PRP Inection Rehab Protocol

Before Injection

Avoid NSAIDs for 7 days prior.

First 72 Hours

• Avoid ice
   
• Avoid NSAIDs
   
• Relative rest
   
• Walking allowed if tolerated in a boot for two weeks
   

Days 3–14

• Continue avoiding NSAIDs
   
• Gentle ankle range of motion
   
• Begin light loading
   

Weeks 2–6

• Begin progressive eccentric loading program
   
• Physical therapy emphasizing:
   
  • calf strength
     
  • ankle mobility
     
  • posterior chain strengthening
     
  • gait mechanics
     

6 Weeks

• Clinical reassessment
   
• Consider repeat PRP injection if symptoms persist
   

Key studies supporting PRP use in Achilles tendinopathy and biologic protocols include:

• de Vos et al., JAMA 2010 – PRP for chronic Achilles tendinopathy
   
• Fitzpatrick et al., AJSM 2017 – PRP effectiveness in tendinopathy
   
• Filardo et al., KSSTA 2015 – biologic treatment principles for tendinopathy
   
• Mautner et al., PM&R 2015 – orthobiologic consensus guidelines
   

While protocols vary, avoidance of anti-inflammatory interventions (NSAIDs and cryotherapy) during the early post-PRP period is widely recommended.