Tendinopathy & PRP

TENDINOPATHY AND PLATELET RICH PLASMA (PRP) INJECTIONS

Tendinopathy refers to a condition where a tendon — the strong band of tissue that connects muscle to bone — becomes painful, thickened, and less effective at handling load. It’s a common cause of pain around the joints and can affect anyone from elite athletes to active older adults.

UNDERSTANDING TENDINOPATHY: THE FRAYING ROPE ANALOGY

One useful way to understand tendinopathy is to imagine a healthy tendon like a strong, wound rope. In tendinopathy, the inner fibres of this rope begin to fray — not through a clean cut or tear, but through cumulative micro-damage. If left untreated, the frayed fibres begin to heal in a disorganised, chaotic fashion — much like tying together hundreds of small fragments, creating a ball of elastic bands inside the rope.

This leads to:

  • Swelling

  • Pain with loading

  • Stiffness or weakness

  • Loss of performance or function

Physical therapy acts as a healing guide, encouraging the tendon fibres to realign and strengthen without overloading or worsening the damage. The goal is to reorganise the scarred tissue into a healthier structure that can handle normal forces again.

HOW TENDINOPATHIES HAPPEN

Tendinopathies typically develop due to repeated mechanical overload — activities that strain the tendon beyond its current capacity. This might result from:

  • Sudden increase in loading

  • Poor biomechanics

  • Age-related tendon changes

  • Reduced muscle support

  • Inadequate recovery

They can develop slowly over time or follow a minor injury that never fully settles.

Without intervention, tendinopathies can last many months or even years. With correct diagnosis and a structured rehabilitation plan, most people improve within 12–16 weeks, although chronic cases may take longer. Some cases fail to progress despite good therapy — this is where additional treatments such as Platelet Rich Plasma (PRP) may help.

COMMON TENDINOPATHY SITES

Dr Jenkins regularly treats tendinopathy at the following sites:

  • Shoulder: rotator cuff tendons (especially supraspinatus)

  • Elbow: tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis)

  • Wrist: De Quervain’s tenosynovitis, flexor/extensor tendon irritation

  • Knee: patellar tendon (jumper’s knee), quadriceps tendon

  • Hamstring: high proximal hamstring tendinopathy

  • Ankle: Achilles tendinopathy, tibialis posterior, peroneal tendons

  • Foot: plantar fascia, flexor hallucis longus, tibialis posterior insertion

WHY PRP INJECTIONS?

For many tendinopathies — particularly Achilles, patellar, lateral elbow, and rotator cuff tendinopathies — traditional steroid injections are now discouraged in national guidelines due to concerns over weakening the tendon or offering only short-term benefit. For example, Versus Arthritis  and other guideline bodies increasingly support PRP therapy as a safer and potentially more regenerative option.

WHAT IS PRP AND HOW DOES IT WORK

Platelet Rich Plasma (PRP) is an advanced treatment that uses your body’s own healing mechanisms. A small blood sample is taken and processed using a centrifuge to isolate a concentrated layer of platelets and growth factors — the natural repair cells in your blood.

This growth-factor rich plasma is then carefully injected into the affected tendon under sterile technique. The aim is to:

  • Stimulate cell signalling and tendon repair

  • Improve tissue quality and load tolerance

  • Accelerate a structured rehabilitation programme

The entire process — from blood draw to injection — is completed in a single one-hour appointment, carried out by Dr Jenkins .

WHAT TO EXPECT AND WHAT PRP CAN OFFER

PRP is not a standalone cure. It works best when added to an existing well-structured physical therapy programme — especially when progress has plateaued or symptoms have persisted despite good rehab.

Research shows that outcomes vary by tendon, and while evidence is strongest in certain areas (like lateral elbow and patellar tendon), PRP remains an active area of clinical research across all tendinopathies. There are no guarantees, but many patients report that PRP was the turning point in a stubborn or slow-to-heal tendon problem.

If you are dealing with persistent tendon pain that hasn’t responded to rehab alone, a consultation with Dr Tom Jenkins can help determine whether PRP — alongside tailored therapy — could support your recovery.

THE PRP PROCEDURE

  • PRP injections involve a one-hour appointment with Dr Jenkins.
  • Blood collection.
  • Preparation of platelet-rich plasma (PRP) using a double-spin centrifuge technique, which enhances platelet concentration and growth factor yield compared to single-spin methods.
  • Careful injection of PRP into the tendon under sterile conditions.

This procedure requires specialist skills due to its complexity and the careful preparation involved.

PATIENT TESTIMONIAL

“I have an incredible physiotherapist who has been working with me on my tennis elbow. After months of trying everything, it was still stopping me from playing sports and really interfering with my job. The PRP injection completely changed everything, and having Dr Jenkins work as a team with my physio finally got me better.”

+

Why “Tennis Elbow” Might Really Be “Office Elbow”

Dr Tom Jenkins, Musculoskeletal GP with Expertise in Sport & Exercise Medicine  With Wimbledon season...Read More