Not all PRP is created equal

PRP quality is not just about the machine used, it is the sum of every decision made before, during, and after the injection. Dr. Jazayeri’s protocol addresses each of these variables systematically, because the difference between ordinary PRP and optimized PRP can mean the difference between a modest result and a meaningful, lasting one.

PRP Overview

PRP harnesses your body’s own concentrated healing factors to repair damaged tendons, joints, and ligaments, without surgery. It is among the most extensively researched regenerative treatments in orthopedics today, and the quality of results depends heavily on how it is prepared and delivered.

The PRP Quality Chain — Every Step Matters

  • 1. Pre-procedure optimization

    Nutritional status, BCAA/XR supplementation, pre-exercise conditioning

  • 2. Blood draw technique & volume

    Needle gauge, anticoagulant ratio, draw volume — all affect platelet yield

  • 3. Centrifuge technology

    Arthrex Angel System with real-time optical sensing for exact platelet targeting

  • 4. Precision delivery

    Ultrasound-guided injection directly into the pathology

  • 5. Post-injection protocol

    Heat not ice, NSAID avoidance, BCAA/XR continuation, structured PT program

  • Total time from draw to injection

    <30 min

  • Platelet concentration vs. normal blood

    5–7×

  • Level 1 studies for knee OA alone

    30+

  • Autologous — from your own body

    100%

Watch The Angel® System Animation: The Angel® system offers customized PRP formulations from whole blood or bone marrow aspirate.

Growth Factors in PRP

These proteins are stored inside platelets and released at the injection site to drive tissue repair.

  • PDGF

    Platelet Derived Growth Factor, cell recruitment & proliferation

  • TGF-β

    Transforming Growth Factor Beta, tissue remodeling & repair

  • VEGF

    Vascular Endothelial Growth Factor, new blood vessel formation

  • IGF-1/2

    Insulin-like Growth Factors, cell survival & growth

  • EGF

    Epidermal Growth Factor, tissue regeneration

  • FGF

    Fibroblast Growth Factor, collagen synthesis

  • IL-8

    Interleukin-8, healing signal coordination

The PRP Process — Step by Step

  • 1. Pre-procedure optimization

    Following Dr. Jazayeri’s protocol, you will have completed a 20-minute vigorous exercise session and taken your BCAA/XR supplement 90–120 minutes before arrival — priming your platelets to be more numerous and biologically active before the blood is even drawn.

  • 2. Blood Draw

    A small amount of blood, similar to a routine lab test, is drawn from your arm. The draw volume, needle gauge, and anticoagulant ratio are all controlled to preserve platelet integrity before centrifugation.

  • 3. Centrifugation with the Arthrex Angel System

    The blood is processed in the Arthrex Angel System — the most advanced PRP centrifuge available. Three optical sensors read the spinning blood in real time, detecting the precise boundary between cell layers and automatically stopping collection at the exact platelet concentration target. This precision is not possible with standard bedside centrifuges operating on fixed timing alone.

  • 4. Ultrasound-guided injection

    PRP is injected using real-time ultrasound imaging, not a blind injection guided by surface landmarks. The needle tip is visible on screen throughout the procedure, ensuring PRP is deposited exactly where the pathology exists, not in nearby tissue.

  • 5. Post-injection protocol — heat, not ice

    Apply a warm compress or heating pad — not ice. Heat promotes vasodilation, increasing blood flow to the treated site and delivering the oxygen and nutrients that activated platelets need. Ice causes vasoconstriction, reduces local blood flow, and dampens the inflammatory healing cascade that PRP is specifically designed to harness. Inflammation here is not the problem, it is the mechanism of healing.

  • 6. Recovery, XR supplementation & physical therapy

    Continued BCAA/XR supplementation supports the collagen synthesis phase of healing. A structured PT program is prescribed at the appropriate time to guide tissue remodeling and ensure new collagen forms in the correct load-bearing orientation.

Watch Cellular Components and Growth-Factor Content of PRP From the Angel® cPRP System

Conditions We Treat with PRP

  • Partial Rotator Cuff Tears

    High-grade partial and intrasubstance tears that haven’t responded to conservative care.

  • Knee Osteoarthritis

    30+ Level 1 trials show PRP superior to steroid and hyaluronic acid injections.

  • Tennis Elbow

    Lateral epicondylitis that has failed conservative care. PRP shows superior long-term results.

