Procedures
All procedures at LISM are offered exclusively following a comprehensive consultation — where Dr. Sri determines the right intervention for your specific biology, injury pattern, and goals.
Platelet-Rich Plasma (PRP) Therapy
Concentrating your own platelets to ignite the cellular repair your body never finished — placed by ultrasound, not by feel.
Platelet-Rich Plasma (PRP) Therapy
Concentrating your own platelets to ignite the cellular repair your body never finished — placed by ultrasound, not by feel.
An evidence-based regenerative treatment using a concentrated sample of your own blood platelets to accelerate the natural healing of chronic tendon injuries, ligament sprains, and joint osteoarthritis — exactly where the body has failed to heal on its own.
Your safety, comfort, and precision are my absolute highest priorities. The PRP workflow is unhurried and state-of-the-art:
A small sample is drawn in our private room — exactly like a standard laboratory test.
A specialized high-speed centrifuge isolates the concentrated growth factors and platelets from the rest of the blood.
I visualize the damaged tissue live in high resolution. I never inject blindly — the ultrasound ensures the PRP lands inside the exact area of damage for true healing.
Advanced localized numbing ensures your comfort throughout. Total chair time is 45 to 60 minutes, and you walk out with clear, physician-led post-care instructions.
- Chronic tendon & ligament injuries
- Joint osteoarthritis
| Standard Bundled Price | LISM Member | |
|---|---|---|
| Ages 26+ | $650 | $450 |
| Ages 14–25 | $550 | $400 |
Includes Follow-up/response check within 12 weeks+ 8 weeks Spruce messaging
LISM Members receive exclusive procedure discounts across all regenerative therapies. Learn more about membership
Viscosupplementation Injection Therapy
A medical-grade hyaluronic acid gel that restores the natural cushioning your knee has lost — placed inside the joint capsule with precision, not by feel.
Viscosupplementation Injection Therapy
A medical-grade hyaluronic acid gel that restores the natural cushioning your knee has lost — placed inside the joint capsule with precision, not by feel.
A highly effective, non-surgical option for patients with mild to moderate knee osteoarthritis who have not found sufficient relief from lifestyle modifications alone. As your natural lubricating fluid thins, joint surfaces lose their cushioning — creating the grinding sensation patients often describe as bone-on-bone friction. Viscosupplementation addresses this directly. A purified hyaluronic acid gel is delivered precisely inside the joint capsule — restoring lubrication, dampening pain signals, and signaling the joint to produce more of its own natural hyaluronic acid.
The viscosupplementation workflow is transparent, unhurried, and highly technical:
You are positioned comfortably in our private room. The target joint is cleansed and prepared using sterile, hospital-grade technique.
The entire pathway leading into the joint capsule is numbed before the gel is introduced — ensuring your comfort from start to finish.
Off-target by even a few millimeters and the gel ends up in a fat pad — it will not work and can cause unnecessary discomfort. Ultrasound ensures the gel is delivered precisely inside the joint capsule — exactly where it needs to be.
Most patients walk out of the room immediately following the procedure. Light activity is generally well tolerated the same day — Dr. Sri will provide specific guidance based on your individual response.
- Mild to moderate knee osteoarthritis
| Procedure Fee | Standard | LISM Member |
|---|---|---|
| Ages 26+ | $50 | $25 |
| Ages 14–25 | $50 | $25 |
HA kit billed at direct clinic cost — typically $575-650 depending on product (Euflexxa, Hymovis, etc.).
LISM Members: Your first injection each year — cortisone, tendon hydrodissection, or HA, whichever comes first — is completely free. Additional injections beyond the first are billed at the member rate above.
Includes Follow-up/response check within 12 weeks+ 8 weeks Spruce messaging. If improvement is inadequate, alternative options (including PRP) can be discussed at the follow-up visit.
