What to do for shoulder, hip, or Achilles tendon soreness behind the ankle

What to try during ordinary tasks

Keep shoulder work below the point that brings sharp soreness. Store common items where you can reach them without stretching overhead. For the hip, avoid long spells on the sore side, and try a pillow for sleep.

Shorten steep walks if that back-of-ankle tendon hurts during push-off. Gentle, level walking may be easier than hills or quick starts. Don't add a great deal of distance after a quiet week, because the tissue needs time to adjust.

When to go sooner for medical help

A sudden pop and lost motion need prompt medical care. Get help if you can't lift the arm, push off the foot, stand, or walk. After a hard fall, an area that looks misshapen may mean more than an irritated tendon.

Call for quick advice if a joint becomes hot and very swollen. Fever or spreading redness may mean infection. New numbness or marked weakness also needs a timely exam, and you shouldn't wait when movement disappears suddenly.

What to ask if shoulder, hip, or heel soreness stays

When the soreness stays, QC Kinetix can discuss regenerative options, meaning non-surgical care using your body's own material. Clinic staff make PRP, meaning platelet-rich plasma, by drawing your blood and using a machine to separate the platelet-heavy layer. That layer is given as a shot to the area checked during your visit.

Across human studies, lasting Achilles soreness didn't improve more with PRP than with a comparison treatment, while shoulder and outer-hip studies reported some better results but didn't all agree. Ask how those findings fit the tissue found during your exam. Ask the clinician to be clear about the limits instead of assuming the shot will work.

Sources

1. A placebo-controlled, double-blind randomized trial of 40 patients with chronic rotator cuff tendinopathy compared a single ultrasound-guided subacromial injection of 5 mL PRP with 5 mL saline, with both groups completing a 6-week standard exercise programme and follow-up to one year. PRP did not produce better outcomes than saline on any measure - a reminder that the exercise programme, not the injectate, carried the improvement.

   Kesikburun S, Tan AK, Yilmaz B, et al. — Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. American Journal of Sports Medicine, 2013. DOI: 10.1177/0363546513496542.

2. A double-blind randomized controlled trial of 99 patients with imaging-proven partial-thickness rotator cuff tears or tendinopathy compared ultrasound-guided PRP with corticosteroid, following patients to 12 months. PRP produced significantly better short-term pain relief and function than corticosteroid on VAS, ASES and WORC scores.

   Kwong CA, Woodmass JM, Gusnowski EM, et al. — Platelet-Rich Plasma in Patients With Partial-Thickness Rotator Cuff Tears or Tendinopathy Leads to Significantly Improved Short-Term Pain Relief and Function Compared With Corticosteroid Injection: A Double-Blind Randomized Controlled Trial. Arthroscopy, 2021. DOI: 10.1016/j.arthro.2020.10.037.

3. A meta-analysis of eight randomized trials of PRP for rotator cuff tendinopathy concluded PRP was a safe and effective intervention for long-term pain control and shoulder function - while noting that the studies varied in PRP preparation and injection technique and that the control interventions differed between trials (saline in four, rehabilitation or dry needling in the other four).

   A Hamid MS, Sazlina SG — Platelet-rich plasma for rotator cuff tendinopathy: A systematic review and meta-analysis. PLOS ONE, 2021. DOI: 10.1371/journal.pone.0251111.

4. In a double-blind, placebo-controlled trial of 54 patients with chronic midportion Achilles tendinopathy, all doing eccentric exercises, VISA-A scores improved 21.7 points with PRP and 20.5 points with saline over 24 weeks - an adjusted between-group difference of -0.9 (95% CI -12.4 to 10.6), excluding the predefined relevant difference of 12 points. PRP added nothing to eccentric loading.

   de Vos RJ, Weir A, van Schie HT, et al. — Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA, 2010. DOI: 10.1001/jama.2009.1986.

