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Dr. Kalika’s experience comes from working with Prof. Pavel Kolar the renowned Czech School of Rehabilitation as well as Prof. Christopher Powers who is one of the worlds leader in treatment and prevention of running injuries. Another unique approach that Dr.Kalika is certified in is ISM (integrated system model) therapy.This approach is now used by most elite EPL soccer teams (Manchester city and Chelsea) to keep their players away from injuries as well as for in season rehabilitation. Dr. Kalika has knowledge not only in several different types of therapy he also has expertise with diagnostic ultrasound, gait and running analysis, orthopedics, and sports medicine. The combination of all these different experiences helps him correctly diagnose and rehabilitate athletes better than most clinics in NYC. Dr. Kalika has also studied under top leading running authorities like Brian Hidershide and Irene Davis. These experiences and extra training has given Dr. Kalika the unique expertise in running performance.

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Despite 10 years of experience with instrumented gait analysis, attending multiple running medicine conferences, certification in clinical biomechanics, and personal experience with Chris Powers, I decided to undertake this additional certification to ensure that no single detail concerning the assessment and treatment of running injuries escapes me.

Gait Analysis

Gait Analysis Blog

 

Gait analysis is the study of the way in which a person walks or runs. By analyzing a person’s gait, you can determine whether that person has a problem or abnormality in the joints or muscles. If a person’s muscles are unable to provide the support necessary for proper movement — or the joints don’t have the normal range of motion — overcompensation could lead to further injury.

These are some of the typical gait irregularities detectable through analysis:

  •  Striking the sides of the heels rather than the center
  •  Incorrect knee angle
  •  Hip hitching due to weak gluteus muscles
  •  Inability to bend the ankle fully upward
  •  Abnormal tilting of the pelvis

How Gait Analysis Works

A doctor such as a podiatrist typically performs gait analysis. With proper equipment and training, though, any professional with experience in sports medicine can analyze an athlete’s gait. The professional performing the analysis will have the patient walk or run on a treadmill. The analysis involves careful examination of the patient’s hips, knees, ankles and feet — sometimes with the aid of a video recorder. Gait analysis professionals often use computers to slow down or freeze the video for closer examination.

The results obtained from gait analysis can help to protect an athlete and potentially extend his or her career. These are just a few of the sports injuries that an athlete can potentially prevent simply by using corrective footwear:

  •  Lower back discomfort
  •  Damage to the Achilles tendon
  •  Damage to the connective tissue of the knee
  •  Plantar fasciitis
  •  Shin splints

Do you think that you might have an abnormal gait? Examining the wear pattern on a well-used pair of shoes can help. If the wear on the bottom of the shoe is far from the center of the heel, you may pronate or supinate.

How Gait Applies to Walkers and Runners

We can understand the gait more fully by analyzing its two components: the stance and the swing. The foot touches the ground during the stance. It does not touch the ground during the swing.

These are the four phases of the stance:

  • The moment in which the heel touches the ground
  • The moment in which the foot is flat
  • The moment in which the athlete begins to transfer weight to the front of the foot
  • The moment in which the athlete pushes the toe away from the ground

These are the three phases of the swing:

  •  The moment in which the athlete flexes the knee to lift the foot up
  •  The moment in which the athlete moves the leg forward
  •  The moment before the heel strikes the ground

When the athlete walks, he or she spends more time in the stance than in the swing. During running, however, the swing phase is the longer of the two. The swing phase becomes longer as the athlete runs more quickly.

Correcting an Abnormal Gait

After gait analysis identifies the abnormality in an athlete’s gait pattern, a professional can help the athlete determine the next course of action. In some cases, therapy is necessary to correct an abnormal gait. In most cases, though, orthotic inserts or corrective footwear can correct gait issues.

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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)

image

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

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