  • Other Conditions

    Achilles tendinopathy, shoulder OA, and many more.

After Your PRP Injection

  • What to do

    Apply a warm compress for comfort and blood flow. Take Tylenol (acetaminophen) for pain. Rest from strenuous activity for 1 week. Continue BCAA/XR as directed. Follow your PT program when cleared by Dr. Jazayeri.

  • What to avoid

    Ice — constricts blood flow and suppresses the healing response PRP depends on. NSAIDs (aspirin, ibuprofen, naproxen, Aleve) for at least 2 weeks. No strenuous sports for 1 week.

  • Scientific References

    1. Fernandes GCAM, Rodeo SA. Metabolic Optimization Before Orthobiologic Therapies (MOBOT): A Narrative Review. Sports Health. 2026. DOI: 10.1177/19417381251409133

    2. Montagnino J, Kaufman MW, Shetty M, Centeno C, Fredericson M. Optimizing orthobiologic therapies with exercise, diet, and supplements. PM R. 2025;17(4):452–462.

    3. Chamberlain KG, Tong M, Penington DG. Properties of the exchangeable splenic platelets released during exercise-induced thrombocytosis. Am J Hematol. 1990;34(3):161–8.

    4. Schmidt KG, Rasmussen JW. Exercise-induced changes in the in vivo distribution of 111In-labelled platelets. Scand J Haematol. 1984;32(2):159–66.

    5. Taniguchi N et al. Effects of treadmill exercise on platelet functions and blood coagulating activities in healthy men. Jpn Heart J. 1984;25(2):167–80.

    6. Wang JS. Exercise prescription and thrombogenesis. J Biomed Sci. 2006;13(6):753–61.

    7. Hvas AM, Neergaard-Petersen S. Influence of Exercise on Platelet Function in Patients with Cardiovascular Disease. Semin Thromb Hemost. 2018;44(8):802–812.

    8. Dalçóquio TF et al. Effects of exercise on platelet reactivity after myocardial infarction: a randomized clinical trial. Platelets. 2022;34(1):2139821.

    9. Lippi G, Maffulli N. Biological influence of physical exercise on hemostasis. Semin Thromb Hemost. 2009;35(3):269–76.

    10. Olsen LN et al. Does Exercise Influence the Susceptibility to Arterial Thrombosis? An Integrative Perspective. Front Physiol. 2021;12:636027.

    11. Chen YW, Apostolakis S, Lip GYH. Exercise-induced changes in inflammatory processes: Implications for thrombogenesis in cardiovascular disease. Ann Med. 2014;46(7):439–55.

    12. Anz AW et al. Exercise-mobilized platelet-rich plasma. Arthroscopy. 2019;35(1):192–200.

    13. Baria MR et al. High Intensity Interval Exercise Increases Platelet and TGF-β Yield in PRP. PM R. 2020;12(12):1244–1250.

    14. Callanan MC, Plummer HA, Anz AW et al. BFR Training Using the Delfi System Is Associated With a Cellular Systemic Response. Arthrosc Sports Med Rehabil. 2020;3(1):e189–e198.

    15. Callanan MC, Christensen KD, Anz AW et al. Elevation of Peripheral Blood CD34+ and Platelet Levels After Exercise With Cooling and Compression. Arthrosc Sports Med Rehabil. 2021;3(2):e399–e410.

    16. Walsh JJ et al. Short-Duration Maximal and Long-Duration Submaximal Effort Forearm Exercise Achieve Elevations in Serum BDNF. Front Physiol. 2017;8:746.

    17. Xu et al. BCAA platelet functional activation and granule release, 60-min peak. Circulation. 2020. (Full citation pending)

    18. Jiang et al. mTOR/p70S6K/TMOD3 megakaryocyte maturation and platelet production. 2023. (Full citation pending)

    19. BFR-enhanced PRP pilot RCT protocol. J Exp Orthop. 2025. PMID: 39822661

    This content is provided for patient education and reflects current peer-reviewed evidence. All pre-procedure protocols are individualized by Dr. Jazayeri based on your clinical history and physical condition, and will be discussed with you prior to your visit.

*IF YOU HAVE ANY ADVERSE EFFECTS WITH THE MEDICATIONS or QUESTIONS, PLEASE CALL OUR OFFICE during clinic hours at 855-892-0919 or the After-hours nurse advice at 1-888-576-6225.