Your Orthobiologic
Therapy Guide
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
Contact Dr. Jazayeri’s Office
Call or text, Monday to Friday, 8 to 5
Email
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.
1
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
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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.
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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
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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.
5
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.
6
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.
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Do & Don’t
The short version to keep on the fridge
Do
- 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
8
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.
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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
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
