Regenerative
Rehabilitation for
Meniscus Tears

About Meniscus Tears

Each knee has two menisci, horseshoe-shaped spongy disks that work like shock absorbers between the femur and tibia. The menisci can become ruptured, either from trauma or from wear and tear over time. Traumatic meniscus tears are common in high intensity sports, especially contact sports like rugby and football. Degenerative tears are common among middle aged and older adults.

The vast majority of meniscus tears do not require surgical intervention. In fact, it is recommended that 98% of meniscus tears be treated conservatively, as surgery has been shown to increase the risk of knee osteoarthritis later in life. Moreover, patients who undergo surgical repair fare no better than patients treated with physical therapy alone. In cases of unstable tears that produce knee locking or catching, surgery may be necessary, but partial meniscectomy should only be considered as a last resort, as it can produce early-onset arthritis.

Rehabilitative physical therapy at NYDNRehab can accelerate healing and help to prevent recurring meniscus injuries.

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Why Ultrasound is Superior to MRI for Diagnosing Meniscus Tears

While overall MRI remains the diagnostic imaging method of choice for meniscus tears, high resolution diagnostic ultrasonography can be used effectively to diagnose simple meniscus tears.
In a healthy knee, the medial meniscus extrudes at 0 degrees flexion, but retracts into the joint during dynamic knee flexion, while a torn meniscus remains extruded throughout dynamic flexion to 90 degrees. Dynamic meniscus extrusion can also occur without a meniscus tear in cases where the meniscus is degenerating – a precursor of a meniscus tear.

Research shows that high resolution diagnostic ultrasonography conducted by an experienced professional is as accurate as dynamic MRI in identifying dynamic meniscus extrusion. Given that ultrasound is more accessible and significantly less expensive than MRI, it is the preferred imaging mode for meniscus tears.

Eighty-five percent of meniscus tears do not require surgery (simple meniscus tears), and can be easily treated with a combination of rehabilitation and regenerative therapy or regenerative injections. Early detection with dynamic high resolution ultrasonography can influence the choice of conservative treatment over surgery. Conservative care is preferable to surgery because surgery prolongs the rehab process and predisposes patients to knee osteoarthritis later in life.

Why Ultrasound is Superior to MRI for Diagnosing Meniscus Tears
Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Knee Pain Specialist Dr. Lev Kalika

Dr. Kalika revolutionized knee pain treatment by introducing high resolution diagnostic ultrasonography for structural diagnosis, combined with gait and motion analysis technology to visualize and objectify the functional movement of the knees and lower extremities.

Dr. Kalika has created his own proprietary methodology for restoring meniscus tears without surgery. He uses regenerative technologies and injection therapies to stimulate and accelerate healing, combined with targeted physical therapy based on the patient’s gait analysis results.

The motion and gait analysis lab at NYDNRehab is the only private lab in the US to feature research-grade technology, normally found only at top research universities. We have made this cutting edge technology available to our patients in our private clinic. We are quick to embrace new evidence-backed technologies that are proven to provide therapeutic benefits to our patients.

Dr.Kalika’s expertise is sought by runners, dancers and professional athletes across the United States.

Why Meniscal Tear Physical Therapy at NYDNRehab is Better than Conventional Physical Therapy

At NYDNRehab, we use the most advanced technologies for torn meniscus rehab, including regenerative technologies to eliminate pain and accelerate healing. Whether your goal is to return to sports, or simply to improve your quality of life, meniscus tear physical therapy at NYDNRehab is superior to therapy at run-of-the mill PT clinics that use a one-size fits all approach to treatment.

We believe that every patient is unique, and that every injury has distinct characteristics that demand personalized attention. We never use cookie cutter approaches to treat knee pain. Our one-on-one personalized approach ensures that every patient gets the care they need and deserve, so they can enjoy fluid pain-free movement and avoid future injury.

Why Meniscal Tear Physical Therapy at NYDNRehab is Better than Conventional Physical Therapy

Symptoms, Causes and Risk
Factors for Meniscus Tears

Symptoms

  • Mild to severe knee pain

  • A stiff and swollen knee joint

  • A knee that locks out or hitches

  • Snapping or popping sounds or sensations

  • Reduced knee range of motion

Causes

  • Trauma during sports or exercise

  • Sedentary lifestyle

  • Knee osteoarthritis

  • Certain medications

  • Overweight and obesity

Risk Factors

  • Participation in high intensity contact sports

  • Occupations that require kneeling or climbing

  • Poor nutrition/hydration

  • Taking medications that promote inflammation

  • Muscle weakness and limited range of motion

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We Embrace the Latest Technologies for
Optimal Results

Meniscus tears can range from mild to severe, and many people turn to surgery as a first line of treatment. However, most meniscus tears can be treated and healed without surgery. We use the latest non-invasive technologies and innovative therapies to rehabilitate meniscus tears and restore functional pain-free movement.

