Condition · Tendons & sports
Tendon, ligament & sports injuries: regenerative and non-surgical care in Orlando
The tendon that flares every time you get back to tennis, running or lifting. Dr. Chantasi examines it with ultrasound, builds a loading plan around it, and tells you honestly whether PRP or another injection adds anything — or whether you need a surgeon.
Scheduling opens securely in Prospyr · in-office or telemedicine evaluation
Understanding the injury
Why tendons and ligaments are slow to settle
Tendons connect muscle to bone; ligaments connect bone to bone. Both have a modest blood supply compared with muscle, which is why an overuse injury can linger for months.
It is rarely just inflammation
Long-standing “tendinitis” is usually tendinopathy: disorganized collagen, a thickened tendon and reduced tolerance to load. Anti-inflammatory treatment alone often falls short.
Healing means remodeling
New collagen is laid down and then reorganized over months. Too much rest weakens the tendon; returning too fast triggers the next flare.
Load is part of the treatment
A progressive strengthening program is the most consistently supported treatment for most tendinopathies. Any injection is judged by whether it helps you complete it.
Common presentations
Tendon and ligament problems we evaluate
Typical stories: pain at the start of activity that warms up and then returns worse the next morning; a sore spot where tendon meets bone; a sprain that never fully settled.
- Elbow
- Tennis elbow (lateral epicondylitis), golfer’s elbow, distal biceps and triceps tendinopathy
- Shoulder
- Rotator cuff tendinopathy and selected partial-thickness tears — more on shoulder pain
- Hip & thigh
- Gluteal tendinopathy (pain on the outside of the hip), proximal hamstring tendinopathy
- Knee
- Patellar tendinopathy (“jumper’s knee”) and quadriceps tendinopathy
- Foot & ankle
- Achilles tendinopathy, plantar fascia disorders, peroneal and posterior tibial tendon problems
- Ligaments
- Partial ligament injuries, chronic sprains, and pain where tendons and ligaments attach to bone
Physician evaluation & diagnosis
An examination you can see on the screen
Every patient starts with the PrimeCell Candidacy Assessment: history, a hands-on examination of strength, range and the specific tendon, and a review of prior imaging and treatment.
Musculoskeletal ultrasound is especially useful here. It can show tendon thickening, partial tearing, fluid, calcification and disorganized tissue, and it can image the tendon while it moves — which an MRI cannot. If a procedure is chosen, the same ultrasound guides the needle in real time. MRI still has a role for deeper structures or when surgery is being considered.
When surgery comes first. A complete rupture, a retracted tendon, progressive weakness or a major loss of function needs a surgical opinion, not a series of injections. PrimeCell refers promptly when that is the case.
Care categories
Loading first. Injections as support, not substitutes.
Listed in the order they are usually considered, with the regulatory status of each for tendon and ligament conditions.
- 01
Structured loading & rehabilitation
Standard care
Progressive strengthening, activity modification and a return-to-sport plan. Complete rest is rarely the answer.
- 02
Medication, bracing & supports
FDA-approved
Short courses of anti-inflammatory medication, counterforce straps, heel supports or night splints where they help.
- 03
Corticosteroid injection
FDA-approved drugs
Can quiet pain quickly, but in tennis elbow it has been linked to worse one-year outcomes than placebo,1 and it is used cautiously near weight-bearing tendons.
- 04
PRP, PRF & prolotherapy
Off-label
Your own concentrated platelets (PRP, including a thicker PRP gel preparation), a related fibrin preparation (PRF), or dextrose-based injections (prolotherapy), placed under ultrasound guidance and followed by a loading program.
- 05
Cell-based & exosome products
Not FDA-approved
Umbilical-cord-tissue-derived stem cell injections, perinatal (birth-tissue) allograft injections and exosome products are investigational for tendon and ligament injuries. Considered only for selected patients, after written informed consent that names the product’s source and status, and for stem cell products under Florida law.
Performed at PrimeCell
Diagnostic musculoskeletal ultrasound, ultrasound-guided injections, small and intermediate joint injections, trigger-point injections, peripheral nerve blocks, prolotherapy, PRP, PRF and, for selected patients, cellular or exosome injections. Dr. Chantasi performs them himself.
Coordinated or referred
Physical therapy, MRI when ultrasound cannot answer the question, EMG and nerve-conduction studies when a nerve may be involved, and a surgical opinion for complete ruptures or major loss of function.
Evidence & limitations
Does PRP work for tendon injuries? It depends on the tendon.
Short answer
The evidence is strongest for chronic tennis elbow and weakest for the Achilles tendon, where a large placebo-controlled trial found no benefit. For most other sites, trials are smaller and results vary. No injection guarantees that a tendon returns to its original strength.
- Tennis elbow
- In a 230-patient trial, significantly more PRP patients reported improvement at 24 weeks than those given an active needling control.2 A 2024 meta-analysis found steroid better in the short term and PRP better from six months on, with wide variation between trials.3
- Achilles
- In the 240-patient ATM trial, PRP was no better than a sham injection at six months.4 This is discussed directly with anyone considering PRP there.
