okay now we're going to talk about injections intra-tenderness so in the knee the two main intratendency types of injections i have had to do using ortho-biologics not cortisone of course or hyaluronic acid this is for basically prp or stem cells whatever biologic you want to use where it's safe to go into tenderness you know it is good and possible to come here like you can see some actually some tendinopathy within that right there you get the optimized image you can see that the inside of that tendon is not ideal but what's nice about this technique of coming in this way is that again it's all in plane you can of course go this way into the tendon and that's fine but the best way really is to come kind of short axis find the area you want to enter into the tendon for find the area you want and then come in basically in plane in line bring in your needle go directly into the tendon you want to go into like there's a spot that i see a little bit hypoacric area of the tendon and if i want to inject i can just inject the tendon there move forward a little bit come to the tendon there inject a little bit so you can actually get your biologic introduced to the exact spot you want to be now this is the quad tendon we could of course change this over and go to the patellar tendon but same concept right and there you can see that totem that actually looks really good actually you see that patellar tendon very nicely but again same concept in plane come in see your needle get into the tendon where you want to be and then give your injection so this really makes it point specific wherever you want to be within the tendon to hit your spot but you can see how easy it is to find and localize and be point specific with your biologic for hopeful healing you
