Does PRP Work for Runners and Athletes. Achilles,Jumper’s Knee and Ligaments

Key points

• The 2021 ATM trial in JAMA, run across 24 UK sites, randomised 240 adults with midportion Achillestendinopathy of more than 3 months to a single PRP injection or a sham needle and found no significant difference in the VISA-A score at 6 months. Around 150,000 people a year in the UK experience this condition.

• A 2019 randomised trial in the American Journal of Sports Medicine gave 57 athletes with patellar tendinopathy ultrasound-guided leukocyte-rich PRP, leukocyte-poor PRP or saline, all followed by 6weeks of supervised loading. By 12 weeks 58 percent had improved with no difference between groups,and the leukocyte-rich group did worst.

• A systematic review of 16 randomised trials and 1,025 patients found PRP added nothing to function,laxity, motion or pain when used with ACL reconstruction.

• Where the evidence is positive it is in tendons compared against steroid. A 2025 meta-analysis of 26 trials and 1,877 tennis elbow patients found PRP better beyond 6 months, and a 2025 meta-analysis of 24 trials and 1,653 plantar fasciitis patients found it better at 3 and 6 months.

If you are an athlete weighing up PRP, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will tell you which of these your injury is before anyone talks about injections.

Why athletes are sold PRP harder than anyone

PRP arrived in sports medicine through professional athletes, and the association has stuck. The logic soundsright. Growth factors from your own blood, injected into a tendon that will not heal, in a patient who ismotivated and otherwise healthy. The problem is that the athlete is also the patient most likely to improve with time and a good loading programme, which is exactly the effect that a placebo-controlled trial strips out andan unblinded case series does not.

The result is a literature with many positive small studies and few positive large blinded ones. That gap is the reason this article exists. Athletes are also the group most likely to have an injection done quickly, without imaging, in the middle of a season, and then to keep training through the window when the tendon needsrelative rest. Every one of those choices lowers the odds of success before the biology has a chance.

message us on WhatsApp or email team@thewellnesslondon.com

The Achilles evidence is negative, and it is British

Midportion Achilles tendinopathy is the commonest tendon problem in runners, and around 150,000 people ayear in the UK experience it. The best trial of PRP for it is the ATM trial, published in JAMA in July 2021 and runby the University of Warwick across 24 UK sites. It randomised 240 adults with painful midportion Achillestendinopathy confirmed on ultrasound or MRI and lasting more than 3 months to a single injection of PRP into the tendon or a sham injection, a subcutaneous dry needle that did not enter the tendon. The primary outcome was the VISA-A score at 6 months, a composite of pain, function and activity, with a minimal clinically important difference of 12 points.

There was no significant difference between PRP and sham at 6 months. A 2026 systematic review and meta-analysis in the Journal of Foot and Ankle Surgery pooled the placebo-controlled Achilles trials, including a2011 double-blind trial and a 2017 three-arm trial in the American Journal of Sports Medicine, and the pattern across them is the same. For the runner with a thickened, painful midportion Achilles, the treatment with evidence is a progressive loading programme over 12 weeks, and a clinic offering PRP first should be asked why it is ignoring the largest trial in the field.

Send your Achilles scan report on WhatsApp and a doctor will tell you where the evidence does and does not support an injection.

Jumper’s knee and the tendons that respond to loading

Patellar tendinopathy, jumper’s knee, is the other tendon athletes are most often offered PRP for. The best trial is from 2019 in the American Journal of Sports Medicine. It enrolled 57 athletes with symptoms for more than6 months despite physiotherapy and tendinopathy confirmed on ultrasound, and randomised them toultrasound-guided leukocyte-rich PRP, leukocyte-poor PRP or saline, all followed by 6 weeks of supervisedconcentric and eccentric loading. By 12 weeks 58 percent had improved on the VISA-P score with no significant difference between groups. The leukocyte-rich group did worst, with 35 percent improved against72 percent for leukocyte-poor and 71 percent for saline.

A 2014 double-blind trial in the same journal found no long-term benefit of PRP over dry needling. One trial using 2 consecutive injections reported benefit, which is the thin thread the case for patellar PRP hangs on.The honest reading is that for jumper’s knee the loading programme did the work in every arm, and the injection added nothing measurable. That is the same less on as the Achilles, and it is worth noticing that in both conditions the trials gave everyone rehabilitation, which most clinics selling the injection do not.

message us on WhatsApp or email team@thewellnesslondon.com

Ligaments, muscles and the injuries PRP does not help

The clearest negative in sports medicine is ACL reconstruction. A systematic review of 16 randomised trials and 1,025 patients found no improvement in function scores, knee laxity, range of motion or pain when PRPwas added to the operation. Some imaging studies showed changes in how the graft remodelled, but those changes did not translate into a better knee. For ankle ligament injuries there is no good trial evidence either way, and for acute muscle injuries the trials that exist have not shown faster return to play.

