Advanced Procedures

dr. jonathan hersch performing the tenex procedure

Tenex™ Procedure

Dr. Hersch also performs the Tenex™ procedure, a minimally invasive method of treating chronic tendon pain that involves removing scar tissue that causes pain as a result of overuse or an active lifestyle.


To perform the procedure, Dr. Hersch uses a small instrument that he inserts through a small incision into the damaged tendon. The instrument vibrates at ultrasonic frequencies to break up and remove damaged scar tissue.


The Tenex procedure is performed on an outpatient basis using local anesthesia and generally takes less than half an hour.


Using this method, Dr. Hersch can offer patients an option that is faster than traditional surgeries, creates a smaller incision that results in less scarring, and allows for a quicker and less painful recovery.


Some of the conditions Dr. Hersch treats using the Tenex procedure include:

  • Tennis and golfer’s elbow
  • Jumper’s knee
  • Calcific tendonitis
ultrasound-guided prp injections

Ultrasound-Guided Injections & Diagnostics

Ultrasound is an imaging method that uses high-frequency sound waves to produce real-time and dynamic images of the body. Dr. Hersch uses this advanced imaging method in two different ways: as a diagnostic/evaluation method to identify injuries and abnormalities, and to help guide injections into the knee, shoulder, and hip.


The use of ultrasound improves the accuracy of the injection of corticosteroids, hyaluronic acid, or other therapies such as platelet-rich plasma (PRP). Ultrasound can also be used for joint aspirations to rule out joint infection or gout. Lastly, guided injections can be used diagnostically to help determine which structures are generating the patient’s pain.


Ultrasound-guided injections allow Dr. Hersch to visualize the needle in real-time as it enters the body and traverses to the desired location. This assures that the medication is accurately injected at the intended site. Additionally, ultrasound-guided injections have been shown to be less painful than blind injections and allow Dr. Hersch to watch the desired treatment being delivered to the intended target and even visualize surrounding structures both before during, and even after the procedure.

PRP Injections Dr. Jonathan Hersch

PRP Injections

PRP injections – or platelet-rich plasma injections – are a minimally invasive medical treatment that Dr. Hersch uses to stimulate the regeneration of soft tissues in patients who have sustained injuries or have degenerative diseases in the shoulder, hip, or knee joints.


Platelet-rich plasma is derived from the patient’s own blood and has a concentration of platelets and a number of growth factors that help stimulate healing. The patient’s blood is drawn in the office, concentrated in a centrifuge, and then reinjected back into the patient at the site of the injury.


One of the best things about PRP injections is that they are minimally invasive, meaning healing can be administered with a needle instead of a scalpel. The healing and regenerative nature of these injections can help many patients avoid the need for surgery altogether.


The most common areas Dr. Hersch uses PRP injections for include:

  • Tennis and golfer elbow
  • Relief for knee, shoulder, and hip arthritis
  • Sports injuries


Dr. Hersch typically uses ultrasound-guided technology to administer the injections.