PRP injection vs Heavy Slow Resistance for Tendonsis

What have been peoples experience with PRP injection or “Heavy Slow Resistance” training for quadriceps tendonsis?

I have had quadricep tendonsis for about 6 months and rest/PT has not resolved it. Any thoughts/experiences on these other treatment modalities?

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The data is very much mixed on PRP as a legitimate form of treatment. I have no experience with it treating a quad, but I did have it for Achilles Tendinitis back in 2009. Long story short, it got me back to about 70% but my rehab process was interrupted after a week due to a blood clot and pulmonary embolism. (Untreated to the PRP).

Could it have gotten me to go full strength without the interuption, I’ll never know….

My first recommendation would be to try other PT / therapists first and see if you can find one that can help resolve your issue. If you have done that and are out of options ( and have the finances to pay for PRP since most insurance doesn’t’t cover it), there is no downside to PRP (other than the usual risks of such a procedure…infection, etc). You are just injecting yourself into you, so there is almost zero risk of anything adverse happening.

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I domt know if it would work for quad tendonosis, but i had patella tendonosis and had a doctor do dry needling and it worked like a charm, solved it in a few days after dealing with it for months. May want to ask about that

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Sadly, this past year I’ve had a couple injuries.
I tore my left hip labrum and partially tore my left patella tendon. I received stem cell, and a subsequent PRP injection for the torn labrum, and a PRP injection for the partially torn patella.
The good news is both injections worked! The hip was a worse injury and I recovered in approximately two months, and I was back to running in two weeks following the PRP injection in my knee. Initially, I was told both of these injuries would require surgery and over six months of recovery. Truly grateful for the PRP and the quick recovery. I would certainly consider PRP, given that PT and rest has not resolved your injury. Hope this helps, and feel free to PM me if you have any questions regarding PRP.

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No help on those two therapies, but I can share my experience. I was recently diagnosed with the same ‘advanced tendinitis distal quadriceps tendon’. The Dr has put a big emphasis on eccentric exercises to strengthen and stretch the various leg muscles-(nordic hamstring curl, side steps, eccentric calf raises (up on two feet, down slowly on one), etc. I feel like the PT was not as on board with emphasis on eccentric movements, but I’ve found them to be very helpful. While I am not sure of their benefit, I do not mind the massage , scraping, ice & stim!

I was never restricted on riding and given the green light to road cycle as much as I wanted, they just did not want me to any type of mountain biking where there could be any type of impact to extended leg. I felt like it was a huge help to have a Dr who not only specializes in sports medicine, but is a cyclist as well.

At this point, the only things that give me pain are ladders & scaffold.

Best of luck to you!

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Physio here :wave:

I personally struggled with hamstring tendinopathy/tendinosis for 2 years.
Heavy slow resistance, targeted at the muscle group affected, worked an absolute charm for me. The reduction in pain I was experiencing was relatively quick, probably 3-4 weeks of consistent heavy slow training.
It did take time to fully recover- it took probably 6-9 months to return to a full running/triathlon program absolutely pain free, but now I can just do maintenance strength work and the issue stays quiet.

Like others have said, the PRP won’t hurt anything and might work wonders but I think the rehabilitation still needs to be done regardless of whether you get PRP or not.

Hope this helps :slight_smile:

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I appreciate your input and have recently started a HSR program. Mainly Box Squats 3x/week complemented with plyometrics and isometrics daily. While your were going thru Heavy Slow Resistance did you resume your riding or wait until a few months into your HSR training to resume riding?

I did endurance riding for the first 4-6 weeks from memory, definitely avoiding climbs and punchy type riding. Then I re-introduced it gradually once my pain dropped down. It was more running that was an issue pain wise so that was way slower to re-introduce.