Orthobiologic therapy uses your body’s own healing factors to treat injured tissue. A small amount of blood, or bone marrow for BMAC, is drawn, concentrated in a centrifuge, and injected under live ultrasound guidance at the exact site of your injury.

Because the biologic comes entirely from you, how well you prepare and how closely you follow the after-care directly shape your result.

5 to 7x Platelet concentration Above normal blood, using real-time optical sensing
30 to 45 min Preparation Individually formulated to your condition
100% Autologous From your own body, no additives or foreign substances

Two rules that are different from most treatments

Use heat, not ice

Apply a warm compress to the injection site, never ice. The soreness afterward is the healing response. Ice shuts it down; heat supports it. Use heat through the first week.

No NSAIDs for 2 weeks

No ibuprofen (Advil, Motrin), naproxen (Aleve), aspirin, Celebrex, or Mobic for 2 full weeks. They block the healing your injection is designed to trigger. If unsure whether a medicine is an NSAID, call the office first.

Contact Dr. Jazayeri’s Office

Call or text, Monday to Friday, 8 to 5
424.347.8564 or (310) 746-5918

Email
[email protected]

Emergencies
For a medical emergency, call 911.

Office
DOCS Health, 8436 W 3rd St, Ste 800, Los Angeles, CA 90048

Call us right away if you experience

Redness, warmth, or swelling that worsens after 72 hours
A fever of 101 F or higher
Severe pain not controlled by Norco and Tylenol
Numbness or tingling near the injection site
Signs of infection, such as drainage or skin changes

Call the office to arrange an evaluation. For a medical emergency, call 911.

How It Works

Your own healing factors, concentrated and placed precisely

Your treatment is made entirely from your own body, with no synthetic drugs or foreign substances. A small blood draw, or bone marrow for BMAC, is concentrated in a centrifuge using real-time optical sensing to reach your precise platelet target, then injected under live ultrasound at the site of your injury. Each formulation is tailored to your condition and takes about 30 to 45 minutes to prepare.

Growth factors released at injection:

PDGF – Cell recruitment
TGF-beta – Tissue remodeling
VEGF – Blood vessel formation
IGF-1 and 2 – Cell survival and growth
EGF – Tissue regeneration
FGF – Collagen synthesis
IL-8 – Healing coordination
All factors – Stored in alpha-granules

Step 1 · Optimize Your Body

Metabolic screening before scheduling

Before scheduling, Dr. Jazayeri orders a personalized lab panel to find correctable factors, such as vitamin deficiencies, elevated inflammation, or hormonal imbalances, that could limit your healing. Once these are addressed, your procedure is scheduled with your body at its biological best. Correcting them first, through nutrition, supplementation, or other strategies, meaningfully improves the outcome.

Examples of labs Dr. Jazayeri may order:

Vitamin D – Musculoskeletal regeneration
Albumin – Nutritional and healing status
hsCRP – Systemic inflammation
HbA1c – Blood sugar regulation
CBC – Platelet count and baseline health
Testosterone – Anabolic and repair status
IGF-1 – Growth factor signaling
Fasting Insulin – Insulin sensitivity

Your specific panel is set at your consultation. Not every patient needs every test.

Step 2 · Prepare for Your Procedure

Diet, supplementation, and timing

Preparation timeline

1 to 2 weeks before: Start an anti-inflammatory diet. Stop all NSAIDs (ibuprofen, naproxen, aspirin). Stop alcohol, tobacco, high-dose fish oil, and vitamin E. Begin hydrating daily.
1 week before: Begin daily XR amino acid supplementation as directed, which supports platelet production leading up to your procedure.
Day before: Rest, hydrate well, and eat a light anti-inflammatory meal. No alcohol. Confirm your exercise plan if you have mobility limitations.
Day of, about 1 hour before: Take 1 Norco tablet and your XR supplement about an hour before your blood draw. Bring 1 more Norco to take right after your injection.
Day of, exercise: Complete your prescribed exercise within 60 to 120 minutes of your blood draw to mobilize your spleen’s platelet reserve.
Just before the draw: Cool down, check in, and hydrate. Blood is drawn at the peak platelet window.

Diet: eat and avoid

Eat and drink

Fatty fish: salmon, sardines, mackerel
Leafy greens: spinach, kale, arugula
Colorful berries and pomegranate
Olive oil, nuts, and seeds
Eggs, poultry, and lean protein
Turmeric and ginger
Plenty of water, every day

Avoid, before and after

Alcohol: stop 1 week before, avoid 1 week after
NSAIDs: stop 7 to 10 days before, avoid 2 full weeks after
Sugar, soda, pastries, sweetened juices
Fried and processed foods
High-dose fish oil and vitamin E: stop 1 to 2 weeks before
Tobacco, at any point during recovery

Pre-procedure exercise

Exercise makes your spleen release its stored platelets into your bloodstream, raising platelet count and activation. Studies show this can raise platelet yield by 20 to 35 percent and key growth factors by up to 160 percent. Aim to finish 60 to 120 minutes before your draw. The exercise is matched to the joint being treated, for example lower body cardio before a shoulder injection, or upper body work before a knee injection. Dr. Jazayeri will choose the best option for you.

