Hip Pain Specialist

Due to its unique ball-and-socket architecture, the hip and pelvic complex plays a key role in human locomotion, providing both mobility and stability, and helping to mediate load transfers between the upper and lower body. Hip pain is relatively common among adults of all ages, but it should not be accepted as a normal part of aging. Whether caused by degenerative hip disorders, trauma, or repetitive overuse, most cases of hip pain can be successfully treated with conservative holistic methodologies. If left untreated, hip pain and dysfunction can cause mechanical issues throughout the body that lead to reduced mobility and diminished quality of life.

At NYDNRehab, we use the most advanced technologies and treatment methodologies available for hip pain diagnosis and treatment. Our state-of-the-art Manhattan clinic is second to none for hip pain treatment and rehabilitation in NYC.

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We’re located on 25th street in Manhattan NYC.
Open Monday-Friday, 10am-8pm.

Dr. Lev Kalika

Clinical director & DC RMSK

Dr. Kalika and Dr. Brosgol are Pioneering Next-Level Hip Pain Treatment

Dr. Lev Kalika, DC has devoted much of his life’s work to revolutionizing lower extremity 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 lower extremities.

Dr. Kalika has spent many years developing a unique diagnostic approach to hip pain that combines:

  • Diagnostic musculoskeletal ultrasonography
  • Integrative gait and motion analysis
  • Biomechanical screening and analysis
  • Specialized gait physical therapy
  • Ultrasound guided procedures
  • Extracorporeal shockwave therapy (ESWT)
  • Electromagnetic transduction therapy ( EMTT)

In addition to his clinical practice, Dr. Kalika is an accomplished researcher, with multiple peer-reviewed publications to his credit.

Dr. Yuri Brosgol

Orthobiologic specialist

Dr. Yuri Brosgol, MD is a neurologist with 20+ years of experience in treating pediatric and adult myofascial pain. When emerging research on the critical role of fascia in human mobility captured Dr. Brosgol’s interest, he pursued training in orthobiologics and fascial release techniques. Dr. Brosgol has become a pioneer in the use of orthobiologic solutions and fascial plane hydrodissection, paving the way for transformative advancements in the treatment of myofascial disorders.

Together, Dr. Kalika and Dr. Brosgol are combining their skills to revolutionize the way myofascial pain is diagnosed and treated. By leveraging the most advanced, evidence-based approaches, they are dedicated to improving the quality of life for hip pain patients in NYC.

Why Hip Pain Treatment at NYDNRehab is Superior to Traditional Physical Therapy

The hip joint is a multi planar joint surrounded by a complex network of muscles, ligaments, tendons and nerves. Conventional medical treatment for hip pain often focuses on pain management, along with physical therapy to enhance mobility and stability. But physical therapy does not provide a stand-alone solution for resolving the underlying causes of hip pain.

Hip pain can sometimes be caused by isolated conditions such as labral tears, femoroacetabular impingement (FAI), hip osteoarthritis, or bursitis, but more often it stems from the complex interplay of numerous structures in the lumbo-pelvic-hip complex, and affects multiple tissue types.

Factors that contribute to hip pain include:

  • Biomechanical imbalances
  • Fascial distortions and densifications
  • Failed load transfer
  • Joint hypermobility
  • Gait abnormalities
  • Muscle weaknesses
  • Compensatory movement patterns developed over time
  • Old injuries in the lower kinetic chain that were never properly rehabilitated, affecting hip alignment and function

Conventional treatment of hip pain often begins with physical therapy and ends with surgery, without ever addressing its root cause. We believe that successful diagnosis of hip pain can only be achieved using objective tools, and that surgery should be the absolute last resort.

We use the most advanced motion and gait analysis technology and the highest resolution musculoskeletal ultrasonography found in any private clinic in the USA to accurately identify the exact cause of your hip pain. From there, we create a customized treatment plan based on your unique diagnostic profile.