LISM Members receive exclusive procedure discounts across all regenerative therapies. Learn more about membership
Tendon Fenestration (Percutaneous Tenotomy)
A controlled micro-trauma that restarts the healing engine in chronic, scarred tendons — no biologic injected, just precise mechanical stimulus.
Tendon Fenestration (Percutaneous Tenotomy)
A controlled micro-trauma that restarts the healing engine in chronic, scarred tendons — no biologic injected, just precise mechanical stimulus.
An advanced, non-surgical option for chronic tendon pain that has not healed with physical therapy or rest. When a tendon becomes stuck in a degenerative state, a micro-needle is used to make precise multiple passes through the diseased tissue. Like PRP, the goal is to trigger your body's own healing response — except here we use a mechanical stimulus instead of a biologic.
The fenestration workflow is unhurried and state-of-the-art:
The exact borders of the tendon degeneration are mapped — isolating the precise therapeutic zone before anything begins.
Because multiple passes into a tendon would be highly uncomfortable, the skin and surrounding tissue are frozen completely before the procedure begins — ensuring your comfort throughout.
To stimulate true healing without damaging healthy tissue, I must see the exact area of scar tissue being targeted. The micro-needle is deployed only where the tendon needs repair — never beyond it.
Under continuous ultrasound view, precise micro-passes initiate the healing cascade and you walk out with a progressive recovery blueprint.
- Tennis elbow (lateral epicondylitis)
- Gluteus medius tendinopathy
- Patellar tendinopathy
- Rotator cuff tendinopathy
- Chronic tendon degeneration unresponsive to conservative treatment
| Standard | LISM Member | |
|---|---|---|
| Ages 26+ | $350 | $125 |
| Ages 14–25 | $275 | $100 |
Includes Follow-up/response check within 12 weeks+ 8 weeks Spruce messaging
LISM Members receive exclusive procedure discounts across all regenerative therapies. Learn more about membership
Barbotage — Calcific Tendinitis Washout
Breaking up and flushing out the calcium deposit trapped inside your tendon — followed by a precisely placed, ultra-low-dose anti-inflammatory.
Barbotage — Calcific Tendinitis Washout
Breaking up and flushing out the calcium deposit trapped inside your tendon — followed by a precisely placed, ultra-low-dose anti-inflammatory.
A highly specialized non-surgical intervention for calcific tendinitis — a stone-like calcium deposit inside a tendon, most commonly in the rotator cuff. The hardened deposit acts like gravel in a smooth gear: sharp pain, restricted motion, and intense inflammation that conventional treatments cannot resolve. Using high-resolution ultrasound, the exact boundaries of the deposit are located, a micro-needle enters the calcium shell, breaks it up, and repeatedly flushes sterile solution through the area to aspirate and wash out the crystals — clearing the obstruction your tendon has been working around.
Barbotage requires a meticulous, unhurried, and state-of-the-art workflow:
The exact depth, density, and size of the calcium deposit are mapped using high-resolution diagnostic imaging before any intervention begins.
The skin, the subacromial bursa, and all surrounding tissues are completely frozen before any micro-needle work begins — ensuring your comfort throughout.
Blind attempts to break a calcium deposit miss entirely, damage healthy tendon, and cause needless pain. Ultrasound puts the needle in the center of the deposit — precisely, every time.
Under continuous ultrasound view, the calcium fragments are broken up and washed away. A precisely measured ultra-low-dose steroid is then placed into the surrounding bursa — strictly to extinguish the post-washout inflammatory spike. See the honest note below.
If you follow modern sports medicine, you know that routine high-dose steroid injections are generally avoided because they weaken tendon tissue over time. Barbotage is the exception. Breaking up a calcium deposit creates a significant temporary spike in local inflammation. A precise, ultra-low-dose steroid is deployed into the surrounding bursa strictly as a localized fire extinguisher — the absolute minimum dose required to manage the post-procedure inflammatory response while your tendon begins to heal. This is not a routine steroid injection. It is a deliberate, measured clinical decision in service of your recovery.
