Platelet-Rich Plasma (PRP) Injections for Plantar Fasciitis and Achilles Tendinopathy

Quick answer: Platelet Rich Plasma Prp Injections Plantar Fasciitis Achilles is a common foot/ankle topic that affects many patients. The 2026 evidence-based approach combines proper diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.

Reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · 3,000+ surgeries · @MichiganFootDoctors (950K+ subscribers)

Last reviewed May 11, 2026 · (810) 206-1402

Watch: How To Cure Plantar Fasciitis FAST & FOREVER [Heel Pain & Heel Spurs] — MichiganFootDoctors YouTube

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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What Is Platelet-Rich Plasma (PRP)?

Platelet-rich plasma is an autologous blood product — meaning it comes from your own blood — that contains a concentrated dose of platelets, growth factors, and bioactive proteins that drive tissue healing. A small blood draw is processed in a centrifuge to separate and concentrate the platelet-rich fraction, which is then injected directly into the injured tissue.

Platelets contain over 1,500 bioactive proteins including platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-β), vascular endothelial growth factor (VEGF), and insulin-like growth factor (IGF). These proteins stimulate cell proliferation, collagen synthesis, blood vessel formation, and tissue remodeling — the exact processes needed to repair chronic tendon and fascia injuries.

PRP typically contains 3-5 times the platelet concentration of normal blood. This concentrated delivery of healing factors to a specific injury site creates a biological repair environment that the body’s normal healing response cannot achieve on its own, particularly in chronically damaged tissues with poor blood supply.

PRP for Chronic Plantar Fasciitis

Chronic plantar fasciitis that persists beyond 6 months despite stretching, orthotics, and physical therapy involves degenerative tissue changes (fasciosis) rather than active inflammation (fasciitis). PRP addresses this degenerative pathology by delivering growth factors that stimulate new collagen formation and tissue remodeling.

A systematic review in Foot & Ankle International (2024) reported that PRP injection produced statistically significant pain improvement compared to corticosteroid injection at 6-month and 12-month follow-up. While corticosteroid provided faster initial relief (at 1-3 months), PRP produced superior long-term outcomes because it promotes actual tissue healing rather than temporarily suppressing inflammation.

The PRP injection is performed under ultrasound guidance, ensuring accurate delivery into the thickened, damaged plantar fascia. Dr. Biernacki uses the peppering technique — multiple small injections through a single skin puncture — to distribute PRP throughout the degenerative tissue zone for maximum coverage.

PRP for Achilles Tendinopathy

Achilles tendinopathy involves progressive tendon degeneration with disorganized collagen, neovascularization (abnormal blood vessel growth), and mucoid degeneration. The tendon’s poor blood supply limits natural healing capacity, creating chronic pain that resists conservative treatment.

PRP injection into the degenerative zone of the Achilles tendon delivers concentrated growth factors directly to the tissue that needs repair. Research in the American Journal of Sports Medicine (2024) demonstrated improved tendon structure on ultrasound and MRI following PRP treatment, with organized collagen replacing previously degenerative tissue.

Mid-substance Achilles tendinopathy (pain in the main body of the tendon) responds better to PRP than insertional tendinopathy (pain at the heel bone attachment). This distinction is important for setting appropriate expectations and selecting the best treatment approach.

PRP for Achilles tendinopathy is combined with eccentric loading exercises — the evidence strongly supports this combination over either treatment alone. The PRP initiates biological repair while controlled eccentric exercise provides the mechanical stimulus for proper collagen alignment.

The PRP Procedure: What to Expect

The procedure takes approximately 30 minutes in our office. First, 30-60 mL of blood is drawn from your arm — the same as a standard blood test. The blood is placed in a centrifuge that spins for 15 minutes to separate the platelet-rich fraction from red blood cells and platelet-poor plasma.

The concentrated PRP (typically 3-6 mL) is drawn into a syringe for injection. Dr. Biernacki uses diagnostic ultrasound to visualize the target tissue in real time, guiding the needle precisely into the area of maximum damage. Local anesthetic is applied to the skin, but the injured tissue itself is not anesthetized — the inflammatory response from the needle and PRP is part of the therapeutic effect.

After injection, you rest for 15 minutes in the office. Mild to moderate soreness at the injection site is expected and typically lasts 3-7 days. This soreness represents the intended inflammatory healing response — it means the PRP is working. Acetaminophen is permitted for pain relief, but NSAIDs (ibuprofen, naproxen) must be avoided for 2 weeks as they suppress the PRP healing cascade.

Post-PRP Protocol and Timeline

Week 1: Relative rest with walking only for necessary activities. Ice is avoided for the first 48 hours to preserve the inflammatory response. Gradual return to walking as comfort allows. No impact activities.

Weeks 2-4: Progressive walking and gentle stretching. Begin physical therapy with range-of-motion exercises and light strengthening. The tissue is actively healing during this period — avoid activities that produce significant pain at the injection site.

Weeks 4-8: Graduated return to impact activities. Running resumes with a progressive program if treating plantar fasciitis or Achilles tendinopathy. Eccentric exercises intensify for Achilles patients.

Months 2-6: Full return to activity for most patients. Maximum PRP benefit often takes 3-6 months as tissue remodeling completes. Some patients benefit from a second PRP injection at 6-8 weeks if initial response is partial. Dr. Biernacki assesses progress and determines need for additional treatment.

PRP vs Corticosteroid Injections: Key Differences

Corticosteroid injections reduce pain rapidly (within days) by suppressing inflammation. However, corticosteroids do not heal tissue — they mask symptoms while potentially accelerating tendon degeneration. Repeated corticosteroid injections into tendons increase rupture risk by up to 3-4 times.

PRP injections produce slower initial improvement (weeks rather than days) but address the underlying tissue pathology. By stimulating actual collagen repair and tissue remodeling, PRP produces more durable results that persist beyond the treatment period. Long-term studies consistently favor PRP over corticosteroid for tendon and fascia conditions.

The practical trade-off: corticosteroid provides fast relief but may weaken tissue; PRP provides slower but more lasting improvement by promoting actual healing. For patients who have already received 2-3 corticosteroid injections without lasting benefit, PRP represents the next logical step before considering surgical options.

Cost considerations: PRP is typically not covered by insurance and costs $500-$1,000 per injection. Corticosteroid injections are generally covered by insurance. Despite the cost difference, PRP’s superior long-term outcomes may represent better value for chronic conditions that fail corticosteroid treatment.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your plantar fasciitis, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

When should I see a podiatrist?

If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).

What does treatment cost?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.

How quickly can I get an appointment?

Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.

What is Plantar fasciitis?

Plantar fasciitis is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.

Symptoms and warning signs

Common signs of plantar fasciitis include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.

Conservative treatment options

Most cases of plantar fasciitis respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including MLS laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.

When is surgery considered?

Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.

Recovery timeline and prevention

Recovery from plantar fasciitis varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.

Dr. Tom Biernacki, DPM

Affiliate Disclosure: This page contains affiliate links to products we recommend. If you purchase through these links, Balance Foot & Ankle may earn a small commission at no additional cost to you. We only recommend products we use with our patients.

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.