About Platelet-Rich Plasma (PRP)
Platelets are the small blood cells that arrive first at an injury. They carry growth factors, which are signaling proteins that call in repair cells and help organize healing. PRP concentrates those platelets from a tube of your own blood so a stronger dose can be placed right where the tissue is struggling.
We most often use PRP for tendons that have stopped healing on their own, such as tennis elbow, patellar or Achilles tendinopathy, and gluteal tendon pain, and for small partial tendon tears. It is also used for knee, hip, and shoulder arthritis. In arthritis, PRP does not rebuild cartilage, but it may calm pain and help you move and exercise more comfortably.
Dr. Gruner and Dr. Chen use ultrasound to guide every PRP injection, so the platelets reach the damaged part of the tendon or the inside of the joint rather than the tissue next to it. PRP is one part of a plan that also includes progressive strength training and attention to load, sleep, and nutrition.
Where we use PRP
Shoulder
- Rotator Cuff Tendinopathy and Partial Tears
- Shoulder Arthritis
- AC Joint Arthritis
- Shoulder Labral Tear
- Subacromial and Subcoracoid Impingement
- Shoulder Instability and Dislocation
- Biceps Tendinopathy (Front of Shoulder)
Elbow
- Tennis Elbow
- Golfer's Elbow
- Distal Biceps Tendinopathy and Partial Tears
- Cubital Tunnel Syndrome
- Elbow Arthritis
- Little League Elbow
- Elbow UCL Sprain
Hand and Wrist
- Thumb (CMC) Arthritis
- Wrist and Hand Arthritis
- De Quervain's Tenosynovitis
- Gamekeeper's Thumb
- TFCC Tear (Pinky-Side Wrist Pain)
Hip and Pelvis
- Hip Arthritis
- Gluteal Tendinopathy and Partial Gluteal Tendon Tears
- Hamstring Tendinopathy
- Hip Labral Tears and FAI
- Sports Hernia and Chronic Groin Pain
- Hip Flexor Strain and Iliopsoas Tendinopathy
- Hamstring Strain
Watch: PRP explained
More videos
Who is likely to benefit from a PRP knee injection, what the visit involves, and when another option makes more sense.Featuring Dr. Gruner A patient's experience with a minimally invasive, ultrasound-guided procedure for stubborn tennis elbow.Featuring Dr. Gruner
What happens during treatment
- 1.
At a prior visit, your physician examines you and uses ultrasound to confirm which tendon or joint is the source of pain and whether PRP fits your goals.
- 2.
On the day of the procedure, a nurse or physician draws a small amount of blood from your arm, similar to a routine lab draw.
- 3.
The blood is spun in a centrifuge to separate and concentrate the platelets, which takes about 15 to 20 minutes.
- 4.
The skin is cleaned and numbed, and your physician places the PRP under live ultrasound into the exact area of damage.
- 5.
You leave the same day with written instructions for activity, pain control, and when to start your rehab progression.
Who may be a good candidate
- Adults with tendon pain lasting several months that has not improved with a solid course of rehab.
- People with small partial tendon tears seen on ultrasound or MRI, where surgery is not needed.
- People with mild to moderate knee, hip, or shoulder arthritis who want to stay active and prefer to limit repeated steroid injections.
- Patients who are willing to follow a structured, progressive loading program after the injection.
Recovery
Soreness for several days is common, because PRP starts an inflammatory healing response on purpose. Most people use acetaminophen, ice, and relative rest for the first few days, then begin gentle loading guided by our team. Tendons respond slowly, so improvement is often gradual over weeks to a few months. Some patients benefit from a second injection, which we decide on together based on how you are doing.
Risks and limits
The most common side effect is post-injection soreness and swelling, which can be significant for a few days. Less common risks include infection, bleeding or bruising, and irritation of a nearby nerve. We usually ask you to pause anti-inflammatory medicines such as ibuprofen or naproxen for a period before and after PRP, since they may blunt the platelet response. PRP is not right for people with an active infection, certain blood or platelet disorders, active cancer, or a complete tendon rupture, which often needs a surgical opinion that we can help arrange.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Rehab protocols
Dr. Gruner's week-by-week recovery guidelines. Your plan is individualized; follow these with your physician and physical therapist.
- Shoulder — Ultrasound-Guided Lipogems / PRP ProtocolView PDF
- Elbow — Ultrasound-Guided Tenotomy / PRP ProtocolView PDF
- Knee & Hip Joint — Ultrasound-Guided PRP / Adipose / BMAC Injection ProtocolView PDF
- Knee (Quad / Patellar Tendon) — Ultrasound-Guided PRP / Tenotomy ProtocolView PDF
- Hip (Gluteal Tendon) — Ultrasound-Guided Lipogems / PRP ProtocolView PDF
- Hip (Hamstring Tendon) — Ultrasound-Guided Lipogems / PRP / Tenex ProtocolView PDF
- Foot (Plantar Fascia) — Ultrasound-Guided Tenotomy / PRP ProtocolView PDF
- Achilles Tendon — Ultrasound-Guided Tenotomy / PRP ProtocolView PDF
Clinical evidence
Published studies our physicians draw on. Results in studies do not predict any one person's outcome.
- Platelet-Rich Plasma (PRP) for Knee Osteoarthritis: AAOS Technology OverviewAmerican Academy of Orthopaedic Surgeons
- The 2020 NBA Orthobiologics Consensus StatementPubMed Central
- Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of RCTsPubMed
- Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patientsPubMed
Questions about PRP
- Does a PRP injection hurt?
- The skin is numbed first, so most people feel pressure more than sharp pain during the injection. The treated area is usually sore for a few days afterward. We give you a plan for managing that soreness before you leave.
- Can I take ibuprofen after PRP?
- We generally ask you to avoid ibuprofen, naproxen, and similar anti-inflammatory medicines for a period before and after PRP, because they may interfere with the platelets' healing signal. Acetaminophen and ice are usually fine. Your physician will give you exact timing based on your medications and health history.
- How many PRP injections will I need?
- Many people have a single injection, and some benefit from a second one after several weeks. The decision depends on the condition, how you respond, and what ultrasound shows at follow-up. We do not schedule a fixed series without reassessing first.
- Will PRP help my arthritic knee grow back what it has lost?
- No. PRP does not rebuild or replace worn cartilage in an arthritic joint. It may ease pain and improve function, which can make it easier to stay active and keep strengthening the muscles that support the joint.