Orthobiologic care that supports healing, not masks signals.
We work in the space between physical therapy and surgery. Orthobiologics: ortho meaning orthopedic, biologics meaning biology from you. Every procedure is guided by ultrasound, every biologic is measured and quantified, and every plan is built around a specific diagnosis.
We don't guess. We don't rush. We don't sell you something you don't need.
PRP Therapy
When pain relief stops working, when the cortisone shots wore off and the pain came right back, the question becomes: can we support healing at the site of damage, rather than turning down the signal for a little while?
"Would you take half a Tylenol and expect full relief? Same thing applies to your PRP."
What PRP is
Platelets are cells in your blood that play a critical role in healing. Think of them as a pull lever that tells the body an area needs to heal. They release growth factors that recruit your body's own repair processes to the site of injury. We draw blood, concentrate those platelets in a centrifuge, and inject that concentrated solution into the areas of damage under ultrasound guidance. The goal is to stimulate a healing response in tissue that has stopped healing on its own.
How we do this differently
Not all PRP is the same. Your baseline platelet count is unique to you: one patient might have 150,000 per microliter, another 250,000. Research on knee osteoarthritis suggests therapeutic benchmarks of 5 to 10 billion platelets in the dose. So we run your blood through an in-clinic hematology analyzer to measure the exact concentration after processing. If the count is too low, we draw more blood and adjust in real time. Every injection is performed under ultrasound guidance, sterile field, targeting the specific structures identified in your physical exam.
What to expect
Patient-dependent, but a common trajectory: increased soreness for days 1–3, return to baseline by day 7, gradual improvement starting weeks 2–4, back to pre-procedure activity by weeks 4–6. A re-evaluation at month 3 assesses progress and determines next steps. Expected duration of relief: 6 to 18 months depending on condition and severity. Physical therapy pairs with the cellular signaling: mechanical input and biological input building on each other.
- Knee osteoarthritis
- MCL and meniscus injuries
- Patellar tendon issues
- Rotator cuff and supraspinatus tears
- AC joint pain
- Low back pain (facet joints, ligaments, multifidi)
- SI joint dysfunction
- Hip arthritis
- Chronic tendon injuries
BMC, when you need more than platelets
For advanced joint degeneration, significant cartilage loss, tissue damage beyond what PRP alone can address, bone marrow concentrate is a step up.
"Stem cells are the composers. Platelets are the musicians playing their score."
What it is
Your bone marrow contains adult mesenchymal stem cells. Think of them as the composers of an orchestra. Where platelets are the musicians, stem cells can sense the environment they're in and send out signals that are a lot more specific. They can direct the healing process in a way platelets alone cannot. We take a bone marrow aspirate, usually from the back of the hip, process it to concentrate those stem cells and growth factors, and inject it into the areas of damage under ultrasound guidance. The biology is yours: your own cells, concentrated and delivered where they're needed.
How it works here
Same precision standards as every procedure: ultrasound guidance for aspiration and injection, full sterile field throughout. BMC can be combined with PRP. The PRP provides a concentrated growth factor environment, the BMC adds the stem cell signaling component. Because we address the full functional unit (joint, surrounding ligaments, tendons, muscles), treatment rarely targets just one structure in isolation.
A longer timeline, and why it matters
Most patients see significant improvement by month 3, but that's a checkpoint, not the finish line. Continued improvement builds through months 3–18 as the stem cells and growth factors do their work. Long-term: up to 5 years of relief is possible, depending on severity and how well a patient follows through with rehabilitation. Expect some increased soreness early, similar to PRP. The real improvements build over months, not weeks. Biology doesn't operate on our preferred timeline.
- Advanced joint degeneration
- Significant cartilage damage
- Patients facing a surgical recommendation
- Cases requiring a more comprehensive biologic signal
Nerve procedures that support the nerve
Not all pain comes from joints, tendons, or ligaments. Sometimes the pain generator is a nerve that's become entrapped: compressed or stuck in surrounding tissue. When that happens, pain radiates, numbness sets in, tingling starts. We address the nerve directly, without cutting.
"Kill a nerve and it grows back more dysregulated. We'd rather help it heal."
