Performance Medicine
Your body should be able to keep pace with the life you have built. When pain, stiffness or an injury begins to interfere, you need more than a one-size-fits-all recommendation. You need clarity about what is happening to your body and a thoughtful strategy for moving forward.
At Executive Medicine of Texas (EMTX), performance medicine offers a concierge, physician-led approach to protecting your mobility and physical capability.
Led by board-certified orthopedic surgeon Dr. Edwin E. Spencer Jr., the performance medicine program brings together our orthopedic expertise and services around your individual needs.
Whether you are navigating an injury, returning to an activity or looking ahead to long-term strength and independence, your care is designed around how you want to live, move and perform.
What is performance medicine?
Performance medicine is a personalized approach to musculoskeletal health, physical function and long-term mobility. It is not reserved for professional athletes. It is for people who want to remain strong, active and capable at every stage of life.
Instead of focusing only on short-term symptom relief, the performance medicine team at Executive Medicine of Texas evaluates how your joints, muscles, tendons, ligaments, movement patterns and overall health work together. This creates a clearer understanding of the factors affecting your comfort and performance.
Based on your evaluation, the team develops an individualized care strategy that may combine orthopedic treatment, biologics and supportive recovery services. Recommendations depend on your diagnosis, health history and goals. No single treatment is appropriate for every patient or injury.
The performance medicine physical evaluation
The performance medicine physical provides an in-depth view of your musculoskeletal health, physical capacity and potential injury risks.
It establishes a baseline your care team can use to make informed recommendations and monitor your progress over time.
What the physical includes
Your performance medicine physical includes:
- Review of your medical history, including past injuries
- Full physical exam and joint evaluation
- Neuromuscular assessment
- Advanced functional movement screening
- Advanced laboratory testing covering more than 200 values, including hormones
- Inflammatory marker testing
- Micronutrient testing
- DEXA bone density testing
- Pulmonary function testing
- Stress testing with VO2MAX
- Autonomic nervous system (ANS) testing
- Ankle-brachial index (ABI) testing
- Prostate exam for men or Pap smear for women
- Chest X-ray
- Computed tomography (CT) calcium score of the coronary arteries
- Cognitive assessment
- Brain mapping
- Carotid Doppler testing
- Echocardiogram
- Fecal occult blood testing
- Functional nutrition consultation
- Home sleep study
- Skin cancer screening
- Color vision screening
- Retinal scan
- Hearing screening
- Distance vision screening
- Wellness and lifestyle assessment
- InBody™ screening
- Choice of breakfast or lunch
- Follow-up appointment to review results and personalized recommendations
How it differs from a standard executive physical
EMTX executive physical exams are comprehensive, half-day evaluations designed to establish a detailed picture of your overall health.
Depending on the exam level, they may include:
- More than 100 laboratory tests
- Cardiovascular and pulmonary testing
- Cognitive and preventive screenings
- Body composition analysis
- Fitness evaluation
- Advanced imaging
The performance medicine physical builds on this whole-health foundation with a focused orthopedic and musculoskeletal evaluation.
It takes a closer look at your injury history, joint function, strength, movement patterns, body composition, physical capacity and performance goals.
The purpose is not only to identify broader health risks, but also to understand what may be contributing to pain, limited mobility, recurring injuries or changes in performance.
Every performance medicine concierge program includes detailed annual executive physician exams and year-round primary care.
The added performance evaluation provides Dr. Spencer and the multidisciplinary team at EMTX with the information they need to coordinate orthopedic treatment, biologic options and recovery services tailored to your specific needs.
The performance medicine concierge program
The performance medicine concierge program is designed for patients who want more than a one-time assessment. It creates an ongoing relationship with a board-certified primary care physician, Dr. Spencer and a coordinated team of health and recovery professionals.
Your care begins with an extensive evaluation. From there, the team builds a strategy around your priorities, whether you want to address a persistent injury, support your recovery, return to an activity or preserve strength and mobility as you age.