Where PRP has real evidence in athletes is in a narrower list than the marketing. Tennis elbow, where 26randomised trials and 1,877 patients show PRP beats steroid beyond 6 months and a 2013 JAMA trial found steroid quadrupled recurrence. Plantar fasciitis, where 24 trials and 1,653 patients show PRP beats steroid at 3 and 6 months. Rotator cuff tendinopathy, where 10 trials and 591 patients show a modest advantage over steroid at 6 months. In each of those the comparison is steroid, not placebo, and the message is that PRP isthe better injection when an injection is warranted, not that it beats doing the rehabilitation.

message us on WhatsApp or email team@thewellnesslondon.com

Six questions before any athlete has PRP

This applies whichever clinic you see, including ours. The sport does not change the evidence.

• Which tendon or ligament is it, confirmed on ultrasound or MRI, and is the scan finding actually the sourceof the pain.

• Have I done at least 12 weeks of a structured loading programme with a physiotherapist, and did I do it properly.

• Which trial supports PRP for this specific injury, and was that trial compared with placebo or with steroid.

• If the answer is Achilles, patellar tendon, ACL or an ankle ligament, why is the clinic recommending it against the trials.

• Will I be asked to stop anti-inflammatories beforehand and to rest from the sport for at least 48 to 72hours afterwards, then rebuild over weeks.

• What is the return to sport plan, and who is managing it.

If the clinic answers the third question with a knee arthritis trial or a hair loss study, that is your answer.

Our doctors put it this way. For most running injuries the rehabilitation is the treatment and the injection isthe marketing. PRP has a place in sport, but it is a smaller one than the clinics selling it to athletes would like.

Message us on WhatsApp with the injury, how long it has lasted, what rehabilitation you have done, and any imaging, and a doctor will give you a straight answer.

What PRP does not do for athletes

PRP does not outperform sham for midportion Achilles tendinopathy in the largest trial, does not outperform saline for patellar tendinopathy, and does not improve ACL reconstruction. It does not shorten return to playfrom muscle injury in the trials that have tested it, and it does not substitute for the 12 weeks of loading that every positive tendon trial gave alongside it. It requires relative rest afterwards, which in a season is a cost in itself. It is not routinely commissioned by the NHS for sports injuries and private medical insurance rarely covers it. Where a tendon has torn rather than degenerated, the question is surgical and no injection changes that.

message us on WhatsApp or email team@thewellnesslondon.com

What sports PRP costs in London, and the cost of the wrong injection

Specialist central London clinics commonly charge from around £780 to £900 or more per image guided tendon or joint PRP injection including assessment, with a course of 2 to 3 taking a plan past £2,000. Outsidecentral London PRP is advertised from around £250 to £500, often marketed directly to athletes and often without the scan and the rehabilitation that the trials with positive results included.

The reframing for an athlete is time, not money. A PRP injection into an Achilles that the largest trial says will not respond costs the fee, the 72 hours of rest, and the weeks of believing something has been done while the loading programme that would have worked is delayed. For a runner in a training block that is the expensive part.

Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship central London rates,with your exact figure confirmed at the free suitability review once a doctor has confirmed the injury is one the evidence supports treating.

Ask about the cost for your injury on WhatsApp and we will explain what the review covers.

The free suitability review

Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registereddoctor assesses you and gives one of two answers. Either you are approved for treatment, with a clear plan, areturn to sport timeline and realistic expectations, or you are not approved, with an honest explanation of what would serve you better, whether that is a structured loading programme, a different injection, or a surgical opinion.

We decline a meaningful share of the people who enquire. For Achilles and patellar tendinopathy that share is most of them, because the trials say the rehabilitation is the treatment and we are not going to pretendotherwise.

message us on WhatsApp or email team@thewellnesslondon.com

Why people choose The London PRP Clinic by The Wellness

• An 87 percent patient success rate across treatments.

• More than 187 five star reviews.

• Every treatment performed by a GMC-registered doctor.

• 100 supervised treatments completed by every clinician before they treat a patient here unsupervised.

