PRP treatment for tendonitis – Does it work?
- Maryke Louw
- 4 days ago
- 8 min read
Will a platelet-rich plasma (PRP) injection into your injured tendon speed up healing? The answer is not straightforward. It depends on some factors that you can control and others that you can’t. It might also depend on which tendon we’re talking about. Here’s what we can learn from the latest research.
Remember, if you need help with an injury, you're welcome to consult one of our physios online via video call.
The terms tendinitis, tendonitis, tendinosis, and tendinopathy mean the same thing for all practical purposes, and we use these interchangeably in our articles. Read more (opens in new window).
In this article:
We've also made a video about this:
What is platelet-rich plasma?
Your doctor will prepare the PRP solution from your blood. The blood is drawn and then spun at a high speed. The spinning separates the blood into its different parts – one of these is your blood plasma, which contains a high concentration of platelets.
The platelet-rich plasma is then drawn off and injected into the injured tissue.
How PRP might help tendons
Your tendons have a natural ability to heal, but with tendinopathy or tendonitis this healing process can sometimes become sluggish or stall.
Blood platelets release bioactive substances that boost pro- and anti-inflammatory processes, as well as a variety of growth factors. Studies on animals have shown that high concentrations of platelets that release these substances can decrease pain and stimulate healing – especially collagen growth.
Since collagen is the main building block of tendons, PRP injections might be especially useful for tendon healing.
However, the current research is not painting such a rosy picture – some studies on humans are showing that PRP can help tendon recovery, while others show no improvement, and there appears to be quite a few factors that can affect how well PRP works.
So, let’s look at the three categories of factors that might influence the outcome of a PRP injection:
Lifestyle factors that might impact the quality of your platelets
How the PRP solution is prepared
What you do after the injection
👉 Please don’t get too focused on perfecting every single one of these factors – it is not possible and also not necessary. It is about avoiding the extreme ends of the spectrum rather than optimising every single aspect.
Lifestyle factors that might impact platelet quality
The interesting thing is that the PRP solution can vary on different days, even if it is prepared in exactly the same way for the same patient. This is because the patient’s health and nutrition can affect how many platelets they have in their blood, the quality of their platelets, and how readily the platelets will release their growth factor and other substances.
The following lifestyle factors have been shown to influence platelet quality and function in patients:
Mental stress (like public speaking or doing a maths exam) and physical stress (like exercise) have been shown to cause platelets to release their bioactive substances. This means that if you’re subjected to either mental or physical stress shortly before your blood is drawn, your platelets might already be depleted of the good stuff and won’t have much left for helping your injury.
Diets that are high in the following can affect your platelets:
saturated fats,
sugar,
simple carbohydrates,
caffeine,
quercetin (a flavonoid present in high levels in onions, apples, tea, and wine),
isoflavones (found in chickpeas and soy beans).
Alcohol and smoking aren't good.
Certain medications can also affect your platelets, of which the most common ones are:
anti-inflammatory medication (NSAIDS),
antihistamines,
antibiotics.
💡 If you're due to have a PRP injection, you might want to try and manage your stress and diet in the week before your injection.
How the PRP is prepared
How the PRP solution is prepared can cause a large variation in how many platelets it contains and also how well the platelets release their bioactive substances (like growth factors). It’s no use having a large number of platelets but they’re not willing to release the stuff that is needed to get the healing process going.
There are currently more than 16 types of machine for preparing PRP, and they produce different concentrations of platelets. Some clinicians spin the solution once and others twice. There are also various substances that they can mix into the PRP to stimulate the platelets to release their bioactive substances.
💡 Researchers don’t know yet what preparation method is the best. So, our advice is to not worry about this too much – if you choose a reputable clinic or doctor, the machine should be good enough. Rather focus on the things you can do to ensure your platelets are healthy and that your recovery after the injection is optimal.
What you do after a PRP injection matters
PRP injections are not like other ones, where you inject the substance and then the substance does its work without you having to do anything else. There are certain things you want to avoid or do to fully benefit from the injection.
