What to expect from Protein Rich Plasma (PRP) treatment to the achilles

I’m writing this post to help others who may be considering or recovering from Protein Rich Plasma injections to the achilles tendon. I found very little information online that really prepared me for what I should expect. Hopefully by sharing my experience, others will be better informed.

Your achilles PRP treatment may vary from mine. I believe the severity of the injury may dictate the healing process.

Be sure to follow your doctor’s instructions.

Day of the PRP injection

There was nothing I needed to do in preparation for the appointment.

A large vial (maybe 100 milliliter) of my blood was drawn and then taken to another room for the centrifuge. The vial was marked with my name to insure that I got my own plasma. Also, to prevent any mix up, only one (mine) PRP procedure was scheduled during my appointment hour.

The doctor inspected my achilles and used a marker to identify the scar tissue. He also injected the area with something to numb the ankle. The numbing injections were fairly painful. Two syringes of the numbing agent were used.

I had to wait about 15 minutes for the protein rich plasma to be spun in the centrifuge and collected for injection.

The protein rich plasma injections were not painful because the numbing agent did its work.

I was given a surgical boot and shown how to put it on. I was given instructions to wear the boot for two days. The nurse told me that normally patients were required to wear the boot for a full week. So, I was glad I only had to hobble around in the boot for two days.

I was not supposed to do any walking without the boot. That meant that even if I need to take a midnight trip to the bathroom, I was required to wear the boot. I didn’t have to wear the boot while sleeping.  I was instructed to rest as much as possible the rest of the day and to take it easy the following day. I had to have someone to drive me home from the treatment. Walking in the boot felt odd at first, but I became more comfortable walking in it.

When the numbing wore off about 2 hours later, I could feel some mild pain in my ankle. It wasn’t uncomfortable enough to want to take a OTC pain reliever. I later learned that taking any kind of  anti-inflammatory  painkiller — like aspirin, ibuprofen and Aleve — interferes with the healing process from the PRP injections. In a follow up appointment, the doctor told me not to take any painkiller for ankle pain. He said if I was having a headache or something of that nature and I needed a painkiller that it would be fine to take one.  I’m not certain, but I think that the inflammation caused by the PRP injection is needed for the healing process.

Advice for the day of treatment

  • Wear running sneakers to the appointment. I found that it was easier to walk in the boot when my “good” ankle was in a sneaker. The boot and running shoe height were close enough that it didn’t make me limp as much.
  • Wear pants or shorts that will either fit around a surgical boot or can be rolled up to the knee.
  • Bring something to read while you are waiting for the PRP spinning.
  • Bring a bag to carry your extra shoe home
  • Have someone to drive you home. They may also be needed to help you get in and out of the car.
  • Rest, rest and rest some more after the procedure.
  • Sleep with your boot in easy reach from your bed.

Days 2 – 3

Though the doctor told me to wear the boot for two days, I wanted to be extra cautious, so I wore the boot for one extra day. Based on my pain level, I tried to avoid taking stairs as much as possible.

Day 4

Day four was my first day without the surgical boot. I was instructed to wear a running sneaker at all times while I was up and about. My ankle was SORE. The first time walking on it in my sneakers was OUCH.

Days 5 – 6

My ankle continued to be sore, though I felt some improvement and increased mobility each day.

Day 7 

On the seventh day, the doctor examined my ankle and my progress. The doctor told me that it would take six weeks for my ankle to fully heal. I had unrealistically expected I’d be all better in just a few days.

I was told to continue wearing a running sneaker every day for two more weeks. The doctor told me that I could ease back into exercising in a week, which would be two weeks after the PRP injections. My main exercise choices are walking, tennis and BodyJam (Les Miles dance aerobics). The doctor told me to gently start with walking. He said that once I could walk for 3 miles without an issue that I could play tennis again. He told me not to do BodyJam because when you dance you are up on the ball of your feet a lot which in turn would put too much strain on my  achilles.

Days 8 – 9 

Still quite a bit of soreness.

Days 10 through 13

I experienced a significant reduction in pain. I was tempted to go walking for a little exercise, but I followed the doctors orders to wait.

 Approximately 11 weeks after the PRP Procedure

For a while it felt like my ankle had nearly healed. I had been able to do some extended walking without much if any soreness. At the doctor’s appointment 7 weeks after the procedure, the doctor told me that I could start adding more exercise in. He said I could play some tennis again. I took one lesson a week later and my ankle hasn’t stopped hurting since. it’s really disappointing. In fact, it seems like my ankle is hurting more frequently than before.  I have a follow up appointment with the doctor in about 3 weeks, but I may try to get back sooner.

To Be Continued



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