3D Gait Analysis and Retraining
3D Gait Analysis and Retraining

Mechanical deficiencies in walking or running gait can cause the knee to become misaligned, placing undue stress on the structures surrounding the knee and producing pain. We use our state-of-the art gait lab to analyze joint angles and force loads associated with gait, to identify and quantify mechanical deficits and retrain the way you walk and run, to eliminate wear and tear on the menisci.

Alter-G Antigravity Treadmill
Alter-G Antigravity Treadmill

Our gravity-reducing treadmill unloads the knee joint, to enable retraining of gait patterns without placing undue stress on injured structures. This approach speeds recovery by allowing gradual reloading of the knee and gradual improvement of gait patterns.

C.A.R.E.N.(Computer Assisted Rehabilitation Environment)
C.A.R.E.N.
(Computer Assisted Rehabilitation Environment)

C.A.R.E.N’s advanced technology uses a virtual reality environment to train healthy movement patterns and enhance sports performance. Real-time feedback is provided to optimize motor patterns, retraining the brain-body connection for efficient pain-free movement.

Blood Flow Restriction Training
Blood Flow Restriction Training

BFR makes it possible to rehabilitate injured tissues using much lighter loads, by occluding the blood vessels to elicit a regenerative response in damaged cells. BFR helps prevent tissue atrophy after an injury while protecting damaged structures from overload. It speeds the recovery process for faster return to pain-free activity.

Physical Therapy for Meniscus Tears
Physical Therapy for Meniscus Tears

Physical therapy exercises work to strengthen and rebalance the muscles that support the knee joint, taking pressure off of nerves and connective tissue, and realigning the joint for optimal function. At NYDNRehab, meniscus tear physical therapy is integrative and holistic, looking beyond the locus of pain and dysfunction to take into account the various factors that affect the alignment and function of the knee joint.

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New Cutting Edge Technology for
Meniscus Tears

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.


Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.


High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.

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Ultrasound Guided Injection
Therapies

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.


Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Electromagnetic Transduction Therapy (EMTT)

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to knee pain. Dry needling is an outpatient procedure where non-medicated needles are inserted into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Preventing Meniscus Tears

Athletes can avoid meniscus tears by training for both strength and flexibility, staying hydrated, and regularly analyzing mechanical skills execution and correcting errors. Older adults can avoid knee problems in general by remaining physically active, maintaining a healthy weight, staying strong and flexible, and avoiding medications.

Certain medications like statins, estrogen drugs, antidepressants, osteoporosis medicines and blood pressure drugs can contribute to knee pain and associated joint issues. Making healthy lifestyle choices on a daily basis can steer you away from harmful prescription medications that can damage your joints and increase your risk of injury.

A nutrient-dense, protein-rich diet that promotes collagen production and muscle growth can help to maintain the integrity of the knee joints. Steer clear of sugar and refined carbohydrates and oils, all of which are prime contributors to joint inflammation that can set you up for knee injuries.

Preventing Meniscus Tears

Get Personalized Torn Meniscus Rehab Designed Just for You

If you are experiencing knee pain and suspect you have a torn meniscus, you should not delay seeking help. Early treatment can prevent your meniscus tear from getting worse and reduce your risk of needing surgery.

The knee pain specialists at NYDNRehab have extensive experience in meniscus tear diagnosis and treatment. We will design a personalized treatment plan that keeps you moving toward your goal, and measure your progress every step of the way to ensure that our treatment is effective.

Don’t settle for mediocre treatment for knee pain. Contact NYDNRehab today, and get the best physical therapy for meniscus tears in NYC.

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    Dr. Lev Kalika
    Dr. Lev Kalika

    Clinical director & DC RMSK

    Our Specialists

    Dr. Mikhail Bernshteyn MD (Internist)
    Dr. Michael Goynatsky DPT
    Dr. Daniela Escudero DPT
    Dr. Michelle Agyakwah DC
    Dr. Tatyana Kapustina L. Ac.
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    In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

    Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

    The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

    Dynamic ultrasonography examination demonstrating
    the full thickness tear and already occurring muscle atrophy
    due to misdiagnosis and not referring the patient
    to proper diagnostic workup

    Demonstration of how very small muscle defect is made and revealed
    to be a complete tear with muscle contraction
    under diagnostic sonography (not possible with MRI)

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    Complete tear of rectus femoris
    with large hematoma (blood)

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    Separation of muscle ends due to tear elicited
    on dynamic sonography examination

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