- Calcific tendinitis
| Standard | LISM Member | |
|---|---|---|
| Ages 26+ only | $550 | $300 |
This procedure is offered for patients ages 26 and above only. Calcific tendinitis is primarily a condition of adulthood.
Includes one complimentary follow-up check-in within 6 weeks of injection to assess response, plus 4 weeks of Spruce messaging access. If improvement is inadequate, alternative options (including PRP) can be discussed at the follow-up visit.
LISM Members receive exclusive procedure discounts across all regenerative therapies. Learn more about membership
Tendon & Nerve Hydrodissection Package
A staged release protocol: mechanical decompression first — guided chemistry only when the tissue demands it.
Tendon & Nerve Hydrodissection Package
A staged release protocol: mechanical decompression first — guided chemistry only when the tissue demands it.
An ultra-precise, non-surgical option for nerve entrapments and tendon adhesions. Whether fascia is strangling a peripheral nerve or scar tissue is binding a tendon, the problem is the same: compressed, ischemic tissue that has lost its natural glide — producing burning pain, numbness, tingling, weakness, and stiffness that conventional treatments struggle to resolve. Using high-resolution ultrasound, the exact site of restriction is identified and a specialized fluid solution is introduced around the target structure — mechanically lifting tight tissue away from it and restoring natural glide and blood flow.
This procedure is transparent, unhurried, and highly technical:
The target nerve or tendon is traced along its full path to locate the exact site of entrapment, adhesion, or restriction — before any intervention begins.
The skin and tissue pathway leading to the target structure are gently anesthetized before any further work — ensuring your comfort throughout.
Nerves and tendons are unforgiving of imprecision. Injecting near either without real-time imaging is both dangerous and ineffective. Ultrasound places the needle directly adjacent to — but safely away from — the target structure, every single time. This is non-negotiable.
A low-concentration 5% dextrose solution is deployed: the fluid mechanically lifts restrictive tissue while the dextrose down-regulates hyperactive nerve receptors and reduces tendon sheath inflammation. Many patients feel immediate relief before leaving.
Routine high-dose steroids damage surrounding tissue over time and offer no regenerative benefit to the nerve or tendon itself. My preference is 5% dextrose — a natural, highly effective anti-inflammatory that binds to hyperactive receptors and calms them precisely where it matters. By combining the mechanical lift of the fluid with the soothing chemistry of dextrose, both compression and inflammation are addressed in a single move. In rare, severely scarred cases, an ultra-low-dose steroid may be introduced at Visit 2 — but only when the tissue requires it.
- Carpal tunnel syndrome
- Cubital tunnel syndrome
- Peroneal nerve entrapment
- Meralgia paresthetica (lateral femoral cutaneous nerve)
- Tarsal tunnel syndrome
- Tendon sheath adhesions
- Peritendinous scar tissue restriction
- Chronic tendinopathy with impaired glide
| Standard | LISM Member | |
|---|---|---|
| Tendon Hydrodissection | $50 | $25 |
| Nerve Hydrodissection | $100 | $50 |
Includes one complimentary follow-up check-in within 6 weeks of injection to assess response, plus 4 weeks of Spruce messaging access. If improvement is inadequate, alternative options (including PRP) can be discussed at the follow-up visit.
LISM Members: your first injection each year — cortisone, tendon hydrodissection, or HA, whichever comes first — is completely free. Additional injections beyond the first are billed at the member rate above.
LISM Members receive exclusive procedure discounts across all procedures. Learn more about membership
Standard Prolotherapy
Intentionally restarting your body's healing inflammation — a controlled spark to rebuild loose ligaments and weakened tendons from scratch.
Standard Prolotherapy
Intentionally restarting your body's healing inflammation — a controlled spark to rebuild loose ligaments and weakened tendons from scratch.