• A 32 percent average density increase reported in our hair restoration programme.
  
  message us on WhatsApp or email team@thewellnesslondon.com

Frequently asked questions

Does PRP work for Achilles tendinopathy

Not in the largest trial. The 2021 ATM trial in JAMA randomised 240 UK patients with midportion Achillestendinopathy to a single PRP injection or a sham needle and found no significant difference in the VISA-Ascore at 6 months. A progressive loading programme over 12 weeks remains the treatment with evidence.

Does PRP work for jumper’s knee

A 2019 trial of 57 athletes found no difference between leukocyte-rich PRP, leukocyte-poor PRP and saline at12 weeks when all groups did supervised loading, and the leukocyte-rich group did worst. The loading programme did the work. PRP is not supported as a first-line treatment for patellar tendinopathy.

Can PRP help an ACL injury heal

No. A systematic review of 16 randomised trials and 1,025 patients found PRP added nothing to function,laxity, range of motion or pain when used with ACL reconstruction. Imaging changes in the graft did nottranslate into a better knee.

Which sports injuries does PRP actually help

Tennis elbow, where PRP beats steroid beyond 6 months across 26 trials, plantar fasciitis, where it beats steroid at 3 and 6 months across 24 trials, and rotator cuff tendinopathy, where it gives a modest advantage over steroid at 6 months. In each case the comparison is steroid, and rehabilitation is still the foundation.

How long after PRP can I run or train

Relative rest from the provoking activity for 48 to 72 hours, then a graded return over weeks alongside the loading programme. The tendon is usually sore for several days. Full benefit in the positive trials appears at 3 to 6 months, so the injection does not shorten a return to sport in the way it is often sold.

Is PRP for sports injuries available on the NHS

PRP is not routinely commissioned by the NHS for tendon or ligament injuries, and the largest UK trial for the Achilles was negative. Physiotherapy and steroid injections are available on the NHS. Almost all sports PRP isself-pay.

message us on WhatsApp or email team@thewellnesslondon.com

References

• JAMA, 2021. Kearney et al. Effect of platelet-rich plasma injection vs sham injection on tendon dysfunction in patients with chronic midportion Achilles tendinopathy, the ATM randomised clinical trial.https://pmc.ncbi.nlm.nih.gov/articles/PMC8278266

• BMJ Open, 2020. ATM trial protocol, including the UK incidence of midportion Achilles tendinopathy.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7044811/

• Journal of Foot and Ankle Surgery, 2026. Platelet-rich plasma vs placebo injections in Achillestendinopathy, a systematic review and meta-analysis of randomised controlled trials.https://www.jfas.org/article/S1067-2516(26)00101-8/abstract

• American Journal of Sports Medicine, 2019. Scott et al. Platelet-rich plasma for patellar tendinopathy, arandomised controlled trial of leukocyte-rich PRP or leukocyte-poor PRP versus saline. Summarised in Ochsner Journal, 2021. https://www.ochsnerjournal.org/content/21/3/232

• Orthopaedic Surgery, 2022. Cao and Wan. Systematic review of 16 randomised trials of PRP in ACLreconstruction, cited via https://www.jeremyburnhammd.com/prp-injections-what-they-actually-do-and-dont-do/ Primary paper to be confirmed before publication.

• Clinics in Shoulder and Elbow, 2025. Maroun et al. Platelet rich plasma versus corticosteroids for lateralepicondylitis, a meta-analysis of 26 randomised clinical trials. https://pubmed.ncbi.nlm.nih.gov/40077872/

• JAMA, 2013. Coombes et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia, a randomised controlled trial. https://research-repository.griffith.edu.au/items/8eb56ec1-9503-45fd-9b4f-543d673d816d

• American Journal of Physical Medicine and Rehabilitation, 2025. Platelet-rich plasma versuscorticosteroids in the treatment of plantar fasciitis, a systematic review and meta-analysis of 24randomised trials. https://pubmed.ncbi.nlm.nih.gov/39778212/

• Knee Surgery, Sports Traumatology, Arthroscopy, 2026. Yuwarungsikul et al. Platelet-rich plasma provides modest but durable functional benefit over corticosteroid for rotator cuff tendinopathy, a systematic review and meta-analysis of 10 randomised trials.https://esskajournals.onlinelibrary.wiley.com/doi/10.1002/ksa.70416

• Central London clinic price lists for image guided PRP and steroid injections, accessed September 2026.

This article is for general information and does not replace a medical assessment. Speak to one of our doctors,or a sports physician, before deciding whether PRP is right for your injury.