Depending on your program level and clinical needs, services may include orthopedic care, platelet-rich plasma (PRP) therapy, bone marrow aspirate concentrate (BMAC), chiropractic visits, neuromuscular massage, functional nutrition, IV therapy, red light therapy, peptide protocols and follow-up progress reviews.
Program inclusions vary by tier.
Performance Medicine Essentials — $28,000
Essentials establishes your performance baseline and gives you coordinated access to both a concierge primary care physician and an orthopedic physician throughout the year.
It includes the performance medicine physical, two DEXA scans, InBody™ screenings, an orthopedic evaluation and personalized recommendations.
The program also includes one PRP injection site and a defined number of chiropractic, neuromuscular massage, functional nutrition, IV therapy and red light therapy sessions.
Performance Medicine Elite – $47,000
Elite expands the essentials program with two PRP injection sites and additional chiropractic, neuromuscular massage, functional nutrition, IV therapy and red light therapy sessions.
It also includes BMAC for one treatment site when clinically appropriate, StemWave® therapy, neurofeedback, a prescribed peptide therapy protocol, 3X4 Genetics® DNA testing, Alcat® food sensitivity testing and year-round Bioidentical Hormone Replacement Therapy (BHRT).
Performance Medicine Pro – $73,000
Pro offers the program’s most comprehensive level of ongoing performance support.
It includes unlimited PRP injection sites, chiropractic visits, neuromuscular massage sessions, IV therapy infusions and red light therapy sessions.
When clinically appropriate, it also includes BMAC for up to two treatment sites.
Additional benefits include advanced imaging as needed, telomere testing, a Truvaga device, performance psychiatry sessions and quarterly comprehensive progress reviews with your full care team.
Compare performance medicine concierge programs
| Program feature | Essentials | Elite | Pro |
|---|---|---|---|
| Concierge Primary Care Physician and Orthopedic Physician Access for the year | ✓ | ✓ | ✓ |
|
Performance Medicine Physical See what's included in this exam |
✓ | ✓ | ✓ |
| 2 DEXA Scans (baseline + 6-month follow-up) | ✓ | ✓ | ✓ |
| Inbody™ Screenings | ✓ | ✓ | ✓ |
| Orthopedic Evaluation | ✓ | ✓ | ✓ |
| PRP Injection Session | 1 Site | 2 Sites | Unlimited |
| Chiropractic Visits - stretching protocols, FSR therapy, dry needling, and adjustments | 12 | 24 | Unlimited |
| Neuromuscular Massage Sessions | 12 | 24 | Unlimited |
| Functional Nutrition | 2 Sessions | 4 Sessions | 4 Sessions |
| IV Therapy Infusions | 6 | 12 | Unlimited |
| Red Light Therapy Sessions | 12 | 24 | Unlimited |
| Personalized Supplement Protocol | ✓ | ✓ | ✓ |
| Hormonal Evaluation with Recommendations | ✓ | ✓ | ✓ |
| BMAC (bone marrow aspirate concentrate) | 1 Site | Up to 2 Sites | |
| StemWave® Therapy Sessions | 6 sessions | 12 sessions | |
| Neurofeedback | 12 sessions | 12 sessions | |
| Peptide Therapy Protocol (as prescribed by EMTX provider) | ✓ | ✓ | |
| 3x4 Genetics® DNA Testing | ✓ | ✓ | |
| Alcat® Food Sensitivity Testing | ✓ | ✓ | |
| Year-round Bioidentical Hormone Replacement Therapy (BHRT) | ✓ | ✓ | |
| Advanced Imaging (as needed) - X-Ray, CT, MRI, Ultrasound | ✓ | ||
| Telomere Testing | ✓ | ||
| Truvaga Device | ✓ | ||
| Performance Psychiatry (3 Sessions) | 3 sessions | ||
| Quarterly Comprehensive Progress Reviews with Full Care Team | ✓ | ||
| Annual program cost | $28,000 | $47,000 | $73,000 |
Program services are based on the terms of the signed agreement and individualized clinical recommendations. Not every service or therapy is appropriate for every patient.