Nerve hydrodissection
Under ultrasound guidance, we visualize the nerve in real time: where it's compressed, where it's adhered. We inject fluid around the nerve to physically separate it from the structures trapping it. That's the "hydro" part. The fluid contains growth factors, from PRP or other biologics, that support nerve healing and reduce the inflammation feeding the entrapment. Mechanical release and biological support in a single procedure.
A different philosophy on nerve pain
The conventional approach to many nerve pain conditions is radiofrequency ablation: killing the nerve so it can't send pain signals. The problem: when you kill nerves, they grow back. And they grow back more dysregulated, sometimes more painful. Over time, that approach works less and less. We do the opposite. We resolve the pain so you see us less and less.
Stellate ganglion block
For PTSD, generalized anxiety, and chronic insomnia, we perform stellate ganglion blocks. The stellate ganglion is part of the sympathetic nervous system, the fight-or-flight circuit. In some patients, that system gets stuck in an overactive state. A stellate ganglion block is like unplugging and restarting the router. We inject an anesthetic near the ganglion under ultrasound guidance, temporarily shutting down that part of the nervous system for 4 to 6 hours. When it comes back online, it tends to reset to a more regulated baseline. We treat two levels (stellate and middle cervical sympathetic chain) bilaterally, on separate days about a week apart.
- Carpal tunnel syndrome (median nerve entrapment)
- Cubital tunnel syndrome (ulnar nerve entrapment)
- Peripheral nerve entrapments
- PTSD (stellate ganglion block)
- Generalized anxiety (stellate ganglion block)
- Chronic insomnia (stellate ganglion block)
Why every injection is imaged
Most injections in most clinics are done blind. The doctor feels for landmarks, makes an estimate, and injects. No visualization. No confirmation the needle reached the target. That's like ordering food, paying, and flipping a coin on whether you get it. You wouldn't accept that at a restaurant.
"Ask your provider if they use imaging guidance for injections. If they don't, find one who does."
Diagnostic and procedural
At this practice, every injection is performed under real-time ultrasound guidance. Diagnostically, ultrasound visualizes the tendons, ligaments, nerves, and joint spaces during evaluation, identifying the specific structures generating your pain. You see the screen, and we walk through what we're looking at. Procedurally, you watch the needle on the screen reach the target. No guessing. If the biologic doesn't reach the damaged tissue, it doesn't matter how good the biologic is.
Sterile field, every time
Every procedure is performed with a full sterile field: sterile draping, sterile gel, sterile technique throughout. It takes more time and preparation. It matters for patient safety and procedure integrity.
Comprehensive, multi-structure treatment
Pain is rarely caused by a single structure. A joint surface, a ligament, a tendon, a nerve: multiple generators contribute to what you experience as one painful area. During evaluation we identify all of them. During treatment we address them together, not just the joint but the surrounding structures that support it. That's the difference between treating one piece of the puzzle and treating the whole functional unit.
A2M, a targeted anti-inflammatory
A2M is a protein that occurs in your blood plasma. It acts as a strong anti-inflammatory agent. Think of it as your body's natural steroid, without the tissue-breakdown side effects of synthetic corticosteroids.
How we use it
We take a blood draw, spin it down, and run it through a filter that isolates the specific plasma proteins. The concentrated A2M is injected under ultrasound guidance into areas of inflammation. It works on its own, and it works well combined with PRP or bone marrow concentrate, addressing the inflammatory component of a case so the tissue has a better environment to heal in.
One injection at a time. No pre-sold packages.
Two-fee structure: a biologic processing fee (covers blood draw, centrifuge processing, hematology analysis, biologic preparation) and a per-injection fee for each structure we treat. If your case involves one injection, you pay for one injection. If it involves several, cost scales accordingly.
We don't sell injection packages. No one knows upfront how many injections it'll take to get you better. Anyone quoting that number is guessing. So we take it one procedure at a time: treat, re-evaluate at three months, adjust.
The three-month re-evaluation is included in the cost of your procedure. The initial 15-minute discovery call is free: a conversation to see if we'd be a good fit to work together.
Ready to talk through your case?
Free 15-minute discovery call. No pressure. No obligation. A conversation about what's going on and whether this approach is a fit.