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Home Blog Knee Pain Specialist NYC

Looking for the Best Knee Specialist in NYC?

About Knee Pain Treatment

The knee is a complex joint made up of multiple tissue types, and knee pain can arise from a variety of causes. In many cases, knee pain originates from issues not directly related to the knee, such as inefficient gait mechanics, poor posture, muscle weakness, obesity, metabolic disease and other factors.

Conventional medicine takes a reductionist approach to knee treatment, addressing pain symptoms with drugs and surgery while ignoring other factors that actually cause knee pain. In the vast majority of cases, patients can avoid drugs and surgery with holistic treatment from an experienced knee pain specialist.

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

table of contents

What are the credentials of the knee specialists at NYDNRehab? How is knee pain diagnosed at NYDNRehab? What sets NYDNRehab apart from other physical rehab clinics? How does fascia affect knee pain? Why is pretreatment necessary before beginning physical therapy? What technologies and methodologies are used for knee pain treatment? What knee conditions are treated at NYDNRehab? Knee pain FAQs
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Dr. Lev Kalika

Clinical director & DC RMSK

About Knee Pain Specialist Dr. Lev Kalika

Dr.Kalika has revolutionized knee rehabilitation 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 is a recognized expert in diagnostic musculoskeletal ultrasonography, with multiple research publications to his credit.

Our orthobiologic specialist, Dr. Uri Brozgol, is a neurologist with 20+ years of experience in treating pediatric and adult myofascial pain. As new research on the critical role of fascia began to emerge, Dr. Brozgol became interested in orthobiologic injection therapy and fascial release techniques, and he began treating myofascial and nerve problems with orthobiologic solutions.

Dr. Brozgol’s expertise lends precision to ultrasound-guided needling procedures, including:

  • Prolotherapy
  • Platelet Rich Plasma (PRP)
  • A2M injections
  • Fascial flush therapy

Our top-grade high-resolution ultrasound enables us to dynamically visualize the body’s structures in real time, equipping us with an invaluable diagnostic tool, along with superior capabilities for delivering regenerative and orthobiologic procedures with accuracy and precision.

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 use our advanced technologies to provide our patients with the very best diagnostic and treatment options in Manhattan, NYC.

Together, Dr. Kalika and Dr. Brozgol are revolutionizing the way myofascial pain is diagnosed and treated. Dr. Kalika’s successful track record of rehabilitating musculoskeletal injuries combined with Dr. Brozgol’s expertise in treating myofascial pain makes NYDNRehab the clinic of choice for myofascial pain in NYC.

Successful Knee Treatment Begins with Accurate Diagnosis

Diagnostic ultrasound enables us to identify the structural causes of knee pain in real time, with the knee in motion. Ultrasound also lets us measure and compare characteristics between the injured and non-injured knee, and equips us with sonoelastography, to test the elastic properties of tendons and identify degenerating tissues.

We use sophisticated 3D gait analysis technology to identify sub-optimal gait mechanics that contribute to knee pain. Our high-tech motion and gait analysis lab features some of the most advanced technologies available for quantifying knee mechanics. Systems like ForceFrame and Kineo Intelligent Load provide technologies for objectively and accurately measuring knee strength and range of motion.

Our Rigorous Diagnostic Process
Involves

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Testing for functional knee movement and regional interdependence
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Evaluating biotensegrity by looking for fascial tears and fraying, and examining the integrity of fascial connections affecting the knee
3
Clinical exam for hidden nerve entrapments (pinched nerves) and exploring neural dynamics using high resolution ultrasound
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Examining muscle mechanics with dynamic ultrasound
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Manual exam to detect fascial densifications, followed by ultrasound to identify adhesions and trigger points
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3D motion analysis
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3D walking/running gait analysis
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Comprehensive imaging evaluation with high resolution ultrasound
By visualizing the knee in motion and gathering quantitative data about knee strength and gait mechanics, we are able to establish a baseline for measuring progress. Once the exact cause of knee pain is determined, the most effective treatment plan can be implemented, and patient progress can be objectively measured.
Examining muscle mechanics
with dynamic ultrasound
3D motion analysis
3D walking/running gait analysis
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Our Integrative Approach Sets Us Apart
from Conventional Knee Pain Treatment

For decades, conventional medicine has compartmentalized the human body, with specialists obtaining expertise in very narrow categories of pathology. Insurance providers reinforce this reductionist approach by only paying for therapies and procedures that directly treat the site of the patient’s complaint. However, the human body is not made up of isolated parts, but of integrated systems that work in synchronicity, and dysfunction in one system can cause pain in another.