A time-tested non-surgical option for chronic musculoskeletal conditions where the body's natural repair has stalled. Traditional medicine crushes inflammation with steroids and NSAIDs — often stopping real repair before it can begin. Prolotherapy does the opposite. A concentrated dextrose solution is placed precisely at the affected tissue — where ligament meets bone, where a tendon has degenerated, or where a joint has lost its structural integrity — sparking a controlled microscopic irritation that recruits fresh blood, growth factors, and structural proteins to the area. The goal is always the same: giving your body another chance to get the healing right. Prolotherapy is most commonly indicated for ligament insufficiency and laxity — but also has meaningful clinical application in chronic tendinopathy and early to moderate osteoarthritis where regenerative stimulation can meaningfully restore function.
Prolotherapy follows an unhurried, state-of-the-art workflow:
The affected ligamentous attachments, tendon insertions, and joint structures are physically and visually mapped before any intervention begins — identifying the precise tissue that has lost its integrity and needs regenerative stimulation.
The dextrose solution is blended with a fast-acting local anesthetic — ensuring the injection process stays tolerable and comfortable from start to finish.
To safely stimulate new tissue, the solution must land at the exact interface where ligament meets bone, at the tendon attachment, or within the affected joint structure. Ultrasound guarantees the precision that blind injection simply cannot — every millimeter verified in real time.
You may feel a temporary fullness or stiffness following the procedure — a great sign the healing engine has restarted. You leave with clear, physician-led post-care instructions and a structured plan to build on the repair process that has just begun.
- Chronic ligament laxity and instability
- Plantar fasciitis
- SI joint dysfunction
- Chronic tendinopathy unresponsive to conservative treatment
- Chronic ankle instability
- Tennis elbow (lateral epicondylitis)
- Unstable or hypermobile joints
| Standard | LISM Member | |
|---|---|---|
| Ages 26+ | $250 | $125 |
| Ages 14–25 | $200 | $100 |
| Standard | LISM Member | |
|---|---|---|
| Ages 26+ | $500 (save $250) | $250 (save $125) |
| Ages 14–25 | $350 (save $250) | $200 (save $100) |
Most prolotherapy protocols involve multiple sessions for optimal tissue rebuilding. The three-session bundle reflects this reality — and rewards your commitment to the full healing process.
Includes Follow-up/response check within 12 weeks+ 8 weeks of Spruce messaging
LISM Members receive exclusive procedure discounts across all procedures. Learn more about membership
Medical Acupuncture
Hair-thin filiform needles at precise neuro-anatomical points — a recalibration of the nervous system, not a mystical ritual.
Medical Acupuncture
Hair-thin filiform needles at precise neuro-anatomical points — a recalibration of the nervous system, not a mystical ritual.
I came to acupuncture as a healthy skeptic with a strict evidence-based academic background — and it works. Formally trained through the Helms Medical Acupuncture program and drawing on Matt Callison's Sports Acupuncture methodology with athletes, I apply medical acupuncture with three concrete clinical goals: • Neuromodulation — calming hyperactive pain pathways that have become sensitized over time • Autonomic balance — down-regulating the fight-or-flight state that keeps the nervous system locked in tension • Microvascular blood flow — directing oxygen and cellular resources to tissues that need to heal
Medical acupuncture here is unhurried and deeply calculated:
We use micro-thin, sterile, single-use filiform needles. Because they are hair-thin and precisely placed, the experience is remarkably comfortable — often deeply relaxing. Depending on the protocol, some sessions run 10–20 minutes; others extend longer.
You will leave with clear, specific instructions to help your body fully integrate and reset with the treatment.
For chronic injuries, long-standing neurological tension, or systemic conditions, a single session of medical acupuncture is rarely sufficient on its own. One-session options are strictly a trial — a way to assess how your nervous system responds. Medical acupuncture actively shifts your baseline biochemistry and resets deep nerve pathways. True tissue remodeling takes time.