Chiropractic care with Dr. Tupper
Chiropractic care [1] can support joint mobility, alignment and movement quality as part of your personalized program.
Dr. Chris Tupper works with the broader performance medicine team to understand how musculoskeletal restrictions may be affecting your comfort, mechanics and ability to stay active.
Your care may include chiropractic adjustments, assisted stretching, dry needling or other techniques selected for your needs and program level.
Neuromuscular massage with Trey
Neuromuscular massage focuses on areas of muscular tension, restricted movement and soft-tissue discomfort.
Trey Calhoun, NMT, provides targeted sessions that may incorporate trigger-point therapy, stretching and soft-tissue work as part of your broader recovery plan.
Because this care is coordinated with the rest of your performance medicine services, each session can support the goals established during your evaluation and adjusted as your needs evolve.
Biologics and regenerative medicine treatments
Biologics use substances derived from the body to support its natural healing response. In orthopedics, options may include PRP and BMAC. These treatments are considered only after a careful evaluation of your injury, overall health, previous care and goals.
Biologics are not a cure-all, and results vary. Dr. Spencer will explain the available evidence, realistic expectations and other treatment options so you can make an informed decision.
What are biologics?
When an injury occurs, the body initiates an organized healing process involving inflammation, cell signaling, new blood vessel formation and tissue remodeling.
Tendons, ligaments and cartilage have a relatively limited blood supply, which can make some injuries slow to heal or contribute to lingering symptoms.
Biologics are intended to concentrate specific components involved in the body’s normal response and deliver them to a carefully selected treatment site.
The preparation and intended purpose vary by therapy.
PRP therapy: How it works
Platelet-rich plasma is prepared from a small sample of your own blood. The sample is processed to concentrate platelets, which contain growth factors involved in cell signaling and tissue repair. The resulting PRP is then injected into the targeted area.
PRP may be considered for certain tendon, ligament, muscle or joint concerns. Its potential value depends on the diagnosis, injury location, PRP preparation and the patient’s overall health.
Patients often report improvements in pain and function, but PRP does not produce the same result for every condition or person.
Dr. Spencer coauthored a 2023 study comparing a single ultrasound-guided PRP injection with surgical repair for a specific injury: high-grade intrasubstance partial rotator cuff tears. Both groups experienced comparable improvements in pain and function at a minimum two-year follow-up. In this study, the PRP group returned to unrestricted activity in an average of 3.3 months, compared with 4.6 months for the surgical group.
These findings apply to the specific tear pattern and patients studied. They do not mean PRP can replace surgery for every rotator cuff tear.
A complete orthopedic assessment is necessary to determine whether PRP, surgery or another approach may be appropriate.
Bone marrow aspirate concentrate (BMAC)
BMAC is prepared using bone marrow collected from your own body, typically from the pelvis.
The aspirate is mechanically processed to concentrate components involved in signaling, inflammation and the body’s healing response before it is placed into the treatment area.
BMAC is sometimes casually described as a “stem cell injection,” but that term can create unrealistic expectations. The cells in BMAC are not expanded in a laboratory, and the treatment should not be understood as a way to regrow cartilage.
When BMAC is considered for orthopedic care, the goal is generally to support a healthier joint environment and potentially reduce inflammation and pain.
Patients often report reduced discomfort and improved function, but outcomes vary, and research continues to evolve. Executive Medicine discusses the potential benefits, limitations, regulatory considerations and alternatives with each patient before recommending treatment.
Ultrasound-guided injection techniques
Precision matters when a biologic is intended for a particular tendon, ligament, joint or area of damaged tissue.
Ultrasound allows the physician to view soft-tissue structures in real time and guide the needle toward the planned location.
When appropriate, Dr. Spencer uses ultrasound guidance to support accurate placement while avoiding nearby structures. Your diagnosis and treatment plan determine whether ultrasound guidance is needed.
Conditions we address
Performance medicine may be considered for adults experiencing musculoskeletal pain, activity limitations or recurring injuries.
