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Condition overview · Orthopedics

Tendon & ligament injuries

Long-standing tendon problems (tendinopathies) are often slow to settle with rest and rehab alone. PRP and prolotherapy act on different parts of the problem, so we often use them together.

Tennis & golfer's elbowAchilles tendinopathyPlantar fasciitisHamstring strainPatellar tendinopathy

Therapies for this condition

Two mechanisms, two roles.

PRP works through growth-factor signaling, and prolotherapy aims to start a repair response in the ligament.

01 · Platelet-rich plasma

Platelet-rich plasma (PRP)

Blood-derived · in-office · 60–90 min

Concentrated platelets and growth factors from your own blood, prepared in our lab and delivered into the target tissue under ultrasound guidance. There is more published research on PRP for joints and tendons than on any other autologous biologic.

  • Best fit when
  • Chronic tendinopathy that hasn't responded to PT
  • Small partial tears inside the tendon
  • Anchor therapy when combining with prolotherapy
Read the full Platelet-rich plasma page →

02 · Ligament & joint stabilization

Prolotherapy

Dextrose-based · aims to start a local repair response

A series of small injections of a dextrose (sugar) solution into ligaments and the points where they attach to bone. The goal is a local repair response and a more stable joint. We use it mainly when a loose ligament (laxity) is the main problem. It does not rebuild cartilage.

  • Best fit when
  • Chronic ligament laxity around a joint
  • Recurrent strains in the same tendon-bone junction
  • Patients with concurrent joint instability
Read the full Prolotherapy page →

Talking it through

Find out if biologic therapy is the right next step for you.

These are the situations where biologic therapy most often comes up for this condition. Whether it fits you is something we work out together at your consultation. If another option makes more sense, we'll tell you.

What we look at together

  • Tendinopathy that has outlasted 8–12 weeks of dedicated rehab
  • Localizable, mechanical pain on exam
  • You can pause provocative loading for 1–2 weeks post-injection
  • You're willing to commit to a 12-week, rehab-plus-biologic protocol