PRP is not one standardized product. Two Boulder clinics can both call an injection platelet-rich plasma and deliver very different treatments. Four things decide whether it works, and you can ask about all four before you book: the platelet dose (higher, well-characterized doses outperform diluted ones), the preparation and spin quality (PRP protocols are not standardized between clinics), whether delivery is guided by live ultrasound (accurate placement versus blind), and who performs it (the physician who diagnoses you, or delegated staff). Add honest candidacy, and you have the checklist. Ask these questions of any clinic in Boulder before you spend a dollar.
A physician-written second opinion, not a sales page: the questions that separate PRP that works from PRP that is technically completed and does nothing.
The decision
Choosing PRP therapy is not choosing a product off a shelf. It is choosing a preparation and a pair of hands. The same acronym covers a low-dose, blind, delegated injection and a high-dose, ultrasound-guided, physician-performed one. The price can look similar. The result will not.
So the decision is not “PRP, yes or no.” It is “whose PRP, prepared how, placed how, and chosen for whom.” The five questions below make that decision for you, in words you can read off your phone during the consult.
Five questions that decide your result
Each is a plain question you can ask on the phone. Most clinics answer one or two well. The clinic you want answers all five.
What platelet dose am I actually getting?
Higher, well-characterized platelet doses tend to outperform low-dose preparations for orthopaedic targets. The failure pattern is a small draw spun once, then split across several sites, so each target gets a diluted dose. Ask directly: how many times do you spin, and what concentration am I getting? Dynamic PRP+ uses a larger draw and multi-spin processing to concentrate platelets well above whole-blood baseline. A clinic that measures its dose can name the number; one that cannot may not be measuring it.
How is the PRP prepared?
Preparation is where “PRP” stops being one thing. Single-spin versus multi-spin, leukocyte-rich versus leukocyte-poor, and the final platelet yield all vary between clinics, and most never report them. Ask what system they use and whether the preparation is tuned to your condition: tendon and joint targets can call for different formulations. It is why two injections sold under the same name produce different outcomes.
Will the injection be guided by live ultrasound?
The best PRP in the world does nothing for a tendon if it lands in the tissue next to it. Live ultrasound lets the physician watch the needle tip reach the exact target, confirm the injectate goes where intended, and avoid nearby nerves and vessels. Blind, landmark-based injection relies on surface anatomy and feel. Ask whether your injection is guided by live ultrasound, and who holds the probe.
Who performs the injection?
At many clinics the evaluation, imaging, and injection are split across different staff, so the hands placing the needle never examined the problem. At Dynamic Athlete, Aneesh Garg, DO, CAQ, “The Regen Doc,” performs the diagnostic ultrasound, selects the target, and performs the injection personally. He is a sports and regenerative medicine physician and teaching faculty at the Regenerative Medicine Training Institute. Ask: will the physician who diagnoses me also inject me, or is it delegated? The answer tells you how the clinic is built.
How do you decide if I am actually a candidate?
Honest candidacy is the question most clinics skip, and the one that most determines results. PRP responds best when there is living tissue to stimulate: mild to moderate arthritis, partial tendon tears, degenerative tendinopathy. In advanced, bone-on-bone arthritis or a complete rupture, PRP alone is far less likely to meet your goals, and a responsible physician will say so rather than sell a series. Ask how a clinic decides candidacy, and whether they will tell you if you are not one. A clinic that treats everyone the same is not selecting for results.
Print this. Ask it on the phone.
- What dose am I getting, and how many times do you spin?
- How is the PRP prepared, and is it tuned to my condition?
- Is the injection guided by live ultrasound, and who holds the probe?
- Will the physician who diagnoses me also perform the injection?
- How do you decide if I am a candidate, and will you tell me if I am not?
The one line to remember
When dose, preparation, guidance, diagnosis, and candidacy are all handled correctly, PRP has a real evidence base for the right indications. When any one link is weak, the injection can be technically completed and still not help. These five questions find the weak link before it costs you, not after.
Frequently asked questions
Is all PRP the same?
No. PRP is not one standardized product. Two clinics can both call an injection platelet-rich plasma while delivering very different treatments. The platelet dose can vary several-fold depending on how the blood is drawn and how many times it is spun. The preparation can be leukocyte-rich or leukocyte-poor. The delivery can be blind or guided by live ultrasound. A 2017 systematic review in The Journal of Bone and Joint Surgery called for standardization precisely because clinics rarely report what they actually inject. When you ask a Boulder clinic about PRP, you are not asking about a single defined thing. You are asking what dose, what preparation, what guidance, and which physician. Those four answers determine what you receive.