Conditions evaluated may include:
- Partial tendon tears and tendinopathy
- Rotator cuff injuries
- Tennis elbow and golfer’s elbow
- Ligament sprains or partial tears
- Osteoarthritis and joint discomfort
- Muscle strains and soft-tissue injuries
- Overuse injuries
- Reduced mobility or recurring stiffness
- Sports- and activity-related injuries
- Persistent symptoms after previous conservative care
This list does not determine candidacy for PRP, BMAC or any specific treatment. Your recommendations will be based on a complete evaluation and diagnosis.
Complementary recovery services
Musculoskeletal recovery is influenced by more than the site of an injury.
Sleep, nutrition, metabolic health, strength, movement patterns and recovery habits can all affect how you feel and perform.
Your concierge team may integrate complementary services when they align with your needs.
+ IV therapy
IV therapy delivers fluids and selected nutrients intravenously under medical supervision. It may be incorporated into a broader plan to support hydration, nutrient status and recovery based on your health history and program level.
+ Peptide therapy
Peptide therapy may be recommended as part of a personalized protocol when clinically appropriate. Your EMTX provider determines whether a peptide is suitable, selects the protocol and monitors your response.
+ Functional nutrition and micronutrient testing
Functional nutrition helps connect your eating patterns, nutrient intake and recovery goals.
Your specialist can translate testing and health information into practical recommendations that support your broader care plan.
When indicated, micronutrient testing can provide additional insight into nutrient levels and help guide individualized nutrition or supplement recommendations. Supplements are included only when specified by your performance medicine program.
Who is performance medicine for?
Performance medicine is designed for people who want to preserve or regain the ability to do what matters to them. You do not have to be a competitive athlete to benefit from a performance-focused approach.
The program may be a fit for:
- Active adults working through pain or an injury
- Recreational and competitive athletes seeking coordinated sports recovery care
- Executives who need efficient access to a multidisciplinary medical team
- Patients considering PRP or BMAC who want an evidence-informed orthopedic evaluation
- Adults who want to maintain mobility, strength and independence as they age
- People whose symptoms have continued despite rest, medication, injections or therapy
- Patients seeking comprehensive preventive care through annual executive physical exams and year-round primary care
What to expect at your performance medicine appointment
Your first appointment is designed to understand both the problem you are experiencing and the life you want to return to.
+ A detailed conversation
Your physician reviews your symptoms, health history, previous injuries, treatments, activity level and goals. You will have time to explain how the concern affects your day-to-day life and ask questions.
+ A focused evaluation
Your assessment may include orthopedic examination, movement and strength testing, diagnostic imaging review and other testing based on your needs.
EMTX can coordinate off-site imaging when needed; DEXA scanning is available on-site.
+ A personalized strategy
Your team explains the findings and outlines appropriate options.
Recommendations may include activity modifications, rehabilitation, chiropractic care, neuromuscular massage, PRP, BMAC or other services.
You will also learn what the evidence suggests, what recovery may involve and what limitations or risks to consider.
+ Ongoing coordination
Performance medicine concierge members receive ongoing primary care and coordinated support across their selected services.
With direct physician access by phone, text, email and secure portal messaging, questions can be addressed according to urgency as your care progresses.
Meet your performance medicine team
Your program is led by Dr. Edwin E. Spencer Jr., a board-certified orthopedic surgeon with decades of experience in orthopedic research, product development and patient care.
He earned his medical degree from Duke University, completed residency and postdoctoral training at the University of Michigan Medical Center and completed fellowship training at the Cleveland Clinic.
Dr. Spencer has been a member of the American Shoulder and Elbow Surgeons since 2006 and was inducted into its Neer Circle in 2024 in recognition of his contributions to shoulder and elbow research.
His published work includes research on PRP for partial rotator cuff tears, and his approach emphasizes careful diagnosis, patient education and evidence-informed treatment selection.
Performance medicine is delivered through a team-based model. Dr. Spencer works alongside EMTX primary care physicians and specialists to coordinate recommendations around your medical needs, movement, recovery and long-term goals.
