Achilles tendinopathy: have we moved beyond eccentric loading?

Heavy slow resistance training and progressive tendon loading protocols have been gaining ground over the classic Alfredson eccentric programme, with several RCTs suggesting comparable or superior outcomes at mid-term follow-up. PRP injections continue to polarise opinions despite multiple trials. For a recreational runner with mid-substance tendinopathy of 4 months failing conservative management, what's your actual algorithm?