Treating Tendon Injuries
Autologous blood therapy using PRP can promote healing
Tendons heal slowly because they have very little blood supply, and the body’s own healing substances have difficulty reaching the affected area. Using autologous blood therapy, I deliver concentrated growth factors directly to the damaged tendon tissue—guided by ultrasound, under local anesthesia, and without surgery. Depending on the type of tendon damage, I specifically use White PRP or Red PRP, produced using the IMPACT® Platform.
Key Points at a Glance
PRP for Tendon Injuries: Key Points at a Glance
What is tendon damage?
Partial tendon tears, chronic tendon inflammation (tendinopathy), and degenerative changes in the tendons (tendinosis)—often affecting the shoulder, elbow, knee, or Achilles tendon.
Why Do Tendons Heal Poorly?
Tendon tissue has very little blood supply (avascular). The body’s own healing substances can only reach the affected area to a limited extent—which is why tendon injuries heal slowly and incompletely.
Which type of PRP is used?
White PRP (anabolic, regenerative) for fresh tendon injuries and partial tears. Red PRP (catabolic, anti-inflammatory) for chronic tendinopathies such as tennis elbow, golfer’s elbow, or Achilles tendonitis.
How many sessions?
3 injections administered weekly. Results become apparent 4–6 weeks after the first session.
How much does the treatment cost?
€260–270 per treatment, plus the GOÄ injection fee. Approximately 70% of private health insurance plans cover the costs.
Why tendon injuries are so persistent and what that has to do with blood supply
Tendons are optimized for tensile stress: densely packed collagen fibers, extremely resistant to tension, and highly durable. But this very structure comes at a cost—tendons have virtually no blood vessels of their own. In medical terms, this is referred to as avascular tissue.
What this means in everyday life: When you pull a muscle, blood flows into the injured tissue, carries away inflammatory substances, and delivers growth factors—the healing process begins. With a tendon, this process does not work reliably. Small tears, irritation, and degenerative changes therefore heal slowly, incompletely, or not at all. This leads to chronic symptoms that do not go away despite rest, physical therapy, and a splint.
It is important to distinguish between different types of tendon injuries:
Therapy Comparison
White PRP or Red PRP: Which form of autologous blood therapy is best for tendon injuries?
Not all PRP preparations are the same. The key difference lies in the leukocyte content—that is, the proportion of white blood cells—and in the resulting mechanism of action:
White PRP – low-leukocyte plasma (anabolic, regenerative)
White PRP contains a reduced number of white blood cells. This makes it anabolic—that is, tissue-regenerating. The concentrated growth factors stimulate the regeneration of tendon tissue without causing additional inflammation. White PRP is the right choice for:
- fresh partial tendon tears, where healing and scar formation need to be supported
- Sports injuries involving acute tendon damage
- early degenerative changes in which the tendon still responds to regenerative stimuli
Red PRP – platelet-rich plasma (catabolic, anti-inflammatory)
Red PRP contains a higher proportion of white blood cells. It has a catabolic effect, which is precisely the right strategy for chronic inflammatory conditions: it triggers a new, active inflammatory response in the body that can break the vicious cycle of irritation and chronic pain. Red PRP is the preferred choice for:
Shoulder – Rotator cuff and supraspinatus tendon
Partial tears or irritation of the shoulder tendons are among the most common types of tendon injuries. The supraspinatus tendon, in particular, has poor blood supply due to its anatomical location. PRP can accelerate the healing process following a partial tear outside the joint and help reduce inflammation in cases of chronic tendinopathy.
Elbow – Tennis elbow and golfer's elbow
Epicondylitis—inflammation of the tendon insertion at the elbow—is a classic example of persistent tendinopathy. The affected tissue is chronically inflamed and shows only a short-term response to cortisone. PRP sustainably activates the body’s own healing response at the tendon insertion.
Knee – Patellar Tendon and Patellar Tip Syndrome
Irritation of the patellar tendon—medically known as patellar tip syndrome or jumper’s knee—often affects patients who are active in sports. PRP is injected directly into the tendon insertion under ultrasound guidance and supports the structural healing of the tissue.
