Platelet Rich Plasma for the Treatment of Chronic Achilles Tendon Pain

The treatment of Achilles tendinopathy is a complex and difficult orthopedic pathology. Acute Achilles tendinitis typically responds well to nonoperative therapy including; rest, immobilization, anti-inflammatories, stretching, and physical therapy. However, sometimes the pain can become chronic and develop into tendinosis. Chronic Achilles tendinosis is a complex pathology involving microscopic degenerative injury to the tendon with local disruption of the collagen matrix. The tendon is usually affected within its midsubstance, 2 to 6 cm from the insertion point, but can also involve the insertion point itself. Because of the high failure rates and prolonged recovery from open surgical intervention. Platelet Rich Plasma (PRP) injection therapy is a promising alternative.

What is Platelet Rich Plasma?

Platelets are small, nonnucleated bodies found in peripheral blood. Platelet Rich Plasma is believed to enhance healing by the direct delivery of increased growth factors to the location of injury. Platelet Rich Plasma is concentrated from anticoagulated whole blood. Approximately 50ml of blood is required to about 5ml of PRP. A two step centrifugation process concentrates the PRP. The PRP is then injected into the location of injury under local anesthetic. The use of Platelet Rich Plasma has been utilized for chronic tendon pathology in orthopedic literature for decades. Ultrasound guidance should be utilized to verify that the injection is positioned directly into the affected area. Typical post procedure management includes immobilization for 2-6 weeks. Followed by ROM exercises, physical therapy, and gradual return to activity as tolerated. PRP-for-achilles-tendon-pain-platelet-rich-plasma Filardo et al(1) published a case series with follow up at 4 years following PRP injection series. The study consisted of 34 Achilles tendons that failed conservative or surgical therapy. The authors found significant improvement in all scores from baseline at each assessment. They also found an 89% return to sport and 93% of the patients were satisfied and would repeat the treatment if needed. Deans et al(2) reported a case study of 26 patients with painful and ultrasound-confirmed Achilles tendinopathy with symptoms greater than 6 months. They reported significant improvements pain, activities of daily living, participation in sports activities, and quality of life. At University Foot and Ankle Institute we utilize Biomet Biologics plasma concentration system. Following local anesthesia, PRP concentrate is injected under ultrasound guidance. The patient is allowed to walk afterwards in a CAM boot. Patients are instructed to refrain from anti-inflammatory medication and icing the injection site as this can decrease the bodies’ response. Patients are followed after two weeks, then are usually referred after six weeks to physical therapy. Platelet Rich Plasma has become a promising non-surgical options for the treatment of chronic Achilles tendon pain. We have found great success with PRP therapy by following proper selection criteria and rehabilitation. A thorough examination and discussion with one of our foot & ankle specialist can determine how successful PRP therapy would be for improving your Achilles pain. At the University Foot and Ankle Institute, our physicians are always taking advantage of new techniques and products in order to treat the most complex foot and ankle conditions.   It is our mission to have patients return to high levels of functioning with an expedited recovery.  If you would like to schedule a consultation with one of our foot and ankle specialists, please call (877) 989-9110 or visit us at 1)    Filardo, G. Kon, E. Di Matteo, B. Di Martino, A. Tesei, G. Pelotti, P. Cenacchi, A. Marcacci, M. Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years. Blood Transfus. 2014 Jun 19:1-8. 2)    Deans, Victoria M. et al. A Prospective Series of Patients with Chronic Achilles Tendinopathy Treated with Autologous-conditioned Plasma Injections Combined with Exercise and Therapeutic Ultrasonography. The Journal of Foot and Ankle Surgery , Volume 51 , Issue 6 , 706 – 710

Dr. Brayton Campbell
Follow me

Dr. Brayton Campbell

Dr. Brayton Campbell received his Doctor of Podiatric Medicine degree from Des Moines University College of Podiatric Medicine and Surgery. He then took his residency at Department of Veterans Affair’s Loma Linda Healthcare System in Ohio as part of three-year program designed to produce a podiatric surgical specialist who is an expert in the recognition and management of all foot and ankle conditions. Brayton continued his training by pursuing a fellowship at UFAI.

Dr. Campbell enjoys the outdoors and shortly after he moved to Southern California took up surfing. However, when the waves are flat you can find him on the golf course or riding his motorcycle.

Dr. Campbell is available for consultation at our Santa Barbara office.

Learn more about Dr. Campbell by visiting our website:
Dr. Brayton Campbell
Follow me

One comment

  1. I am not great with English but I found real easy to understand and helpful. There is not much information here about PRP, thank you for this.

Leave a Reply

Your email address will not be published. Required fields are marked *


three × three =

  • CustomerSure
    Dr. B and all the staff is awesome. I appreciate the level and focus of my care. I have, and will continue, to recommend Dr. Baravarian every chance I get.
    Stephen L.
  • CustomerSure
    Thanks for taking the extra time to treat my foot during the appointment. You saved us a second trip.
    Jill V.
  • I am so grateful to have found you. I was dealing with so much pain and frustration for a lack of diagnosis. You have been very patient with me and all my questions and concerns. I appreciate how you take the time to ...
  • Yelp
    I saw Dr. Baravarian after being misdiagnosed by a previous doctor. I was suffering from foot pain for several months - I am a runner and even short walks were becoming increasingly painful. Everyone in the office is ...
    Christie C.
  • CustomerSure
    Exceptional care! The therapist really pays you personal attention. Something I especially liked was being asked my expectations for physical therapy at the onset of the treatment.
    Benji M.
  • CustomerSure
    So far so good. Oh, how I hope my ankle improves!!
    Whitney G.
  • I want you to know how much I appreciate all of your efforts to help me and how much I truly respect you as a person and a doctor. Your kindness has brightened my world on many days that would have otherwise been gloomy.
  • Yelp
    So fortunate to have found Dr Franson. I was treated by him last year for a torn achilles tendon, and today my daughter was treated by him. She's pregnant and he was very attentive to her concerns about treatment for ...
  • Yelp
    I am in process with Dr. Baravarian now for a chronic ankle problem, and am completely delighted to be in his care.  Both he and the rest of the staff are professional, courteous, helpful, and clearly are very very g...
    Whitney G.
  • CustomerSure
    I've already told Dr. Campbell that I think he's great. He listens to his patients and has a very cool, low-key approach that is genuine and comforting.
    Wendy V.
Same day appointments now available!
or call us:
  • University Foot & Ankle, a Preferred Provider to:
  • UCLA Health System - UCLA Medical Group
  • MPTF - Member Industry Health Network
  • Cirque du Soleil
  • ATP - Association of Tennis Professionals
  • And consulting physicians for:
  • C&S - Cedars-Sinai
  • Saint John's Health Center