Before beginning physical therapy, we pretreat your damaged tissues, address fascial adhesions and trigger points, and restore functional joint range of motion. Only then do we begin to build strength and stability using specialized physical therapy.

Accurate Hip Pain Diagnosis Means Successful Treatment

Because hip pain can stem from a number of causes and can affect multiple structures, accurate diagnosis is key to successful treatment. At NYDNRehab, we use advanced technologies to diagnose, analyze and treat hip pain and dysfunction.

In addition to a thorough clinical exam, we use diagnostic ultrasonography to dynamically visualize tendons, ligaments, bursa, muscles, fascia and nerves that surround the hip, in real time. Your ultrasound exam takes place on your first visit, in the comfort of our clinic, with no wait time for lab results.

Our sophisticated video gait analysis technology empowers us to visualize and measure ground reaction forces, joint kinematics, muscle firing patterns and other quantitative parameters, to get a clear functional overview of the hip, pelvis and lower kinetic chain.

In addition to ultrasound imaging and gait analysis, our assessment protocol includes:

  • Combined lumbopelvic hip stability test using DLEST methodology with C.A.R.E.N, our computer assisted rehab environment.
  • 3D star excursion banner test (SEBT) to assess the hip joint’s effect on postural stability.
  • 3D kinematic joint angle analysis during a squat, lunge, drop jump and pelvis-on-hip rotation.
  • Rehabilitative ultrasonography to view hip stabilizer activation patterns.
  • ForceFrame total body isometric testing to identify imbalances in muscle strength and symmetry.

We use your collected data to create a baseline and a personalized treatment plan, We monitor your progress every step of the way, to ensure you get the fastest and most effective results.

Hip Conditions We Treat

Hip tendonitis

Femoroacetabular impingement (FAI)

Hip labrum tears

Adult hip dysplasia

Running hip pain

Hip flexor strains

Snapping hip syndrome

SI joint pain and dysfunction

Post-surgical hip replacement pain and rehab

Hip fracture rehabilitation

Femoral head stress fractures

Symptoms, Causes and Risk Factors
of Hip Pain

Symptoms

  • Pain when standing and walking
  • Snapping or popping sounds or sensations
  • Pain when climbing or descending stairs
  • Pain in the groin area
  • Stiffness and reduced range of motion in the hip and pelvic region

Causes

  • Repetitive overuse from sports, exercise or occupation
  • Trauma from falls or sports injuries
  • Excessive sitting that weakens supporting structures
  • Sprains and strains to muscles acting at the hip
  • Muscle imbalances that affect joint alignment

Risk Factors

  • Osteoporosis
  • Poor posture and balance
  • Deficits in gait mechanics
  • Being overweight or obese
  • Participating in high-intensity sports

Fascia Plays a Key Role in Hip Mobility and Function

Fascia is a complex network of connective tissues that surrounds and connects structures, tissues and organs throughout your body. Fascia works together with muscles to guide and control movement, and mediate outside forces. Together, muscles and fascia – aka the myofascial system – creates tensegrity that plays a key role in hip mobility and stability.

Fascia is rich with nerve endings, and capable of transmitting stronger tension and pain signals than muscle tissue. Healthy fascia is made up of collagen and hyaluronic acid, making it tough, elastic and slippery. But fascia is highly adaptive to chronic tension or injury, which can lead to fascial thickening, making it dense, sticky and inelastic. When damaged, it can adhere to other structures, entrapping nerves and blood vessels and preventing them from gliding.

Fascial densification can interfere with muscle action, restricting mobility and causing pain. Densified fascia can pull on adjacent structures, creating a feedback loop of widespread pain and tension in other areas of the body that doesn’t align with the locus of hip pain.

In cases of musculoskeletal pain, treatment strategies that do not consider and address the role of fascia are destined to fail, because fascia plays an integral role in all aspects of human mobility.

