PRP is Not the Same at Every Practice

Never has platelet-rich plasma (PRP) therapy had more traction in the orthopedic world than it does today. After more than a decade of use, PRP—a treatment that uses your own blood and growth factors to stimulate healing—has proven its staying power.

Because of this, more orthopedic practices than ever are offering PRP as a minimally invasive, more holistic treatment option. But here’s the important truth: PRP at one practice can be vastly different from PRP at another.

The success of a PRP injection depends on many critical factors. Here are some of the most important:

1. The Experience of the Physician

PRP is a highly technique-sensitive procedure. The skill, training, and experience of the physician performing the injection can make all the difference in your outcome.

2. Ultrasound Guidance for Accuracy

PRP injections are most effective when placed precisely at the site of injury. Practices that always use ultrasound guidance ensure the highest accuracy, which translates to better results.

3. The PRP System and Preparation Process

Not all PRP systems are equal:

• The amount of blood drawn

• The method of preparation

• The sophistication of the centrifugation system
  

All of these determine how concentrated the final platelet product will be. More advanced systems can isolate a higher number of platelets, which release more healing growth factors. Think of PRP preparation as a science experiment—precision matters.

4. Pre- and Post-Injection Protocols

The success of PRP doesn’t just depend on the injection itself. What happens before and after is just as important.

• Before: Patients should be “primed” to produce the highest quality PRP possible. Your physician should provide detailed instructions and handouts, not just a casual “see you at your appointment.”

• After: Proper aftercare is crucial. Which medications and supplements should be stopped? How should you protect the injection site? When can you return to exercise or physical therapy? These details matter for healing and long-term success.

5. The Number and Timing of Injections

Some conditions require more than one injection, and the timing of these sessions can significantly impact outcomes. A practice with deep PRP experience knows how to tailor this to your condition.

6. Setting Realistic Expectations

Finally, your physician should provide clear, realistic expectations based on expertise and years of experience—not vague promises.

Choosing the Right Practice for PRP

The reality is that many orthopedic practices are now “diving into” PRP. Some have the knowledge and experience to deliver outstanding results, while others are new to the field and may not fully understand the science behind it.

At Impact Sports Medicine, we are leaders in PRP therapy:

• 15+ years of experience performing PRP procedures

• Ultrasound guidance with every injection

• Detailed before-and-after instructions for every patient

We believe PRP is too important to be treated as a “side service.” Physicians can only be excellent at a limited number of things—and if PRP isn’t a routine part of a practice, it’s unlikely they have the expertise to maximize your outcome.

If you’re considering PRP, choose wisely. We’d be happy to answer your questions and help determine if PRP is the right option for you

F. Clarke Holmes, M.D.

When Is PRP a Great Option — And When Is It Not?

Platelet-Rich Plasma (PRP) injections may be the single biggest game-changing treatment I’ve seen in nearly 25 years as a Sports Medicine and Orthopedic physician. The role of PRP is constantly expanding, and the results we see today are more exciting than ever.

But like any treatment in medicine, PRP isn’t the right answer for every situation. There are times when it can be life-changing, and other times when a different approach is more effective.

Here are some common examples we see in practice:

When PRP Is a Great Option

✅ Advanced Tennis or Golfer’s Elbow

When ultrasound shows moderate to severe tendon damage and patients are experiencing significant pain and loss of function, PRP can be an excellent choice. In these cases, PRP helps heal tears that we can clearly see on imaging.

✅ Mild to Moderate Knee Osteoarthritis

This is one of PRP’s true strengths. PRP not only reduces pain and inflammation, but also helps improve function and may even slow or stop further deterioration of the joint.

✅ Partial Rotator Cuff Tears

For patients with mild pain, good strength, and preserved motion, PRP can support healing and help avoid surgery.

✅ Insertional Gluteal Tendinopathy (Often Miscalled “Hip Bursitis”)

This common condition—especially in middle-aged to older women—causes pain on the outside of the hip, difficulty sleeping on that side, and pain with stairs or longer walks. PRP is often a great option here.

✅ Chronic Plantar Fasciitis (Lasting 3+ Months)

When rest, therapy, footwear adjustments, and medications haven’t helped, PRP can provide real relief—often avoiding the need for more invasive surgery.

When PRP May Not Be the Best Choice

❌ Early/Mild Tennis or Golfer’s Elbow

If ultrasound only shows minimal tendon changes and pain is mild, conservative options like therapy, rest, bracing, and medications usually work well without the need for PRP.

❌ Severe Knee Osteoarthritis With Significant Misalignment

If the knee is badly worn down with severe pain, bowing, or disability, knee replacement is usually the best option. PRP won’t reverse severe structural damage.

❌ Full-Thickness Rotator Cuff Tears in Younger or Middle-Aged Patients

If there’s significant loss of strength and motion, surgical repair is the better route—PRP won’t replace the benefits of fixing the tendon directly.

❌ Advanced Hip Osteoarthritis

When the hip joint is severely damaged, total hip replacement remains the gold standard.