At NYDNRehab, we treat the whole patient, not just your symptoms. We understand that knee pain can arise from a number of factors, such as:

  • Faulty gait mechanics
  • Inefficient biomechanics during sports and exercise
  • Repetitive overuse of the structures that support and stabilize the knee
  • Injuries to other structures along the lower kinetic chain
  • Densified fascia and myofascial trigger points
  • Muscle weakness, tightness, and imbalances
  • Obesity and sedentary lifestyle
  • Excessive sitting
  • Chronic systemic inflammation leading to arthritis
  • Old injuries that were never properly rehabilitated
  • Poor posture and pelvic misalignment
Our holistic treatment approach includes personalized one-on-one therapy, based on your unique patient profile. We never rely on one-size-fits-all exercises like squats and gimmicky hip/knee strengthening exercises that fail to alleviate pain. Our goal is to quickly restore functional mobility and performance using the most advanced methodologies available.

Fascia: The Missing Link in Knee Pain Treatment

One commonly overlooked component of knee pain is fascia — the tough thin network of collagenous tissue that encases and connects structures throughout the body. Muscles and fascia work together to create tensegrity – a state of tensile integrity where individual body components are held in place by continuous elastic tension. Tensegrity works to control and guide forces, facilitating muscle action during physical activity. It governs joint alignment and works together with ligaments to promote knee stability. Fascia is densely embedded with sensory nerves that send pain signals to the brain when tensegrity is compromised, and that is often the source of knee pain. Fascia can become damaged by trauma, disuse, or overuse. Its slippery and elastic properties can be affected by poor nutrition, dehydration, and toxins, making it dense and sticky. Densified fascia can form adhesions that stick to other structures, entrapping nerves and blood vessels, and preventing them from gliding. Densified fascia can interfere with muscle action, undermining its role in knee mechanics and stabilization. Fascial manipulation is a therapeutic approach that restores the slippery and elastic properties of fascia, freeing up entrapped nerves and optimizing muscle action. Dr. Kalika is certified in the Stecco method of fascial manipulation. He teams up with an injection specialist to perform fascial plane hydrodissection, a procedure that injects a neutral solution into densified fascia to liberate fascial layers and restore its gliding properties.

Why Physical Therapy Alone is Not Enough
to Resolve Knee 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 fascia 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 patient profile.

Once we pre-treat your damaged tissues and eliminate compensation patterns, your body will be ready to begin physical therapy.

Get Personalized One-on-One Therapy that Leverages
the Latest Technologies and Methodologies

Medical doctors often treat knee pain with pain medications, anti-inflammatory drugs and steroid injections, all of which provide temporary relief, but fail to eliminate the cause of knee pain. In fact, excessive use of steroids and drugs can create more serious health problems. When symptoms persist, conventional imaging modalities like MRI may be used to look for mechanical issues, but MRI is unable to visualize neurological factors that contribute to knee pain symptoms.

At NYDNRehab, we use high-resolution ultrasonography and other diagnostic technologies to precisely identify the underlying cause of knee pain.

Diagnostic ultrasonography offers multiple advantages over MRI:

  • Dynamic imaging lets us view the various tissues and structures of the knee in real time, at rest and during movement
  • Ultrasound lets us view the interactions of tissues that provide stability, tensegrity and mobility, which is impossible with MRI
  • An ultrasound transducer can trace the entire paths of long bodies like nerves, fascia, muscles and bones
  • Ultrasound helps us detect fascial plane densifications, nerve entrapments, and myofascial trigger points in deep tissues
  • We can generate dynamic images of multiple joints and regions in a single session, with no wait time for lab results
  • We can easily and quickly compare images of the left and right knees
  • High resolution ultrasound provides a tool for accurately guiding needling procedures, shockwave therapy, and manual interventions
  • Ultrasound imaging is done on-site, with minimal expense and inconvenience for the patient

We use advanced technologies to assess your knee strength, joint range of motion, and
mechanical parameters that affect knee function:

Kineo Intelligent Load System

The Kineo intelligent loading system lets us assess various performance parameters and create customized training and rehabilitation programs for our patients. The Kineo variable resistance system lets us design a personalized variable load curve based on the needs of the individual patient. Intelligent loading lets you safely rebuild strength and restore joint range of motion while protecting damaged tissues.