Why Physical Therapy Alone is Not Enough
to Resolve Hip Pain

Identifying and treating underlying issues prior to beginning physical therapy is key to getting fast and effective results. Failure to pre-treat your condition can completely undermine your treatment protocol, and in some cases, your condition may even worsen.

Obstacles to physical therapy success include:

  • Scar tissue and fascial adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury

At NYDNRehab, we use a broad range of regenerative technologies and integrative therapeutic approaches to resolve issues that can stand in the way of successful physical therapy.

Our staff is certified in a diverse array of holistic treatment methodologies, and our one-on-one treatment sessions are personalized, based on your unique diagnostic profile. Once we pre-treat your damaged tissues and eliminate compensation patterns, your hip will be ready for physical therapy.

We Use Advanced Technologies and Therapies for Optimal Results

Your pre-treatment phase may incorporate a combination of the following methodologies:

  • Stecco myofascial manipulation, to restore the slippery and elastic properties of damaged fascia and liberate entrapped nerves and blood vessels.
  • Ultrasound-guided dry needling to relieve myofascial trigger points.
  • Multimodal shockwave therapy, to reduce pain and inflammation and trigger a regenerative cellular response that accelerates tissue healing.
  • Ultrasound guided orthobiologic procedures like Prolotherapy and PRP, to attract growth factors to avascular tissues that are slow to heal.
  • Interfascial plane and nerve hydrodissection, to separate densified fascial layers and free up entrapped nerves and blood vessels.
  • Gentle chiropractic care to realign the lumbopelvic region.
Once your tissues are healed and aligned, and pain has been mitigated, you will be ready to begin physical rehabilitation, to restore optimal strength, stability and mobility to the hip joint and adjacent structures.

Your personalized physical therapy plan may include:

  • Posture correction therapy to restore optimal joint alignment.
  • Feedback training on C.A.R.E.N, to promote weight-bearing symmetry and gait stability.
  • Pelvic stability training to enhance capabilities for load transfer.
  • Dynamic neuromuscular stabilization (DNS) to restore optimal motor strategies.
  • Functional Patterns Training, to enhance functional range of motion and promote pain-free mobility.
  • Specialized physical therapy, to strengthen the muscles and structures that support and mobilize the hip joint.
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Regenerative Technologies
at NYDNRehab

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)

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.

INDIBA CT9 Radiofrequency Device

Our INDIBA Tecar therapy machine converts electrical current into a stable radio frequency current of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing. INDIBA can be used to successfully treat joint and muscle disorders, low-back pain, sports injuries, surgical incisions and various pain syndromes. Another therapeutic effect of INDIBA is extreme and prolonged cellular hyperthermia. Due to this effect, INDIBA therapy combined with manual therapy and soft tissue tissue manipulation enables instantaneous release to occur, significantly shortening the number and duration of physical therapy sessions. What is normally accomplished in two months of physical therapy can be accomplished in 3-4 sessions with INDIBA.


Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to lower back pain. Dry needling is an outpatient procedure that inserts non-medicated needles 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.

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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.

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.

Range of Available Unique Physical Therapy
Treatments at Nydnrehab

Strategies for Preventing Hip Pain

A strong and stable hip and pelvic region is fundamental to long-term mobility. Once hip pain becomes chronic, it can set off a cascade of issues that affect structures throughout your body. In response to chronic pain, you are likely to develop compensation strategies to offload the affected hip.

As pain persists, compensation patterns can become habitual, affecting your spinal and joint alignment anywhere along the kinetic chain. This can result in inefficient muscle recruitment patterns, fascial densifications, and nerve compression that sends pain signals to the brain.

