Today I received a call from a runner who wants to know whether his painful Achilles tendon would get better faster if he had a cortisone shot or the newer Platelet Rich Plasma (PRP) injection.
Cortisone injections are one of the oldest and most common treatments for tendon pain when inflammation arises due to running and over-training. However it is not always the best treatment.
What you need to understand about cortisone injections (also known as corticosteroid injections) and PRP injections is that they are both very effective at reducing Achilles tendon pain, but for very different reasons. They are essentially opposite ends of the same spectrum.
Corticosteroid injections stop the inflammatory process cold. If you're trying to remove pain, swelling and inflammation, cortisone injections are a great tool. The problem is that if you have a small tear in the tissue that needs to heal, you have essentially stopped the healing process. In addition, the corticosteroids are well know for breaking up collagen bonds. Because your Achilles tendon is really a huge cable made of collagen, corticosteroid injections can weaken the tendon and make it more likely to rupture or completely tear.
PRP injections work in the opposite way. The PRP injection takes all of the growth factors that are present in your blood stream (within the platelets) and concentrates them many times. The powerfully concentrated growth factors are then injected directly into the injured tendon tissue in order to stimulate new blood flow, unlock the body's natural healing response and directly stimulate healing of the injured tendon. If there are small micro-tears in the Achilles tendon, a PRP injection will be much more effective than corticosteroid injection.
One injection turns the inflammation off while the other turns the healing on. Each has its place, just make sure you explain all of your running goals with your sports medicine doctor when considering either of these injections for your aching Achilles tendon.
You can learn more about what happens before your Achilles PRP injection by clicking here and what happens after your Achilles PRP injection by clicking here.
Dr. Christopher Segler is a 6-time Ironman Finisher and an award winning foot and ankle surgeon. He even does house calls for busy runners and triathletes in San Francisco, Marin and the East Bay. If you have a question about foot pain related to running, you can call him directly at 415-308-0833. For more information on Achilles running injuries, visit www.anklecenter.com.
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