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Final Program

Sports Medicine

608 - Synergistic effect of extracorporeal shockwave therapy & platelet-rich plasma in midportion achilles tendinopathy: a case series

Friday, February 20, 2026
5:00 PM - 6:30 PM AST

    Presenting Author(s)

  • AA

    Abhinay Aeruva, BS

    Medical Student
    University of Arizona College of Medicine Phoenix
    Phoenix, Arizona, United States

    • Co-Author(s)

  • CH

    Chris Ha, DO

    Senior Associate Consultant
    Mayo Arizona
    Scottsdale, Arizona, United States

    • Submitter(s)

  • AA

    Abhinay Aeruva, BS

    Medical Student
    University of Arizona College of Medicine Phoenix
    Phoenix, Arizona, United States

Case Diagnosis: Chronic midportion Achilles Tendinopathy

Case Description: We present 4 patients with chronic midportion Achilles Tendinopathy (MAT) refractory to conservative treatment. These patients had no prior complete tendon rupture or corticosteroid injection in the last 3 months. Patient 1 had a partial Achilles tear 10 years ago that was initially treated with stem cell therapy, and had a reaggravation earlier this year. Patient 2 presented with a history of a partial tear with persistent symptoms. Patient 3 was status-post Achilles reconstruction with an allograft with ongoing pain. Patient 4 had chronic midportion Achilles tendinosis. Each patient underwent a treatment protocol consisting of 3 sessions of extracorporeal shockwave therapy (ESWT) weekly followed by a platelet-rich plasma (PRP) injection. Post-procedural outcomes were collected with primary outcome being changes in VISA-A and secondary outcomes being changes in VAS, SANE, and Single-Leg Heel Rise Test.

Discussions:

 Achilles tendinopathy is a common overuse injury of the lower extremity, with an incidence of 1.85 per 1000 in the general public and an incidence of 80 per 1000 in athletes. Conservative, non-surgical management is first-line with surgical intervention considered for refractory cases. ESWT has demonstrated efficacy in improving pain and function in MAT; however, PRP injections have been limited to emerging data. Recent studies in other conditions, such as patellar tendinopathy, have shown a synergistic effect between ESWT and PRP, leading to greater improvements in pain and function as compared to monotherapy. Our case series suggests a potential similar synergistic effect between ESWT and PRP for MAT.

Conclusions:

Our preliminary findings at 6-weeks suggest combination therapy of ESWT and PRP can reduce pain and improve function for patients with MAT, as demonstrated by improved VISA-A, VAS, SANE and SLHR scores. Longer-term follow-up will be important to determine sustained efficacy, and we plan to collect and present our 3, 6 and 12-month data.