Our Approach at Impact Sports Medicine

At Impact Sports Medicine, our goal is simple: to help you get the best possible outcome—even if that means recommending a treatment we don’t provide ourselves. We want every patient to be cared for as if you were part of our own family.

PRP is a powerful tool, but like all tools, it works best when used at the right time, in the right situation. If you’re struggling with joint, tendon, or ligament pain, we’d be glad to help you figure out whether PRP—or another treatment—will get you back to doing what you love.

PRP Is Evolving: Here's How

One of the most exciting things about platelet-rich plasma (PRP) therapy is that it’s always improving. This isn’t a static treatment. It continues to evolve through better science, smarter techniques, and new technology.

I’ve been using PRP since 2011, and today’s approach looks very different from when I started. At a recent regenerative medicine conference, I had the chance to learn from national experts, exchange ideas with peers, and explore the latest advances in PRP and stem cell therapy.

What’s Changing with PRP?

We’re upgrading our PRP system to deliver a higher concentration of platelets to the areas where you hurt. That means more growth factors—natural healing signals that reduce inflammation, encourage repair, and help preserve tissue.

More Platelets = More Power to Heal

In addition to increased platelets, we’re now able to add important components like:

• Alpha-2 macroglobulin (A2M): A protein that helps protect cartilage and reduce inflammation.

• Extracellular vesicles (EVs): Tiny messengers that carry proteins and RNA to promote healing and calm inflammation.

These additions enhance the effectiveness of PRP—especially for joint pain, soft tissue injuries, and degenerative conditions.

Better PRP. Better Results.

If PRP has helped you before—or if you’ve been considering it—this is a great time to revisit it. With these upgrades, we’re seeing even greater potential to relieve pain, improve function, and support long-term healing.

And we’re not stopping here. Stay tuned as we begin to introduce autologous (your own adipose/fat tissue) stem cell therapies into our practice soon.

F. Clarke Holmes, M.D.

PRP is a Game-Changer for Shoulders, Elbows, Hips and Feet

Our number one application for platelet rich plasma (PRP) injections is knee osteoarthritis.

Yet, shoulder osteoarthritis, rotator cuff and labral problems also respond very favorably to PRP.

Tennis elbow and golfers’ elbow are great applications of PRP.

Hip osteoarthritis, insertional gluteal tendonopathy and bursitis of the hip are commonly treated with great success with PRP.

Finally, in the foot and ankle, osteoarthritis, particularly of the big toe joint, Achilles tendonopathy and plantar fasciitis are common conditions we treat with PRP.

For a tendon problem, why would you choose PRP over a steroid/cortisone injection?
With a PRP injection, we use your own platelets to stimulate healing and tissue regeneration by releasing growth factors. It aims to repair the tendon, not just reduce symptoms. Steroid injections can lead to tendon degeneration or even rupture with repeated use, while PRP is safer for tendon tissue, especially with chronic degenerative tendon conditions.

What about in the case of osteoarthritis? Here’s a table that highlights the differences.

Factor PRP Steroid

Onset of relief Slower (weeks) Fast (days)

Duration of Relief Months to years Weeks

Cartilage effects Potentially protective Potentially harmful

Side effects Minimal Possible systemic and local issues

Disease-modifying? Likely No

Are you interested in improving your quality of life? Reducing your pain? Improving your function? Are you seeking the healing of damaged tissues? Stopping or slowing the deterioration of your joints? If so, then PRP is likely a very good option for you.

As always, let us know if we can be of assistance!

F. Clarke Holmes, M.D.

PRP Means Prevention

If there is a relatively low-risk and minimally invasive option for cancer prevention, would you choose to do it? If there is a similar option to reduce your risk of heart disease, would you do it? These would be potentially life-saving measures.

Now in the case of orthopedics, we are talking more about quality-of-life saving measures. Platelet-rich plasma (PRP) is one of those options.

We know that PRP is very beneficial in terms of reducing symptoms and improving function in most patients, yet did you know that it has also has a preventative benefit? Slowing the deterioration within your joint, particularly of the articular cartilage, is a benefit of the PRP.

How does being in less pain sound? What about being able to go up and down stairs much more easily? What about being out to enjoy longer walks and hiking? What about enjoying your grandkids with less pain during and afterwards?

What about more fulfilling trips to the gym? What about using fewer prescription medications to manage your symptoms? These are the goals of PRP, especially when we are treating osteoarthritis. When we are treating most tendon problems like of the rotator cuff, tennis/golfer’s elbow, lateral hip and the Achilles, the goal of PRP is not only to feel better, but actual healing.

This week, we repeated PRP on a patient with moderate knee osteoarthritis (OA) that last had PRP with us 5 years ago. Her benefit has lasted that long. This week we updated x-rays on a patient with knee OA and noted that in the last 2 years, his x-rays have not changed. This means no substantial loss of cartilage. In contrast, the average OA patient is losing 4%-6% of cartilage per year. What if we can change that to 0%-2%? Would you take it? If so, come see us, as we’re doing more PRP than ever, and the results remain very promising.

F. Clarke Holmes, M.D.