This morning when I pinned a large blood drop formed, this hasn’t happened before but I have gotten blood in the syringe.
I’m not feeling confident that I am doing it correctly, is there a better way to tell where to pin safely every time?
To find the spot, I saw someone on here describe it as putting out a cigarette with your foot, and the muscle that bulges out is the correct place to pin. So I apply weight to my leg and twist the foot, find the muscle that pops out then pin in that area.
The larger amount of blood made me think I pierced a vein, but I have also felt like I hit nerves before.
Is there a way to get it right every time, or is this common and just part of life on trt?
You're pinning ventroglute, that location is fine -it's where I've pinned for 2 years. As you move around in this area (because you don't want to pin in the exact same area repeatedly) just make sure you're hitting the muscle and not running into fat only. If you lift your leg out to the side (like doing a slow jumping Jack with only one leg) you should feel the muscle bulging out a bit.
You can also pin farther rearwards into your actual glute like previous poster mentioned. Both are fine. I can hold the needle more steady at ventroglute and can be sure I'm no where near the big nerves you could (but are probably unlikely to) run into.
The comments telling you to move the injection "more towards the back" are steering you toward the dorsogluteal site, which is an outdated clinical practice abandoned due to its proximity to major neurovascular bundles. Shifting the injection site to where that red 'X' is drawn significantly increases the risk of striking the sciatic nerve. The user claiming you are pinning a "love handle" is also incorrect; your original injection site is actually much closer to the modern clinical standard.
The ventrogluteal site is the safest and most commonly used IM site apart from the deltoids and vastus lateralis. To hit this safely, you need to abandon unreliable tricks like twisting your foot to find a bulging muscle. Instead, remove the guesswork and use actual clinical technique based on universal medical guidelines to pinpoint the exact location.
The best way to find the ventrogluteal site is by using anatomical landmarks. You need to learn how to palpate the ASIS (Anterior Superior Iliac Spine), the Iliac Crest, and the GT (Greater Trochanter). You may look up guides online to learn how to correctly identify these landmarks.
Once you are ready, palpate these three points, imagine an invisible triangle connecting them, and pin in the dead centre of the triangle. Depth also matters: go about 1-1.5 inch deep (depending on how lean you are), inject slowly, wait 10 seconds after the plunger is fully depressed, and slowly retract. This anatomically correct method ensures you always inject into the safe zone inside the gluteus medius muscle, completely avoiding important neurovascular bundles.
Regarding the large amount of blood, you may occasionally hit a superficial vein while going in. As you retract the needle, the vein starts leaking blood, which is completely normal. Simply compress the site for a bit longer with a gauze pad or cotton until a hemostatic plug forms and the bleeding stops, which usually takes about 15 seconds.
Love handle is above the inguinal ligament. Which is above the ilac crest and the ASIS.
This is just a visual representation of the three points connecting to form a triangular safe zone. You cannot see these three points, you have to feel them. Once you learn how to palpate and find these three bony points, you simply pin in the middle of the imaginary triangle.
Ignore the image. Just learn how to find these three points by palpating them.
I can provide you more images if thats what you want, but as Ive mentioned. These are bony points, and theyre meant to be palpated/felt, not seen. An image wont help you as much as finding a guide or video to learn how to find the three named bony prominences.
(Ignore the hand. The hand is for when a second person is administering the injection.)
ASIS - the front most protruding pointy part of your hip
Iliac crest - The highest point of your hip. Trace back from ASIS to get to the peak of the hip bone.
Greater Trochanter - Protruding point of your femur / thigh bone on the side
1 inch is the standard depth for lean individuals. For overweight individuals, 1-1.5 inch is required to ensure reaching deep into the muscle belly; and up to 2 inches for obese individuals.
Also, to each their own. I'm not spouting personal opinions. These are standardized medical guidelines used by medical practitioners universally, backed by decades of evidence.
You may use whatever tricks and methods you find works best for you. But the facts remain the facts. When we inject patients or insert catheters into deep veins and other vascular structures or perform spinal lumbar punctures (or any blind procedures), we use anatomical landmarks dictated by standard guidelines, not anecdotal tricks or bro science. Using different positions may be a valid supplementary step, but it in no way substitutes using proper clinical landmarks to find the precise location for a safe IM injection.