ForceFrame Strength Assessment System

ForceFrame lets us test individual muscle groups on both sides of the body for strength and symmetry. By testing individual muscle groups isometrically, we eliminate the potential for compensation of weak muscles that could be masked during compound exercise testing. Test results appear as objective data on a screen in real time, helping us to identify and correct muscle imbalances, asymmetrical muscle strength, inefficient muscle firing patterns, and compensation patterns developed from past injuries.

3D Motion Analysis

Our 3D motion analysis technologies enable us to precisely measure force loads, joint angles, center of mass, muscle firing patterns and more. We use your collected data to establish a baseline, then provide feedback retraining to fine-tune your movement patterns and perfect your athletic performance skills.

3D Gait Analysis

Our cutting-edge gait analysis lab pairs evaluative tools with proprietary software to assess walking and running gait in all three planes of motion. The system collects precise measurements for joint kinematics, ground reaction forces, muscle firing patterns, weight distribution and more. Our technology-backed approach gives us quantitative data that we then use to coach and retrain your gait.

ACL stability testing and training

  • 3D Star excursion Banner Test (SEBT) to assess knee joint involvement in postural stability
  • 3D kinematic joint angle analysis during squat, lunge, drop jump, and pelvic-on-hip rotation
  • Single leg squat stability test with C.A.R.E.N, our computer assisted rehab environment, using perturbation and 3D motion analysis
  • Knee joint DLEST stability test with C.A.R.E.N

Advanced Knee Treatment Options at NYDNRehab

Regenerative technologies

Regenerative therapies tap into the body’s own healing mechanisms by using electro-hydraulic, radiofrequency, electromagnetic, and sound waves to stimulate tissue repair and regeneration at the cellular level.

SoftWave Electro-Hydraulic Shockwave Therapy

SoftWave Electro-Hydraulic Shockwave Therapy

SoftWave’s defocused and linear focused shockwaves use mechanotransduction technology to recruit stem cells to the treatment site to promote healing. SoftWave is the most effective unfocused shockwave technology currently available. According to recent research, SoftWave defocused waves combined with focused and radial shockwaves have maximum regenerative potential.

Myofascial Acoustic Compression Therapy (MyACT)

MyACT focused shockwave technology allows for deeper compression of focused waves, for precise neuro modulation under ultrasound guidance. MyACT transforms the mechanical energy of shockwaves into biochemical signals that precisely target damaged tissues.

Myofascial Acoustic Compression Therapy (MyACT)
Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is a regenerative treatment for damaged tendon, muscle and bone tissue. This technology is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.

Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT transmits high energy magnetic pulses to targeted tissues that synchronize with the body’s own magnetic fields, triggering a regenerative response.

Extracorporeal Magnetic Transduction Therapy (EMTT)
Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT uses mechanical pressure waves to enhance blood circulation, improving oxygen and nutrient delivery to injured muscle and fascia tissues.

High Energy Inductive Therapy (HEIT)

HEIT delivers high-intensity magnetic pulses to peripheral nerve tissues, to stimulate neuroplasticity.

High Energy Inductive Therapy (HEIT)
INDIBA Radiofrequency Therapy

INDIBA Radiofrequency Therapy

INDIBA is a form of TECAR therapy that helps to restore the ionic charge of damaged cells, for faster injury healing and rehabilitation.

NESA Neuromodulation Therapy

NESA generates a low-frequency electrical current that soothes hypersensitized nerves and restores optimal signaling between the autonomic nervous system and the brain, to enhance motor control.

NESA Neuromodulation Therapy

Ultrasound-guided needling and orthobiologic

procedures

Platelet Rich Plasma (PRP)

PRP therapy spins a sample of the patient’s own whole blood 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, to stimulate the synthesis of new connective tissues and blood vessels.