5. A 24-site, 240-patient participant-blinded randomized trial of a single intratendinous PRP injection versus a sham (subcutaneous dry needle) for chronic midportion Achilles tendinopathy found VISA-A scores of 54.4 versus 53.4 at six months (adjusted mean difference -2.7; 95% CI -8.8 to 3.3) against a 12-point minimal clinically important difference. The authors stated the findings do not support the use of this treatment for chronic midportion Achilles tendinopathy.

   Kearney RS, Ji C, Warwick J, et al. — Effect of Platelet-Rich Plasma Injection vs Sham Injection on Tendon Dysfunction in Patients With Chronic Midportion Achilles Tendinopathy: A Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.6986.

6. An updated meta-analysis of six randomized trials (422 patients) found no benefit of PRP over placebo for Achilles tendinopathy on VISA-A at 3 months (mean difference 1.7; 95% CI -1.8 to 5.2), 6 months (0.5; 95% CI -8.5 to 9.3) or 1 year (-7.9; 95% CI -27.3 to 11.6), nor on VAS pain at 3 months. Funnel-plot asymmetry suggested publication bias inflating apparent benefits. The authors wrote that PRP should not be used to treat Achilles tendinopathy until high-quality trials show a clear clinical benefit.

   Barreto ESR, Antunes Junior CR, Silva IC, et al. — Is Platelet-rich Plasma Effective in Treating Achilles Tendinopathy? A Meta-analysis of Randomized Clinical Trials. Clinical Orthopaedics and Related Research, 2025. DOI: 10.1097/CORR.0000000000003349.

7. A randomized double-blind trial of 80 patients with chronic gluteal tendinopathy (lateral hip pain) compared a single ultrasound-guided PRP injection with a single corticosteroid injection. At 12 weeks the PRP group had significantly better modified Harris Hip Scores (P=.048), and 82% versus 56.7% of patients reached the minimal clinically important difference (P=.016).

   Fitzpatrick J, Bulsara MK, O'Donnell J, et al. — The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection. American Journal of Sports Medicine, 2018. DOI: 10.1177/0363546517745525.

8. Two-year follow-up of the same 80-patient gluteal tendinopathy trial found the single leukocyte-RICH PRP injection produced improvement that was sustained at 104 weeks (mHHS 53.77 at baseline to 82.59 at two years; P<.0001), whereas the corticosteroid improvement peaked at six weeks and was not maintained beyond 24 weeks. This is one of the clearest demonstrations that leukocyte-rich PRP is the formulation with evidence in TENDON, not in cartilage.

   Fitzpatrick J, Bulsara MK, O'Donnell J, et al. — Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up. American Journal of Sports Medicine, 2019. DOI: 10.1177/0363546519826969.

9. A meta-analysis with bias assessment covering PRP for tendon and ligament healing found significantly less long-term pain with PRP overall (weighted mean difference -0.84; 95% CI -1.23 to -0.44), driven by rotator cuff injuries (-0.53) and lateral epicondylitis (-1.39). Heterogeneity was substantial (I2 about 76%) and the funnel plot was asymmetric, suggesting possible publication bias.

   Chen X, Jones IA, Park C, et al. — The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment. American Journal of Sports Medicine, 2018. DOI: 10.1177/0363546517743746.

10. The devices used to spin PRP at the point of care are cleared by FDA as clinical centrifuges, product code JQC, a Class I device under 21 CFR 862.2050 - for example the Biomet GPS Platelet Separation Kit (K030555, cleared 2003) and the Harvest SmartPrep2 / SmartPrep Platelet Concentration System (K103340, cleared 2010). That clearance covers the equipment that separates blood. It is not an FDA approval of platelet-rich plasma as a treatment for osteoarthritis, tendinopathy or any other orthopedic condition, and copy must never blur the two.

    U.S. Food and Drug Administration (Center for Devices and Radiological Health) — 510(k) Premarket Notification database and Product Classification: JQC, Centrifuges (Micro, Ultra, Refrigerated) For Clinical Use, 21 CFR 862.2050. FDA accessdata (CDRH device databases), 2003.