PRP injection into PTT

Had a PRP injection for a plantar fascia that was torn and close to ruptured but not quite. Started as bad PF that I ran and raced on for 2 years. I was on crutches for 10 days post-injection, then in a boot for 2 weeks after, but I could cross train during that time. I aqua jogged since everything else put pressure on the foot, and it was explained to me that a good comparison is that constantly stressing the area (even low impact) would be like constantly picking at a scab trying to form.

Anyway, took about 6 weeks off total and it got progressively better as I started back running, have never had a single problem since. I’d recommend it, it’s not a quick fix necessarily (although compared to just trying to let it heal itself it sure is) and it can cost $$ but it’s highly effective.

I couldn't walk or put pressure on the foot for the week after. Took 3 weeks to transition from crutches to boot to walking again and 5-6 weeks to being able to bike again. In the end it was a massive waste of money that didn't help in the slightest, don't waste your time. There's a reason after decades no clinical trial has shown it to be effective.

DontDoIt wrote:

I couldn't walk or put pressure on the foot for the week after. Took 3 weeks to transition from crutches to boot to walking again and 5-6 weeks to being able to bike again. In the end it was a massive waste of money that didn't help in the slightest, don't waste your time. There's a reason after decades no clinical trial has shown it to be effective.

Were you able to recover without surgery? I'm doing the PRP with hopes of avoiding surgery. I've been dealing with tendinosis now for many months with no improvement. MRI in Feb showed the tendinosis. MRI last week showed tendinosis AND a partial tear. I don't want to be out for months, but I don't want to be unable to cross train either.

I've looked into PRP injections for my chronic proximal hamstring tendinopathy - I have a few MD friends who have told me that the efficacy of PRP injections is questionable. One strongly advised that I don't waste my time and money.

Same again wrote:

I've looked into PRP injections for my chronic proximal hamstring tendinopathy - I have a few MD friends who have told me that the efficacy of PRP injections is questionable. One strongly advised that I don't waste my time and money.

For me the shot is $600. I'm trying to figure out if it is worth it or if I should just continue to rest and do eccentric exercises.

This injury usually comes with a significant biomechanical issue, ie, overpronation. If that's you, hopefully you are addressing this as well (good custom orthotics, appropriate running shoes) otherwise no injection is going to resolve your problem.

RobA wrote:

DontDoIt wrote:

I couldn't walk or put pressure on the foot for the week after. Took 3 weeks to transition from crutches to boot to walking again and 5-6 weeks to being able to bike again. In the end it was a massive waste of money that didn't help in the slightest, don't waste your time. There's a reason after decades no clinical trial has shown it to be effective.

Were you able to recover without surgery? I'm doing the PRP with hopes of avoiding surgery. I've been dealing with tendinosis now for many months with no improvement. MRI in Feb showed the tendinosis. MRI last week showed tendinosis AND a partial tear. I don't want to be out for months, but I don't want to be unable to cross train either.

I still have problems with it over one year out without surgery. It's hard to say because for some it seems the immobilization and healing response caused by the injection tends to help. I can't say it made it worse in the end, but from my experience if it made any improvements they were minimal. I've heard that the more chronic the problem is the less effective it is (that is if it is effective at all), and pro athletes normally get PRP when the tendon injury is fresh to facilitate healing and blood flow early on. When I got mine I had already been dealing with the injury for over a year, so that may be why it didn't do much. Surgery options are almost always just debriding (removing the damaged tendon tissue/scarring). Their consensus is that the surgery would probably not be effective for my case (moderate tendinosis), and they only encourage it for people with foot deformities/collapsed arches where they would be fixing a structural issue alongside debriding the tendon. It might not hurt to try PRP if money's not an issue, but as others said, it's not a quick fix.

Grassrunner wrote:

This injury usually comes with a significant biomechanical issue, ie, overpronation. If that's you, hopefully you are addressing this as well (good custom orthotics, appropriate running shoes) otherwise no injection is going to resolve your problem.

Foot is completely flat. I got custom orthotics back in February. No improvement. The tendon actually partially tore AFTER getting them.

You say it's not a quick fix, but is it quick-er than just resting? I've been dealing with this for awhile and I'm just sick of it.

Unfortunately, most typical custom orthotics out there aren't made aggressively enough to control the strain on the posterior tibial tendon from significant overpronation. Some people (not many) are too severely out of alignment for even the best custom orthotics to control the issue. Also, once the tendon starts to rupture, the misalignment of the foot (flattening/collapse) can become more severe, unfortunately (although not specifically directed at runners, here is some good general info about your condition https://www.podiatrytoday.com/conservative-care-principles-adult-acquired-flatfoot). I'm not sure how an injection is going to somehow fix your issue if your overpronation isn't appropriately controlled after you are healed (if, in fact, you heal).

Some very basic information:

https://www.acfas.org/footankleinfo/pttd.htm

Update: I received the injection 2 days ago. I'm in a boot for now and can't put much weight on the injured foot, very swollen. I'll let you guys know how it responds in a few weeks.

See you in at least 6 weeks!

Hang in there, buddy!

Update: 1 week since injection and first day out of the boot (walking around in stability shoes + orthotics). Initial swelling is down. My foot is still a little sore and definitely weak, but I did some very light ROM with it today in addition to trying to do 'normal daily activities' out of the boot. That is the goal for the next 7 days. Fingers crossed that I'm on the mend. No cross training of any kind yet.

Glad to hear you're moving forward! If you don't get total relief, try shockwave therapy. Worked a miracle on my Achilles tendinosis, and it's non invasive. 4-6 treatments and I was back to full running with no pain after a gradual ramp of 2-3 weeks. Be advised, it hurts a lot to have shockwave therapy, but it works!

I had Shockwave on my achilles. I had ultrasound. I had laser. I had massage. I had chiro. I did eccentric exercises. I am having PRP next week.

beatmeupwakemeup wrote:

Glad to hear you're moving forward! If you don't get total relief, try shockwave therapy. Worked a miracle on my Achilles tendinosis, and it's non invasive. 4-6 treatments and I was back to full running with no pain after a gradual ramp of 2-3 weeks. Be advised, it hurts a lot to have shockwave therapy, but it works!

I'll keep that in mind if things don't improve, but I have to say, I'm impressed so far!

I am now 10 days post-PRP injection and on day 17 of no running (took off a full week before getting my injection) and I have experienced a significant reduction in pain over the last 72 hours especially. I have nearly full range of motion in my left foot, which I haven't had in months. I started doing some PT exercises yesterday (eccentric heel drops, thera-band exercises on my feet, walking on tippy toes, etc.) and have been able to do so with only mild discomfort. For cross training I have started to use the elliptical in addition to the stationary bike, and even went for a short (1mi) walk yesterday.

I'll keep you guys posted if you are curious.

Any updates on how this went? I have been dealing with PTTD for about four months and I go in for the first injection of PRP next week.