Alpha-2-Macroglobulin (A2M)

Alpha 2 macroglobulin (A2M) is a naturally occurring blood plasma protein that acts as a carrier for numerous proteins and growth factors. As a protease inhibitor, A2M reduces inflammation in arthritic joints and helps to deactivate a variety of proteinases that contribute to cartilage degradation.

Prolotherapy

Prolotherapy uses a biologically neutral solution to irritate stubborn tissues, triggering the body’s innate healing mechanisms to grow new normal tendon, ligament and muscle fibers.

Interfascial Plane and Nerve Hydrodissection

During the hydrodissection procedure, a saline solution is injected into densified fascia under ultrasound guidance. The solution works by separating fascial layers and freeing up entrapped nerves and blood vessels. We often use hydrodissection in conjunction with manual fascial manipulation.

Ultrasound Guided Dry Needling

The dry needling procedure inserts filament-thin non-medicated needles into trigger points to evoke a twitch response, relaxing contracted fibers and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing patient discomfort.

Holistic therapeutic approaches

SM Neuromuscular Electrical Stimulation (SMNMES)

SM neuromuscular electrical stimulation (NMES) dynamically interacts with the patient during therapeutic exercises, providing real-time sensory, auditory and visual biofeedback to the patient. This breakthrough technology helps patients to recalibrate muscle actions, to optimize joint function. SMNMES has helped numerous patients to avoid unnecessary shoulder, knee and ankle surgeries, even in complex scenarios.

Ultrasound Guided Percutaneous Neuromodulation (PENS)

During PENS treatment, filament-thin needles are inserted through the skin into muscle tissue adjacent to the targeted nerve. A low frequency electrical current is then delivered via the inserted needles to stimulate the dysfunctional nerve. PENS normalizes nerve activity, improves brain plasticity and optimizes muscle recruitment patterns. This therapy is so effective that patients typically need only 4-6 treatment sessions.

Blood Flow Restriction Training

BFR makes it possible to rehabilitate injured tissues using much lighter training 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.

Myofascial Release Therapy

Myofascial release techniques help to eliminate fascial adhesions, release entrapped nerves and blood vessels, and restore the elastic and gliding properties of densified fascia.

Personalized state-of-the-art physical therapy

Physical therapy restores functional mobility after tissues have been treated, repaired and healed. We custom-design our physical therapy to meet the needs of the individual patient, from older adults who need post-surgery rehab, to elite athletes who want to return to sports at high performance levels.

Knee Arthritis

Patella-Femoral Pain Syndrome (Runner’s Knee)

Frontal Knee Pain

Patellar Tendinitis/Tendinosis (Jumper’s Knee)

Knee Bursitis

Inner Knee Pain

ACL/PCL Tears (Pre-, Post- and Non-Surgical)

Meniscus Tears

Failed Knee Surgery

Meniscus Tears (Post- and Non-Surgical)

MCL Tears (Post- and Non-Surgical)

Pes Anserine Bursitis / Tendinopathy

Medial Retinaculum Pain Syndrome

Plica Syndrome

Runners Knee

Jumper’s Knee

IT Band Syndrome

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Get the Most Advanced Knee Pain Treatment in NYC

Despite its complexity, the knee is designed to handle force loads many times a person’s body weight. The structures of the knee provide stability during rapid directional changes, and shock absorption during jumping activities. Holistic knee pain treatment helps you restore pain-free functional mobility, strength and stability after an injury.

If you are looking for the best knee pain doctor in NYC, contact NYDNRehab today, and see what a difference technology paired with expertise can make, for a lifetime of pain-free movement.