Standard, no lower extremity restriction

Stairmaster, stationary bike, treadmill, or elliptical
15 to 20 minutes at 70 to 85 percent max heart rate
Finish within 60 to 120 minutes of your draw

Modified, knee pain or limited mobility

Arm bike, swimming, or upper body ergometer
Blood flow restriction (BFR) training
20 to 30 minutes of sustained upper body work
Intensity matters, not the muscle group

Day of Procedure

What to expect, start to finish

Blood draw. A small volume from your arm, similar to a routine lab draw.
Centrifugation. Optical sensing concentrates your blood to your precise platelet target, about 30 to 45 minutes.
Ultrasound-guided injection. Delivered under live imaging for accurate placement at the site of your injury.
Second Norco tablet. Take immediately after your injection, as directed.
Brief rest, then discharge with these instructions.

Driving: because you take Norco before the procedure, please have someone drive you.

Pain Control

Heat and the right medications

Norco Hydrocodone with acetaminophen

1 tablet every 4 to 6 hours as needed for pain, for the first 1 to 2 weeks while soreness peaks. Take 1 about an hour before your appointment, and bring 1 for right after the injection. Filled in advance.

Tylenol Acetaminophen 500 mg

Up to 4 tablets a day (2,000 mg maximum). Safe alongside Norco or on its own. As soreness eases in week 2, Tylenol alone is usually enough.

Use heat, not ice. Apply a warm compress for 20 minutes, 2 to 3 times a day, for the first week. Heat brings blood, oxygen, and nutrients that support healing. Ice shuts that healing cascade down.
No NSAIDs for 2 full weeks. No ibuprofen, naproxen, aspirin, Celebrex, or Mobic. If you are not sure whether a medicine is an NSAID, call the office before taking it.

Recovery Timeline

Soreness first is a sign the healing is active

Day of

Rest and heat. Norco before and after as prescribed. Warm compress 20 minutes, 2 to 3 times. No ice. Rest, eat lightly, hydrate, no alcohol. Have someone drive you home.

Days 1 to 3

Peak soreness, normal. Soreness, aching, and mild swelling are expected. Continue Norco and Tylenol as needed. Warm compress 2 to 3 times daily, no ice. Light walking is fine; no gym or sports. No alcohol, NSAIDs, or tobacco.

Days 4 to 7

Soreness eases. Aching should begin improving; Tylenol as needed, Norco if needed. Heat if still sore or tight. Continue XR supplementation. Gentle range of motion if tolerated.

Week 2

Begin reactivation. No NSAIDs through the end of week 2. Tylenol or Norco for any remaining soreness. Begin physical therapy when cleared by Dr. Jazayeri. Light activity as tolerated.

Weeks 2 to 6

Gradual improvement. Soreness fades and early improvement begins. Physical therapy guides the healing tissue into the right load patterns.

Months 2 to 6

Progressive healing. Tissue remodels and rebuilds. Full benefit develops over 3 to 6 months and improves with structured rehab.

Do & Don’t

The short version to keep on the fridge

Heat: warm compress 20 minutes, 2 to 3 times daily, first week
Norco as needed; staying ahead of pain beats waiting
Tylenol, up to 2,000 mg a day
XR supplementation, 1 to 2 weeks after, as directed
High-protein, anti-inflammatory meals
Physical therapy, once cleared
Stay well hydrated throughout

Do not

No ice; it suppresses the healing cascade
No NSAIDs for 2 full weeks (Advil, Aleve, aspirin, Celebrex, Mobic)
No alcohol for at least 1 week after
No tobacco at any stage
No strenuous activity or sports the first week
No sugar or processed foods during recovery

Common Questions

What patients ask most

I am in more pain than before my injection. Did something go wrong?

No. A post-injection flare, more soreness in days 1 to 5, is very common and expected. It means your body is responding to the biologic exactly as intended. Take Norco and Tylenol as directed and apply heat. If pain is severe or uncontrolled after 5 days, call the office.

My joint feels swollen and stiff. Should I be worried?

Mild swelling and stiffness in the first week is a normal part of healing and should improve by days 4 to 7. Call the office if you develop worsening redness, significant swelling after 72 hours, or a fever above 101 F.

When will I start feeling better?

Most patients notice meaningful improvement between weeks 2 and 6. Full benefit develops over 3 to 6 months and keeps improving with structured physical therapy.

Can I drive after the procedure?

Have someone drive you home the day of, since you will have taken Norco. After day 1 you may drive as long as you are not under the active effects of Norco. Tylenol alone does not impair driving.

When can I return to exercise and sports?

Light walking is fine starting the day after. Avoid the gym, running, and sport-specific activity during the first week. Full return is guided individually by Dr. Jazayeri at your follow-up.

Follow Up

Reviewing your recovery

Dr. Jazayeri will schedule a follow-up to review your recovery and decide when to begin or advance physical therapy.
Most patients improve gradually over 4 to 12 weeks, with full benefit from PRP, A2M, or BMAC typically developing over 3 to 6 months.
Call the office with any of the warning signs listed at the top of this guide.

Here to support you through your recovery.
Dr. Reza Jazayeri, MD and the DOCS Health team
Orthopaedic Surgery and Sports Medicine

All protocols are individualized by Dr. Jazayeri based on your clinical history and physical condition. This sheet is for patient education only and does not replace a clinical consultation.

Medically reviewed by Reza Jazayeri, M.D. on July 16, 2026

Your Orthobiologic Therapy Guide