Achilles tendon and plantar fascia
Chronic Achilles tendon pain and heel spurs (plantar fasciitis) often respond well to PRP—precisely because these areas are subject to high biomechanical stress and, at the same time, have poor blood supply.
Procedure
Here's how autologous blood therapy works for tendon injuries
The production of autologous cell therapies under the German Medicines Act requires regulatory approval. My practice has obtained this approval from the Darmstadt Regional Council. This means that all production steps, quality standards, and hygiene requirements have been verified by the government.
Make an appointment online now
Blood draw under local anesthesia
Approximately 10–15 ml of blood is drawn from a vein in the arm. From that point on, the blood remains in a closed, sterile system—no open handling, no risk of contamination.
Fully automated processing with the IMPACT® Platform
The blood is processed fully automatically. A built-in optical sensor precisely identifies the blood fractions and controls the separation process without any manual intervention. Depending on the clinical decision—White PRP or Red PRP—different fractions are concentrated. The result is a highly concentrated, autologous preparation, ready for injection.
Ultrasound-guided injection
The prepared PRP is injected directly into the damaged tendon tissue under ultrasound guidance. A tendon is only a few millimeters thick—precision here is not an option, but a medical necessity. Ultrasound guidance shows in real time where the damage is located and where the PRP is being delivered. Blind injections without imaging often fail to reach the target tissue.
The entire treatment takes approximately 45–60 minutes and is performed in a single session. Afterward, I recommend resting the treated area for 24–48 hours.
For more information on the IMPACT® Platform: autologe-zelltherapien.de
Medical assessment
My approach to tendon injuries: the right PRP treatment for your condition
Tendon injuries respond well to surgical treatment: tendon suturing, reattachment, and reconstruction. I perform these procedures when necessary and have many years of surgical experience, particularly with the shoulder and knee.
But tendons respond particularly well to PRP for a simple biological reason: they have very little blood supply. The body cannot reliably deliver its healing substances to where they are needed. PRP can do just that—in a highly concentrated form, directly at the site of the injury, under ultrasound guidance.
What I consider crucial is choosing the right treatment. A fresh partial tendon tear that requires support for healing is clinically different from a case of tennis elbow that has been chronically inflamed for two years, where the body has long since stopped responding to its own healing stimuli. White PRP and Red PRP have different mechanisms of action.
In cases of chronic tendon pain that does not improve despite physical therapy, splinting, and rest, my clinical experience has shown that PRP is an effective adjunct to previous treatment for some of these patients. We will discuss which form is right for you based on your medical findings.
Patients from Frankfurt, Bad Homburg, Königstein, and the entire Hochtaunus district come to me with precisely these complaints: tendon injuries that have not been adequately treated. I will carefully review your findings and explain whether and which PRP treatment is appropriate for your case.
Make an appointment online now
Costs
Costs and Coverage
Autologous blood therapy for tendon injuries is a non-covered service (IGeL) and is not reimbursed by public health insurance. Private health insurance plans may cover all or part of the costs, depending on your plan—please check with your private insurance provider in advance. Self-pay patients are welcome; you will receive a cost estimate when you schedule your appointment.
Dr. Braune's practice is a private practice and is open exclusively to private patients and self-pay patients.
Schedule an appointment now for your tendon treatment in Kronberg
Patients from Frankfurt, Bad Homburg, Königstein, and the Hochtaunus district come to my private practice in Kronberg im Taunus for PRP treatment. Appointments are often available on short notice—please contact us for current availability.
Specific tendon disorders treated in my practice
Knee Osteoarthritis & PRP
Autologous blood therapy for knee osteoarthritis – a regenerative treatment for gonarthrosis.
Treatment
Golfer's elbow
Autologous blood therapy for medial epicondylitis – regenerative rather than symptomatic.
Treatment
Tennis elbow
PRP for Chronic Lateral Epicondylitis – When Cortisone and Physical Therapy No Longer Help
Treatment