Avoid things that suppress inflammation
During the first two weeks after a PRP injection, avoid medications that might reduce or suppress inflammation (e.g. anti-inflammatory medication). Inflammation plays an important role in how PRP is meant to stimulate healing, so you don’t want to reduce that.
Ice is helpful for short-term pain relief, but it is not known to what extent ice treatments suppress inflammation and whether short applications of ice packs can cool tissue enough to impact PRP recovery. So, if you want to err on the side of caution, you might want to avoid these.
However, there are always exceptions to a rule – if you’re experiencing a significant flare-up after an injection, applying ice for short periods (10 minutes at a time) might be useful.
Post-injection protocol
The PRP is creating the right biological environment for healing, but you also need to provide the correct mechanical stimulus to provide the physical signals that tell the tendon cells to get to work.
A 2026 Consensus Statement from a team of 23 doctors who are experts in the field of sports injury rehabilitation as well as PRP treatment highlights the importance of combining PRP injections with a progressive loading programme (gradually increasing strengthening exercises and activity levels).
When you load your tendons through exercise (or just use then to go about your daily business), your brain senses that mechanical stimulus and responds by telling the cells to repair and strengthen.
💡 The optimal loading programme varies from person to person – what is best for you will depend on many factors, including your pre-injection strength, pain levels, how your body responds to the injection, and what your ultimate activity goals are.
It is generally advised that:
You take things very easy for the first 7 to 10 days after the injection – you might even be given a brace to wear depending on the tendon that was injected.
Then, you can usually ease into strength training following the same rehab principles applied during regular tendinopathy rehabilitation – starting with low-load isometrics and working your way up to high-load and even explosive strength training.
The loading plan must build strength and endurance gradually until it matches what is needed for the activities or sport you want to be doing.
The final step is to then slowly ease back into work and sport, allowing the tendon enough time to strengthen and adapt over time.
👉 You can find very detailed articles about progressive rehab programmes for specific types of tendinopathy by picking the relevant type on this page.
How long before PRP starts working?
The experience immediately after having a PRP injection can vary dramatically between people:
Some people experience a nearly immediate pain reduction.
Others don’t really notice much difference in the first few days.
But commonly, people experience quite a significant flare-up in pain for a few days after having the injection.
💡 You cannot tell how effective an injection was from how you feel in the first few days after having it. Your body needs time to respond, repair, and strengthen the tendon, and this takes time.
The team of expert doctors recommended that patients are only reassessed after 12 weeks of following a post-injection rehab plan to decide whether another injection is warranted.
When should you have PRP for tendonitis or tendinopathy?
Having a PRP injection within the first three months of your tendon pain starting is likely a waste of money. During this period, your tendon can still heal without extra interventions if you simply follow a good progressive loading (rehab) plan – and as we’ve seen, PRP doesn’t guarantee better outcomes and doesn't always work.
💡 For this reason PRP is currently recommended only for cases where the tendon’s own healing response has failed (i.e. no progress after 12 weeks of following a well-structured rehab plan).
Which types of tendinopathy might benefit from PRP injections?
The research is showing mixed results, and I am wary of reading too much into them since the studies varied significantly in how they prepare their solutions. Also there is often little to no mention of any pre-procedure advice or post-procedure protocols that were followed. So, there is no way of knowing if their methods were optimal and how much we can trust the results.
With these limitations in mind, the most recent research shows that PRP appears to be a useful adjunct to the standard rehab treatment for the following types of tendinopathy:
greater trochanteric pain syndrome, also referred to as gluteal tendinopathy
lateral epicondylitis, also known as tennis elbow.
There is low-level evidence that it might be useful for rotator cuff tendinopathy, while it doesn’t seem to work for Achilles tendinopathy.
Other types of tendinopathy that I’ve not mentioned have not yet been investigated.
💡 In our experience, PRP works for some patients (including some cases of Achilles tendinopathy) and not for others. It is not a treatment that we recommend to everyone, and definitely not within the first 12 weeks. However, if you’re stuck with your rehab and unable to progress, it is a treatment worth considering.
How we can help
Need help with an injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.