Why choose Executive Medicine of Texas for performance medicine?
Executive Medicine brings medical expertise and concierge-level coordination together in a luxury, welcoming environment.
Your care is designed to feel thoughtful, unhurried and connected from one service to the next.
With EMTX, you receive:
- Orthopedic leadership from a board-certified surgeon and published researcher
- A Performance Medicine Physical tailored to your body, activity and goals
- A multidisciplinary team that communicates across services
- Evidence-informed PRP and BMAC recommendations with realistic expectations
- Ultrasound-guided injection techniques, when appropriate
- On-site DEXA scanning and coordination of off-site imaging when needed
- Detailed annual executive physician exams and year-round primary care
- Direct physician access through phone, text, email and secure portal messaging
- A personalized strategy that can evolve with your needs
This is not a one-size-fits-all protocol. It is a relationship with a dedicated concierge team focused on helping you become healthier, stronger and more energized.
Frequently asked questions about performance medicine
What is the difference between performance medicine and physical medicine?
Performance medicine is a physician-led concierge program that combines a comprehensive physical evaluation, orthopedic care, primary care, biologic treatment options and coordinated recovery services.
It addresses musculoskeletal concerns while also supporting long-term mobility, physical capacity and overall health.
Physical medicine at EMTX focuses on noninvasive, hands-on services such as chiropractic care, stretching, strengthening and neuromuscular massage. These services may be part of a performance medicine program, but the two offerings are not the same.
What is included in the performance medicine concierge program?
Every performance medicine concierge program includes a performance medicine physical, detailed annual executive physician exams, year-round primary care and access to both a board-certified primary care physician and orthopedic physician.
Depending on the tier, services may also include DEXA and InBody™ screenings, chiropractic care, neuromuscular massage, functional nutrition, IV therapy, red light therapy, PRP, BMAC, peptide therapy, advanced testing and progress reviews.
Specific inclusions and quantities vary among the Essentials, Elite and Pro programs. EMTX will review the program comparison with you before enrollment.
Does insurance cover PRP therapy?
EMTX does not accept health insurance for its concierge programs or PRP services. These services are self-pay.
Patients may choose to maintain separate health insurance for hospital care, outside specialists, imaging or other services not included in their EMTX program.
How many PRP sessions will I need?
There is no standard number that applies to every patient. Some treatment plans may involve one injection, while others may require additional care.
The recommendation depends on the condition, severity, treatment location, overall health and response over time. Dr. Spencer will explain the proposed treatment plan after evaluating you.
What is the difference between PRP and BMAC?
PRP is prepared from a sample of your blood and concentrates platelets and their associated growth factors.
BMAC is prepared from your bone marrow and contains a broader mixture of concentrated cells and signaling components.
Both are autologous, meaning they come from your own body, but they are prepared differently and may be considered for different clinical situations.
What can I realistically expect from BMAC therapy?
BMAC may help reduce inflammation and pain in select orthopedic conditions.
Patients often report improved comfort or function, but individual responses vary. BMAC should not be presented as a treatment that regrows cartilage, and regenerative medicine therapies are not FDA-approved for orthopedic conditions. Your consultation will include a balanced discussion of the available evidence, limitations, potential risks and alternatives.
Do I need a referral to see Dr. Spencer?
No referral is required to request a consultation with Dr. Spencer at EMTX.
Contact the office to discuss your concern and determine the appropriate appointment type. Ongoing primary care is available only through an EMTX concierge program.
Schedule your performance medicine consultation at Executive Medicine of Texas
You should not have to piece together orthopedic care, recovery services and preventive medicine on your own.
Performance Medicine at EMTX provides you with a coordinated team, a detailed understanding of your health, and a personalized care strategy that may incorporate complementary services.
Whether you want to address an injury, explore PRP or BMAC, return to an activity or protect your mobility for the years ahead, the first step is a thoughtful evaluation.
Request an appointment with Executive Medicine of Texas in Southlake, TX, or call 817-552-4300 to schedule your consultation.