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    Range of Available Unique Physical Therapy
    Treatments at Nydnrehab

    Clinical Case Studies
    NYDNRehab

    Case Study: Resolving Runner’s Knee Pain

    Our Patient Our patient is a very athletic 49 year-old female runner and triathlete who came to us for a 3D gait analysis. She complained of posterior-lateral knee pain, along with swelling at the back of her knee, medial to the locus of pain. She described the pain as going up and down during running. […]

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    Case Study: Knee Pain Caused by Nerve Entrapment

    Our Patient Our patient was a 65 year-old male complaining of medial knee pain, with a history of low back pain. He had previously undergone a lumbar discectomy where a degenerative disc had been removed at L4-L5. He suffered from mild arthritis in both knees, and had an old medial meniscus tear. The patient had […]

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    Case Study: Runner’s Pain

    Our Patient Our patient is a 33 year-old female runner complaining of hamstring and calf tightness, and posterior knee pain in both legs. The pain began in 2015, but she continued to run. The Challenge The patient had seen numerous running physical therapists and had undergone multiple gait analyses without any results. Five years prior […]

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    Knee Specialist FAQs

    Why does my knee look normal on MRI when I am in so much pain?
    While MRI can be a useful diagnostic technology, it has multiple disadvantages compared to diagnostic ultrasonography. In particular, MRI cannot capture images of the knee in motion, and it cannot detect neurological issues that are often the source of knee pain. Many doctors are reluctant to refer knee pain patients for MRI because negative results are common.
    I have advanced knee osteoarthritis – is it possible to reverse the condition and avoid knee replacement surgery?
    Knee OA is a pro-inflammatory condition that often arises after a knee injury. It is also linked to metabolic disorders like chronic systemic inflammation and type 2 diabetes. Lifestyle modifications, weight management and physical activity can help to reverse knee OA, and regenerative therapies like shockwave therapy can h Case Study: Runner’s Painelp to halt the progression of knee OA and promote new cartilage synthesis.
    I had ACL surgery after a college football injury and now, 12 years later, my knee is giving way when I walk. Can anything be done?
    According to research, knee instability persists in up to 30 percent of athletes after ACL reconstruction surgery. After an ACL injury and surgical reconstruction, it is imperative to fully rehabilitate the knee joint and address other factors like compensation strategies developed post-surgery. Even years after an ACL injury, you can benefit from knee rehabilitation therapy that addresses knee instability.
    My doctor says I have a torn meniscus. Will that heal on its own, or will I need surgery?
    Meniscus tears are among the most common types of knee injuries, and knee meniscus surgery is one of the most frequently performed procedures, world-wide. Knee menisci are rubbery horseshoe-shaped structures that help to absorb shock, mediate force loads, and provide knee stability during physical activity. Menisci are relatively avascular structures made up of mostly cross-linked collagen, and they are slow to heal on their own. However, new regenerative technologies and orthobiologic procedures can promote and accelerate meniscus healing, with outcomes far superior to surgery.
    My knee pain has been getting progressively worse for over a year, and I'm gaining weight. Is it OK to exercise, or will that do more damage to my knee?
    While it may seem counterintuitive, exercise is actually one of the best things you can do for knee pain. Exercise helps to strengthen the structures that support and stabilize the knees, and improves knee function. However, you should also consider a gait/biomechanical analysis to identify and correct the underlying source of your knee pain.

    Certificates and Continuing Education

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      Physical therapy and rehab can be time consuming,
      and a faulty diagnosis can make treatment a total waste of time.

      Failure to accurately diagnose a condition in its early stages can lead to chronic
      problems and sometimes devastating results

      Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.

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      Below is a prime example of how ultrasound can take the guesswork out of diagnosis.

      Learn more »
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      Accurate Diagnosis Is the ONLY way to
      Successful Treatment
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      A bad physical therapy experience is one of the primary causes of unnecessary surgery

      At NYDNR, we believe in
      medical innovation

      We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.

      • С.A.R.E.N.
      • Kineo
      • Proteus shoulder arm recovery
      • Zebris
      • Manuthera 242
      • ESWT
      • Vertimax
      • Ankle Stabilizing Device
      • Blood Flow Restriction
      С.A.R.E.N. С.A.R.E.N. Kineo Kineo
      • Aplio i800
      • Vibration Platform
      • Sensa mat
      • Force Plate
      • Fascial Gun
      • ShooTools Slider
      • Redcord
      • Cryo Therapy
      • Skier's Edge
      Aplio i800 Aplio i800 Vibration Platform Vibration Platform Sensa mat Sensa mat

      Most importantly,

      we are the only facility in the US

      where structural medical diagnosis is reflected in functional treatment, and vice versa.

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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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