the stopper for a few seconds to make sure it
does not fill up with blood which would indicate that the needle had been injected into a blood
vessel. Providing there is no blood present in the syringe, slowly press the stopper down until
all the oil is injected. Then, quickly pull the needle out and take another alcohol swab and
press firmly on the injection site. This will minimize bleeding, if there is any, and by firmly
pressing on the injection site and slightly massaging it, some of the soreness may be
eliminated. It is important that the liquid is not injected too quickly as this causes more pain at
the site during the injection and in the proceeding days. After this procedure has been
completed, return the plastic caps to shield the needles and make sure they are discarted
properly. To avoid discomfort and excessive scar tissue at the injection site, it is not wise to
inject more than 2 ccs of solution per shot. It is also not prudent to use the same injection site
more than twice a week (once a week is preferred) .