PRP for muscles, tendons & ligaments

What is PRP and how does it work?

PRP (platelet rich plasma) is a concentrate of platelets obtained from your own blood. These platelets contain growth factors and messenger substances (e.g. PDGF, TGF-β, VEGF), which have an inflammatory modulating effect and can stimulate regeneration processes in muscles, tendons and ligaments. PRP does not replace healing, but can support it under appropriate conditions.

• Target tissue: degeneratively irritated tendons (tendinopathies), partial tears, muscle injuries, ligament strains
• Active principle: activation of local healing mechanisms, improvement of tissue homeostasis
• Important: The effect develops over weeks; accompanying rehabilitation is crucial

Who is PRP suitable for? Typical indications

PRP is particularly suitable for chronic overuse injuries and selected acute partial injuries - especially if basic measures have not helped sufficiently.

• Tendons: Tennis elbow (lateral epicondylopathy), golfer's elbow, patellar tendinopathy, Achilles tendinopathy, gluteal/trochanteric pain
• Muscles: Torn/bundled muscle fibers (e.g. hamstrings, calf muscles) with delayed healing
• Ligaments: Distortions and partial tears (e.g. inner ligament of the knee, outer ligament of the ankle) without indication for surgery
• Persistent symptoms despite conservative therapy (load adjustment, physiotherapy, possibly shock wave)

In the case of complete tendon or ligament ruptures, relevant instabilities or structural defects that require surgery, PRP does not replace surgical procedures.

Evidence: What can we realistically expect?

The study situation on PRP is differentiated. For some tendinopathies there is evidence of benefit, for others the effect is inconsistent. Correct indication, preparation and accompanying rehabilitation are crucial.

• Lateral epicondylopathy (tennis elbow): evidence of pain and functional improvement over time
• Patellar tendon tendinopathy: Possible benefits, especially a. in chronic courses
• Achilles Tendon: Results Mixed; Careful patient selection is important
• Muscle fiber tear: data inconsistent; may be considered if healing is delayed
• Ligaments (partial tears): Potential additional benefit if a conservative concept is used

Important: PRP does not replace therapy components such as load management, eccentric training and functional stabilization. A serious application is always embedded in an individualized overall concept.

Process of the PRP treatment in Hamburg-Winterhude

The injection is carried out using sterile technology, usually without general anesthesia. Local anesthesia of the skin is possible. For tendons, a “peppering technique” can be used to stimulate healing.

How many sessions are necessary?

Depending on the findings, we usually recommend 1-3 PRP injections every 2-6 weeks. In individual cases, a refresher after a few months can be discussed. The decision depends on the symptoms, stress goals and course.

• First effects: often after 2-6 weeks
• Maximum effect: often after 8-12 weeks
• Accompanying physiotherapy: plan it in a structured manner right from the start

Conservative basic therapy remains central

PRP is a supplement – ​​not a replacement – ​​for conservative measures. A consistent, individually tailored program is crucial for lasting effects.

• Load control: Reduction of provocative loads, clever training structure
• Targeted exercise program: eccentric, isometric and later plyometric elements
• Physiotherapy/Manual Therapy: Improving strength, mobility, coordination
• Aids: taping, orthoses or insoles depending on the indication
• Additionally, depending on the findings: shock wave therapy, dry needling, educational measures

Safety, risks and contraindications

PRP is obtained from the body's own blood and is generally well tolerated. As with any injection, there are risks that we explain in advance.

• Common: temporary pain, swelling, feeling warm (1-3 days)
• Rare: infection, bruising, irritation of adjacent nerves/structures
• Contraindications: active infections, severe blood clotting disorders, uncontrolled general illnesses
• Relative contraindications: blood-thinning medication, systemic inflammation – individual consideration

Preparation for treatment

• Avoid NSAIDs (e.g. ibuprofen, diclofenac) for 3-7 days before and after PRP if possible - discuss alternatives
• Drink enough the day before and eat a light meal before the appointment
• Do not stop taking blood thinners/anticoagulants on your own – medical advice is required
• Avoid physical exertion on the day of treatment; If necessary, plan an accompanying person

Aftercare and rehabilitation

We recommend relative rest and cooling as needed for the first 24-48 hours. We then start with a step-by-step rehabilitation plan that is tailored to the affected tissue.

• Tendons: Start with isometric exercises, later eccentric/concentric; progressive load control
• Muscles: pain-adapted mobilization, gradual strength and sprint progression
• Ligaments: temporary stabilization (tape/orthosis), sensorimotor training, return-to-sport criteria
• No hard peaks in the first 1-2 weeks; Increase according to findings

Combinations and alternatives

Depending on the findings, PRP can be combined with other conservative procedures. We discuss the benefits, risks and the order in the overall concept.

• Hybrid approaches: e.g. B. PRP in combination with hyaluronic acid for tendinous transition zones – decision on a case-by-case basis
• Shock wave therapy (ESWT): often useful for chronic tendinopathies
• Pure rehabilitation program without injections: often sufficient for milder cases
• Surgical options: for structural defects/instabilities, if conservatively exhausted

Organization, location and cost information

The treatment takes place in our practice at Dorotheenstraße 48, 22301 Hamburg. Every PRP therapy is preceded by a careful diagnosis with realistic goal definition.

Billing: Usually according to GOÄ. Statutory health insurance companies usually do not cover the costs; private payers depending on the contract. We provide transparent information in advance.

Sport, work and everyday life: What is realistic?

Depending on the type of injury, we will plan your return to everyday life, work and sport with you. The goal is a resilient, gradual increase without relapse.

• Everyday life: usually possible again after 1-3 days
• Office/School: usually short term
• Sport: graded depending on structure and severity; Return-to-sport decision based on defined criteria, not just time