What platelet dose should PRP have?
There is no single universal number, but the direction of the evidence is clear: higher, well-characterized platelet doses tend to outperform low-dose preparations for orthopaedic indications. The failure pattern is a small blood draw processed once and then split across multiple injection sites, which dilutes the dose at each target. At Dynamic Athlete, Dynamic PRP+ uses a larger draw and multi-spin processing to concentrate platelets well above whole-blood baseline, so the target tissue receives a therapeutic dose rather than a diluted one. Ask any clinic directly: how many times do you spin, and roughly what platelet concentration am I getting. A clinic that treats PRP seriously can answer. A clinic that cannot may not be measuring it at all.
Does PRP need to be done under ultrasound?
For most tendon, ligament, and joint targets, live ultrasound guidance materially improves placement accuracy compared with landmark-based, blind injection. The best PRP in the world does nothing for a tendon if it is deposited in the tissue next to it. Ultrasound lets the physician see the needle tip reach the exact target in real time, confirm the injectate is going where intended, and avoid nearby nerves and vessels. Landmark-based injection relies on surface anatomy and feel. For a deep gluteal tendon, a specific region of a meniscus, or a partial rotator cuff tear, that difference is not a technicality. Ask whether your injection will be guided by live ultrasound, and who is holding the probe.
Who should perform a PRP injection?
The person diagnosing you should be the person injecting you. At many clinics the evaluation, the imaging interpretation, and the injection are split across different staff, so the hands placing the needle never examined the problem. At Dynamic Athlete, Aneesh Garg, DO, CAQ, “The Regen Doc”, performs the diagnostic ultrasound, selects the target, prepares the plan, and performs the injection personally. He is a sports and regenerative medicine physician, Yale-New Haven Hospital trained, an Andrews Sports Medicine fellow, and teaching faculty at the Regenerative Medicine Training Institute. Ask a direct question before booking: will the physician who diagnoses me also perform my injection, or is it delegated. The answer tells you how the clinic is built.
How do I know if I am actually a candidate for PRP?
Honest candidacy is the question most clinics skip, and it is the one that most determines results. PRP responds best when there is living tissue to stimulate: mild to moderate joint arthritis, partial tendon tears, and degenerative tendinopathy. In advanced, bone-on-bone arthritis or a complete tendon rupture, PRP alone is far less likely to meet a patient’s goals, and a responsible physician will say so rather than sell a series. The RESTORE trial published in JAMA in 2021 is a useful reminder that PRP is not universally superior, which is exactly why diagnosis and selection matter. Ask a clinic how they decide whether you are a candidate, and whether they will tell you if you are not. A clinic that treats everyone the same is not selecting for results.
Why do some PRP treatments fail?
PRP results vary for reasons that are usually knowable in advance. The common failure modes are a low platelet dose from an under-concentrated or over-split preparation, blind placement that misses the target tissue, a wrong or incomplete diagnosis, and treating a joint too far advanced to respond. None of these are mysteries. They are the four things the questions on this page are designed to surface before you spend money. When dose, preparation, guidance, diagnosis, and candidacy are all handled correctly, PRP has a real evidence base for the right indications. When one link in that chain is weak, the injection can be technically completed and still not help. Our companion guide on why PRP fails for active adults covers this in more depth.
Where can I get physician-performed PRP in Boulder?
Dynamic Athlete Sports Medicine and Regenerative Orthopaedics in Boulder provides physician-performed PRP under live ultrasound guidance. Aneesh Garg, DO, CAQ, “The Regen Doc”, personally performs the diagnostic evaluation and the injection, using the high-dose, multi-spin Dynamic PRP+ preparation, and can escalate to bone-marrow or adipose-derived cellular therapy when PRP alone is not the right tool. He founded the American Shockwave Training Institute and is teaching faculty at the Regenerative Medicine Training Institute, where he trains other physicians on biologics. The clinic serves Boulder, Louisville, Lafayette, Erie, Broomfield, Longmont, and the surrounding Front Range. In our Dynamic PRP+ protocol, over 90% of our patients self-report a 75% or greater improvement, all without surgery.
Ask us every question on this page
Physician-performed, ultrasound-guided PRP with a high-dose Dynamic PRP+ preparation, and an honest answer if PRP is not the right tool for you. Same-week evaluations in Boulder.