In advance of the Anti-Doping and Medication Control (ADMC) Program effective date of March 27, 2023, HISA has received requests for clarification of Rule 4222. Please read below.
Rule 4222 (M5 Intra-Articular Injections) reads:
Intra-articular injections are prohibited on Race Day, within 14 days prior to Post-Time, and within 7 days prior to any Timed and Reported Workout.
The prohibitions in Rule 4222 apply to substances injected into any articular space, including, but not limited to, the following:
<ul>
<li>Orthobiologics (such as IRAP, PRP, stem cell therapy)</li>
<li>Corticosteroids (such as betamethasone acetonide, triamcinolone, isoflupredone)</li>
<li>Hyaluronic Acid (HA) products (such as Legend I.A., Hy-Visc, Hylartin)</li>
<li>Antibiotics</li>
<li>Medical devices (such as Spryng, Arthramid Vet*, Noltrex Vet*)</li>
<li>Anesthetics (such as mepivacaine, lidocaine, bupivacaine)</li>
</ul>
*Note that Rule 4224, “M7 Intra-articular injections of polyacrylamide hydrogels,” states: “Intra-articular injections of polyacrylamide hydrogels are prohibited within 180 days prior to Post-Time.”
The intra-articular administration of any Banned Substance, such as stanozolol, constitutes an Anti-Doping Rule Violation.
These stand-down times do NOT apply to injections in or around the following structures:
<ul>
<li>Sacro-iliac areas</li>
<li>Bursae</li>
<li>“Splints”</li>
<li>Proximal suspensories</li>
<li>Tendon sheaths</li>
<li>Epaxial muscles</li>
</ul>
Injections in or around these structures will be regulated through testing under HISA’s Anti-Doping and Medication Control Program.  For many of these administrations, a withdrawal interval greater than 14 days may be necessary to avoid detection in a treated horse’s collected sample. 
ATTENDING VETERINARIANS: PLEASE NOTE that intra-articular administrations MUST be reported to HISA in an electronic format approved by HISA.
<ul>
<li>If you are an Attending Veterinarian currently uploading PDFs of treatment sheets, you will need to separately report these administrations. For a “how-to” video, follow this link: <a href="https://4k9jj7x.r.us-east-1.awstrack.me/L0/https:%2F%2Fhisausregs.org%2Freg-document-video%2F801731148/1/01000186bc84ae54-eee4e8ab-abe8-4ec1-9b77-6816c1a1dbc8-000000/Wc6VQu1cCmdwKIKKsrW_oflNBuU=312">https://hisausregs.org/reg-document-video/801731148</a>
<ul>
<li>If you have not used the HISA portal and need to know in general how to add a record to a horse, follow this link: <a href="https://4k9jj7x.r.us-east-1.awstrack.me/L0/https:%2F%2Fhisausregs.org%2Freg-document-video%2F801767309/1/01000186bc84ae54-eee4e8ab-abe8-4ec1-9b77-6816c1a1dbc8-000000/zMXNeJlnhZOnBZt1pM3AFliaWLw=312">https://hisausregs.org/reg-document-video/801767309</a></li>
</ul>
</li>
<li>Please always select the record type “Intra-articular injection” whenever you are reporting an intra-articular administration through the HISA portal, even if you are performing a diagnostic block.</li>
</ul>
A NOTE WITH REGARD TO TIMING:
The day of administration is considered day 1 (one). A horse may breeze on day 8 (eight) following administration and may enter to race at any time, provided the race is on day 15 (fifteen) or later.
<ul>
<li>A horse injected on a Saturday is eligible to breeze on the following Saturday, and eligible to race two Saturdays after the administration.
<ul>
<li>For example: The horse receives an intra-articular administration on Saturday, January 1st. The horse is eligible to breeze on Saturday, January 8th, or later, and to race on Saturday, January 15th, or later.</li>
</ul>
</li>
</ul>