Medical acupuncture is a versatile clinical tool applied across a wide range of conditions — from musculoskeletal pain and sports injuries to autonomic dysregulation, chronic fatigue, and systemic health concerns. Your consultation will determine whether it is the right addition to your care plan.
Includes: distal points, trigger point dry needling, localized TMM protocols, instrument-assisted soft tissue mobilization (Gua Sha), and myofascial cupping.
| Non-Member | DPC Member | |
|---|---|---|
| Adults | $150 / session | $50 / session |
| Youth (Ages 12–25) | $125 / session | $25 / session |
Includes deep electroacupuncture with extended needle retention, multi-joint and multi-region needling across affected kinetic chains, and advanced dry needling techniques for chronic or complex musculoskeletal presentations.
| Non-Member | DPC Member | |
|---|---|---|
| Adults | $250 / session | $100 / session |
| Youth (Ages 12–25) | $175 / session | $75 / session |
New LISM Members: Your first Tier A Acupuncture session is completely free — a one-time welcome benefit to help you experience the difference.
Tier B complex acupuncture is never performed on the same day as an initial consultation. Patients presenting with severe chronicity or advanced pain sensitization must be pre-staged and booked into a dedicated, standalone session later that week.
Fascial Hydrodissection Add-On (performed same-session with acupuncture, under ultrasound guidance) +$50 (all ages, standard) / +$25 (member)
Includes 2 weeks Spruce messaging after each session
LISM Members receive significant procedure discounts across all services. Learn more about membership
Ultrasound-Guided Cortisone Injection
A double-edged sword — used here as an emergency brake, at the absolute lowest effective dose, placed exactly where the inflammation is burning.
Ultrasound-Guided Cortisone Injection
A double-edged sword — used here as an emergency brake, at the absolute lowest effective dose, placed exactly where the inflammation is burning.
Let's have an honest conversation. Cortisone is incredibly powerful — but it is a double-edged sword. In high-volume clinics it gets overused to mask pain, quietly damaging joints and tendons over time. But used correctly — for an agonizing inflammatory flare that is stopping you from sleeping, moving, or rehabilitating — it is an emergency brake worth pulling. My philosophy is the opposite of standard care: the absolute lowest effective dose, placed only where the inflammation is burning, used only when it is genuinely necessary — and never as a substitute for the regenerative work that comes next.
Cortisone in my clinic follows an unhurried, meticulous workflow:
The exact borders of the inflamed tissue or joint capsule are mapped using dynamic imaging before any intervention begins.
The skin and pathway down to the targeted space are gently frozen before the anti-inflammatory is introduced — ensuring your comfort throughout.
Blind cortisone bleeds into healthy tendons or fat pads, causing structural damage and localized tissue breakdown. Ultrasound delivers the low-dose formulation exactly where it is needed — and nowhere else.
You leave with a calculated plan to use this pain-free window to aggressively rebuild movement mechanics — because cortisone alone is never the finish line.
I will never default to cortisone. I will use it as an emergency brake, at the lowest effective dose, only when inflammation is stopping you from sleeping, moving, or rehabilitating — and never as a substitute for the regenerative work that comes next.
- Severe acute bursitis
- Knee osteoarthritis flare-up
- Subacromial impingement syndrome
- Frozen shoulder (adhesive capsulitis)
- Intense inflammatory flares unresponsive to conservative management
| Standard | LISM Member | |
|---|---|---|
| Ages 26+ | $50 | $25 |
| Ages 14–25 | $50 | $25 |
Includes Follow-up/response check within 4 weeks+ 2 weeks Spruce messaging
LISM Members receive significant procedure discounts across all services. Learn more about membership
Let's navigate your path to true healing.
Whether you need a dedicated primary care home, a precise acute injury evaluation, a sports medicine solution for a barrier preventing you from enjoying movement, or a solution for a chronic problem — your journey back to physical freedom and happiness starts here. You don't have to figure it out alone.