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Triathlete Achilles Tendinitis: “Just Wait for It to Tear so We Can Operate”?

POSTED ON IN Latest News BY Chris Centeno

triathlete achilles tendinitis

As an active person, Achilles tendon problems can cause you to miss out on what you love. This is the story of a seven-time Ironman triathlete with an Achilles tendon that was so bad, his surgeon told him to just let it tear so that it could be repaired. However, in the end, this case of triathlete Achilles tendinitis was repaired without any surgery, just by using precise injections of his own ultra-high-dose platelet-rich plasma.

What Is the Achilles Tendon?

The Achilles tendon gets its name from the god Achilles, who was shot with an arrow in the back of his heel. While he was an immortal, his only weakness was this tendon as when his mother dipped him in the River Styx at birth, she held him by the back of the heel. While this all apparently happened during the Trojan War, many triathletes, runners, and pick-up basketball players will tell you that while they’re not immortal, they can feel this tendon getting in the way.

This tendon connects the calf muscle to the heel, and it’s notorious for failing and tearing in middle-aged athletes. When that happens, surgery is often recommended. However, is there another way?

Randall’s Story: Triathlete Achilles Tendinitis

Randall is a high-level triathlete who just completed his seventh Ironman. He first came to see me in 2005 with a bad back, a bum knee, and a messed up ankle and Achilles. All of this was connected. The irritated nerves in his back were messing with his ability to accurately control his knee and making his calf and other ankle muscles tight, which caused his Achilles to get ripped up. Please see my video below for more information on how the calf is connected to low back problems.

We treated his back with platelet-based therapies that targeted his irritated nerves, joints, and ligaments. His back was soon 80% better, so we then began to focus on the lax ligaments in his knee with precise injections under guidance. Finally, we focused on the back of his heel, initially with lower-dose platelet-rich plasma. Despite these injections being what most clinics would consider high dose at seven times more concentrated than baseline, he only got partial relief. So what could we do better for this severe case of triathlete Achilles tendinitis?

At that point, his Achilles was hypertrophied and had a “moth-eaten” appearance. Basically, when tendons get weak, the body throws more tendon at the problem. However, the density of the tendon tissue goes down and the tendon gets hypertrophed (bigger). In fact, his weak tendon was about twice as big as his normal tendon and so bad that his surgeon told him to just wait until it ruptured and he would then fix it surgically.

Is there another way? What’s injected is important. What if we injected even more-concentrated platelet-rich plasma (PRP)? Most physicians use a mix that has 2–5 times more concentrated platelets than blood. We had already treated his Achilles by precisely injecting PRP that was 7 times more concentrated using ultrasound, but could we go higher? Unlike physicians who have little bedside machines and are limited to the type of PRP that this machine can produce, we have a lab that can make whatever we need. Hence, we upped the concentration to 20 times more than baseline and tried again. This time the patient also decided to go into a walking boot for six weeks. See my video below about how Regenexx PRP is very different.

How did he do? I just saw Randall back yesterday, and he reported being 100% better and just completing his seventh Ironman in Canada! He can run, bike, and swim without any issues. In addition, a major change was that the tendon looked normal under ultrasound, so he’s cured.

The upshot? Even our regular high-dose PRP didn’t work well for this really bad Achilles tendon. However, what ultimately healed the tendon without surgery was ultra-high-dose PRP. Only Regenexx can make PRP at 20 times over baseline, and for this triathlete, that’s exactly what he needed!


    Brett says

    What about Greyledge? I think the system Dr. Karli has might be able to do similar dosage amounts


    Regenexx Team says



    terrence o'neill says

    Thanks for the report; reassuring, for one who is seeking stemcell and platelet procedures for meniscus and arthritis treatment from Centeno-Schutz Clinic., esp. form Dr. Centeno.
    Terrence O'Neill


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    About the Author

    Chris Centeno

    Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…

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