To avoid chronic hip pain, adopt these positive strategies:

  • Get regular physical activity that recruits the hip extensor muscles (glutes and hamstrings). Walking, swimming and resistance training can make a world of difference in hip function. Core exercises can help to strengthen and stabilize the abdominal and pelvic muscles that support hip stability and alignment.
  • Avoid excessive sitting. If you sit for work, take frequent breaks to move and stretch. Focus on stretching the hip flexors and chest – areas that become stiff and tight from sitting and computer work.
  • Develop static and dynamic posture awareness to monitor how you stand, sit and move throughout the day. Look for asymmetrical patterns like shifting your weight to one leg while standing, sitting with one leg tucked beneath you, or favoring one side of the body to carry loads.
  • Achieve and maintain a healthy body weight. Carrying excess weight, especially in your midsection, can place extra stress on the hip and pelvic region.
  • If you’re already physically active, consider getting a 3D gait and motion analysis to identify mechanical issues that can lead to hip pain.
  • Drink plenty of water to supply your muscles and fascia with the fluids they need to function properly.

Get Personalized Hip Pain Physical Therapy, Designed Just for You

Hip pain can be debilitating, interfering with your ability to enjoy life to its fullest. Pain medications and surgeries often fail to get to the root cause of hip pain, addressing the symptoms without resolving their underlying causes. At NYDNRehab, our goal is to get to the source of your hip pain and correct it, so you can move freely, without pain or dysfunction. Our advanced approaches, expertise and personalized treatment programs make NYDNRehab the premier clinic for hip pain treatment in NYC.

Our Awards

Clinical Case Studies
NYDNRehab


Case Study: Femoroacetabular Impingement

Our Patient Our patient is a 29 year-old female, a professional fencer since the age of 11, who came to us with right-sided hip pain. She denied any past trauma, and at the time of her visit she had just recovered from COVID. She had been diagnosed with femoroacetabular impingement (FAI), and had undergone 4 […]

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Case Study: Occupational Hip and Low Back Pain

Our Patient Our patient was a 55 year-old male employee of the Metropolitan Transportation Authority (MTA). The patient’s job required heavy manual labor. He came to us complaining of hip and low back pain. The Challenge The patient’s job did not allow ample recovery time for standard physical therapy and injury rehabilitation to provide significant […]

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Hip Pain FAQs

What are some common causes of hip pain?
Hip pain can arise from a number of sources, including:
  • Osteoarthritis or rheumatoid arthritis
  • Fractures, dislocations, or muscle strains from falls or overexertion
  • Inflammation of the bursae – small fluid-filled sacs that cushion the hip
  • Tendinopathy
  • Sciatic nerve pain radiating from the lower back to the hip
  • Hip labral tear
  • Injuries in the lower kinetic chain that were never properly rehabilitated, affecting hip joint alignment and function
Many hip pathologies share the same symptoms, so it’s crucial to get an accurate and comprehensive diagnosis before you begin treatment.
When should I see a doctor for hip pain?
Sudden or severe pain, inability to bear weight on the affected hip, swelling, redness or warmth in the hip region, and persistent pain are all indications you should seek immediate medical attention. If your hip pain persists or worsens for more than a few weeks, you should see a holistic hip pain specialist.
Does chronic hip pain mean I need a hip replacement?
Hip replacement surgery is not always necessary and it should only be considered as a last resort. Physical therapy, regenerative therapies and orthobiologics may be enough to eliminate the underlying cause of your hip pain. In many cases, hip surgery can create complications that cannot be reversed. Before consenting to hip surgery, get a comprehensive analysis from a reputable holistic practitioner.
Is hip pain linked to age?
Aging increases the chance of developing conditions like osteoarthritis and osteoporosis, both of which can affect the hip. Sarcopenia – loss of lean muscle mass – is common in older adults, meaning reduced strength and stability. Physical inactivity can result in general deterioration of the structures that surround and support the hips. However, younger people can also develop hip pain from injuries, overuse, or congenital issues like hip dysplasia.
Can hip pain radiate to other areas?
Yes, hip issues can cause pain in the groin, thigh, buttocks, or anywhere along the lower kinetic chain. Chronic hip pain can contribute to poor posture and back pain, especially if you develop compensation patterns. Densified fascia can entrap nerves, sending amplified pain signals to the brain.

Our Specialists

Dr. Yuri Brosgol MD
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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