- Other tendons
- A 2025 meta-analysis of patients who had already failed conservative care found PRP reduced pain at 6 and 12 months across several tendon sites, while noting differences in preparation and location between studies.5
- Cell-based
- Early-stage research only; no product is FDA-approved for tendon or ligament injury, and the FDA has warned consumers about unapproved stem cell and exosome products.6
Completed assessments join PrimeCell’s Outcomes Follow-Up program, which tracks pain and function with standardized measures. It has no published results yet.
Candidacy
Who is a reasonable candidate for a tendon procedure
Often worth evaluating
- Tendon pain for three months or more despite a real loading program
- Tendinopathy or a partial tear confirmed on examination and ultrasound
- A clear goal — a sport, a job, a daily activity — to rebuild toward
- Willingness to follow a structured rehabilitation plan afterward
Usually not a candidate
- A complete rupture, retraction or major instability needing surgical repair
- Pain less than a few weeks old that has not yet had conservative care
- Infection, active cancer, pregnancy, or certain blood disorders
- Needing a guaranteed return-to-play date
What to expect
A typical recovery arc
Timelines vary by tendon and by person. Progress is judged by strength and tolerance, not pain alone.
Evaluation
Examination and ultrasound, a diagnosis, and a written plan and estimate. Many patients start with a loading program alone.
Settle the flare
If an injection is chosen, expect soreness for several days and a short period of relative protection — not complete rest.
Rebuild load
Progressive strengthening over the following weeks, with follow-up visits to adjust the plan.
Return to activity
Tendon remodeling takes months. Return to demanding sport is staged; some patients improve only partly or not at all.
Cost & process
One written estimate, before you decide
PrimeCell is a self-pay practice and does not bill insurance; regenerative tendon procedures are generally not covered by insurance. Your estimate reflects the tendon, ultrasound guidance, the preparation and the number of visits. Qualifying patients can use Cherry payment plans, and no referral is needed.
Who treats your injury
Kenny Chantasi, DO
Board-certified in Physical Medicine & Rehabilitation and in Pain Medicine — the specialty built around restoring function after injury. A former Assistant Professor of Rehabilitation and Regenerative Medicine at Columbia University Irving Medical Center, Dr. Chantasi performs PrimeCell’s ultrasound examinations and procedures himself.
Questions
Tendon & sports injury FAQ
Is PRP the same as a stem cell injection?
No. PRP is prepared from your own blood and contains concentrated platelets and signaling proteins. Products marketed as stem cell, birth-tissue or exosome products are biologically different and regulated differently, and none is FDA-approved for tendon injuries.
Can an injection heal a partial tendon tear?
A procedure may be part of the plan for selected partial tears, but healing cannot be guaranteed, and a full-thickness tear usually needs a surgical opinion.
Do I need to stop exercising?
Usually not completely. Activity is modified and then progressed with a structured loading plan; total rest tends to weaken the tendon further.
How long does tendon recovery take?
Tendon remodeling commonly takes several months. Return to demanding activity depends on strength, tolerance and objective progress rather than on pain alone.
Is an ultrasound as good as an MRI?
They answer different questions. Ultrasound shows many superficial tendons and ligaments in real time and during movement; MRI gives broader and deeper anatomical detail.
Can I avoid surgery for a tendon problem?
Most tendinopathies are managed without surgery. PrimeCell starts with a non-surgical plan for eligible patients, but will refer you directly when a rupture or major loss of function calls for a surgeon.
Build the recovery plan around the actual injury.
An ultrasound-informed evaluation, a loading plan you can follow, and a clear answer on whether an injection is worth adding.
$97Initial physician consultation · offer valid through October 31, 2026
THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
References
- Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309(5):461-469. doi:10.1001/jama.2013.129
- Mishra AK, Skrepnik NV, Edwards SG, et al. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med. 2014;42(2):463-471. doi:10.1177/0363546513494359
- Xu Y, Li T, Wang L, Yao L, Li J, Tang X. Platelet-rich plasma has better results for long-term functional improvement and pain relief for lateral epicondylitis: a systematic review and meta-analysis of randomized controlled trials. Am J Sports Med. 2024;52(10):2646-2656. doi:10.1177/03635465231213087
- Kearney RS, Ji C, Warwick J, et al. Effect of platelet-rich plasma injection vs sham injection on tendon dysfunction in patients with chronic midportion Achilles tendinopathy: a randomized clinical trial. JAMA. 2021;326(2):137-144. doi:10.1001/jama.2021.6986
- Nadeau-Vallée M, Ellassraoui S, Brulotte V. Platelet-rich plasma injections as a second-line treatment in patients with tendinopathy-related chronic pain and failure of conservative treatment: a systematic review and meta-analysis. Pain Med. 2025;26(7):407-419. doi:10.1093/pm/pnaf022
- U.S. Food and Drug Administration. Consumer alert on regenerative medicine products including stem cells and exosomes. fda.gov
Medically reviewed by Kenny Chantasi, DO, on September 23, 2026. General education only; not medical advice. Candidacy is determined at an individual evaluation. Individual results vary and are not guaranteed.