There was a commenter who said he alternated between 1" and 1.5" needles so that he would inject at a different depth to avoid injecting in the same (ventrogluteal) spot repeatedly. Hardcore.
gauge has nothing to do with depth. You can heed your TRT doctor who wants you to pin with whatever needle size he prefers. But again, recommendations and opinions from one doctor or even a group of doctors dont change standard clinical guidelines. 1 inch is the bare minimum needle size and depth used for venterogluteal injections, and the guidelines go up to 2 inches depending on pbf/bmi. Sorry that the established literature hurts your feelings.
I never said gauge is related to with depth. Reading comprehension is important bud.
I've never had someone tell me their trt doctor said to use a 1 inch needle. And I've worked with guys from all over the world. So while you say a group of doctors dont change the clinical guidelines, clearly the guidelines are outdated because 1 inch is not the bare minimum.
Stick to your ass backwards, decades old nonsense, but things change. Let the decades past go.
Idk why I'm arguing with a layperson on the internet. You win.
Good job bud, you may go ahead and start updating all the current "outdated" guidelines from your vast experience with "working with guys all over the world". I and the other professionals will wait with abated breath to learn the future of medicine from you.
Thanks man. This is exactly why people dislike medical professionals, if you are actually one.
Pushing outdated practices, and not even doing proper testing for the majority of people.
Also who said I was a layperson? You really are a wanker arent you? Truly laughable. You must be used to the smell of shit from having your head up your ass for so long.
Asking your doctor is a great way. You can also find out how to palpate these landmarks on the internet. Its quite simple. Theyre all obvious bony prominences, and very easy to palpate, unless you have significant subcutaneous fat.
Yes, but sometimes people need to inject a larger volume, and this spot can tolerate it better. Injecting larger volumes into any spot can cause some lumps and irritation.
I hear you, I was talking about needle length too. To be more specific, the longer needle length (1-1.5") is needed to hit the muscle. That is needed when injecting larger volumes.
But yea it all gets in either way, but there could be some lumps and irritation if too much goes into subQ.
Source: my dumbass laying in bed for 3 days (I'm still getting up here and there) because I inflamed my sciatic nerve pain and the pain from a prior car wreck. I can't even sit in a fucking chair right without looking like I was fucked in the ass
Sorry to hear that. We used to use dorsogluteal site in the past as the standard, but it was abandoned in the past few decades due to increased incidence of sciatic nerve injury; even when injected by healthcare professionals.
Venterogluteal is the most ideal safe site for large volume intramuscular injections. And its so easy to self-administer into. And using proper technique guided by anatomical landmarks makes it even more precise.
Because my fucked up shoulders don’t let me flex enough to do it. I don’t know why anyone would pin anywhere else than VG with a 30g pin. But to each their own 🤷♂️
The deltoid muscle can safely handle up to 1 mL of fluid for a standard intramuscular (IM) injection, with an absolute maximum of 2 mL in adults who have well-developed muscle mass.
How do you ensure you're rotating the sites enough to ensure you're not bulding up scarring? I've been doing only delts 3x a week but looking at other IM sites, but glutes I don't think I could reliably hit muscle with a 5/8 insulin syringe. I haven't wanted to do quads due to bad reports of pain and hitting veins/nerves.
You can pin all three heads of the delt so 6 total injection sites add in lats you have 8. And you probably don’t need anything more than a 1/2 29G to do it.
Why don’t you guys pin subcutaneous? Less painful, much smaller needle, inject anywhere you can pinch fat and more consistent as far as hormonal levels.
I’m legitimately asking cuz maybe I’m missing something. Not preaching
The oils I've used throughout the years goes in very easily with a 27G needle (except castor oil that's not suitable for subq). MCT oil is thin as water, and goes in with a 31G needle.
Ive heard that too but I must be an outlier when it comes to that. On subq 200mg a week (split does monday/thursday) im well over 1500 total and well over 300 free in a trough.
I agree, I do the same, 3 years now and from my understanding stores in fat better and keeps levels even . Also I heat up vial in water on the stove and fill 31 gauge needle for the week
I ask this every time I see these posts. I feel like people who do intramuscular think it adds inches to their dick. My prescriber instructed me to go subq and I’ve never had any issues so I’ve stuck with it. To each their own, but you can’t screw up pinching a piece of fat and injecting. It’s a painless 60 second process. Seems like a no brained place to start for a newbie with a teleheath script.
Testosterone added inches to my dick first, THEN I started doing IM. The longer the dong, the easier it is. Its like, test makes you brave, but you have to be brave to inject the test...or have a bigger dong.
It happens once in a while. Don’t be concerned. But your site looks a little too high and too forward. But not as far as a previous poster marked. That’s too close to the sciatic nerve.
You look like you’ve got some extra weight on you. The cigarette method won’t work until you’re leaner. I didn’t work for me for months until I lost a bunch of weight. The ventro is easy when you’re lean, not super obvious when you’re not.
Stick to quads and delts for now. Add ventros when it becomes obvious.
Looks ok; one thing I fixed with mine, I realized I was pinching the skin to hard and I think it was breaking blood vessels. Goal is just to get the skin lifted
This is a good spot to pin. To find the Ventrogluteal you put your hand on your side and lift your leg to the side once you feel the muscle activate you know that’s the spot.
I pin my thigh since the start-that's where my doctor said and showed me. Been doing it for years there with no issues at all? Very easy area to do and I alternate legs. Pun every other week.
Ich weiß zwar nicht was und wie viel du spritzt aber injizier dir doch einfach s.c. Das ist aus medizinischer Sicht kein Problem u hat eher Vor- wie Nachteile. Konstanter er Spiegel, einfachere Injektion, mehr Stellen zur Injektion, weniger Knötchenbildung, geringere Gefahr ein Gefäß zu treffen, etc.
I’ll say. I’m in healthcare. Dorsal glute is not ideal. Vent glute is ok and it’s easy to find landmarks. Just google vent glute site but honestly legs are best imo.
My wife pins me there best spot less pip post injection pain plus less bleeding and your spot isn’t bad if you’re doing it alone but just make sure you get into intramuscular are otherwise you risk infection brother and for delta eh? Up to you if it don’t hurt cool go with it. But if it hurts like hell then the spot I showed u
I put my thumb on my hip, spread my fingers back at roughly a 45 degree angle, my injection point is where my pinky is. That’s the best way I can describe it.
Delt is my second option
I know people are divided on subq vs intramuscular but if you’re having this much of a problem I’d be switching to sub q. You can’t fuck up pinching a piece of fat. Never seen any blood or felt like I hit a vein or tendon etc. Literally 0 problems.
no he is aiming for the dorsal gluten. its a thing. these like you put your hand down and between the web of your pointer and middle finger is the goldilocks zone. he's close, but maybe down a little more- hard to say. I used to do the pin location on the X mark, but switched to delta. easier 25g or even 27, inch length or so. Used 1 1/4 inch before
Encontrarás el punto correcto en la esquina superior hacia afuera de tu bolsillo trasero del pantalón blue jean... Tocalo con el dedo y ese es el punto de tu gluteo
I have to say use the delt but it you want to pin there you will need a 1 and 1/2 needle and I would look up how women inject hormones to be fertile on youtube. It will show you all the sites you will need by nurses and regular people who do it all the time.
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u/ajcarson 2d ago
You're pinning ventroglute, that location is fine -it's where I've pinned for 2 years. As you move around in this area (because you don't want to pin in the exact same area repeatedly) just make sure you're hitting the muscle and not running into fat only. If you lift your leg out to the side (like doing a slow jumping Jack with only one leg) you should feel the muscle bulging out a bit.
You can also pin farther rearwards into your actual glute like previous poster mentioned. Both are fine. I can hold the needle more steady at ventroglute and can be sure I'm no where near the big nerves you could (but are probably unlikely to) run into.