Knee Pain Specialist NYC

About Knee Pain

Your knees are essential to everyday movement, and knee pain can be debilitating, keeping you from doing the things you love. Because multiple structures come together at the knee joint, it can be difficult to pinpoint the exact cause of knee pain, which often leads to misdiagnosis, excessive use of pain medications and unnecessary surgeries. Accurate diagnosis is key to successful knee pain treatment.

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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. When combined with gait and motion analysis technology to visualize and objectify the functional movement of the lower extremities, ultrasound provides invaluable information that lets us accurately identify and treat the cause of knee pain.

Dr.Kalika’s motion and gait analysis lab is the only private lab in the US to feature research-grade technology, found only at top research universities and made available to patients in his private clinic. Dr.Kalika believes that what cannot be measured cannot be treated.

Dr. Kalika is a renowned lecturer on various sports medicine topics, and has been featured on the lecture circuit both in the US and abroad. His particular areas of expertise include sports medicine, diagnostic musculoskeletal ultrasonography, dry needling, virtual reality rehabilitation and technological innovations in rehabilitative medicine.

Dr.Kalika’s expertise is sought by professional athletes across the United States.

Why Knee Pain Treatment at NYDNRehab is Better than Conventional Physical Therapy

Many physical therapists take a one-size-fits-all approach to patient care, using antiquated timelines and cookie cutter exercises that fail to fully rehabilitate knee injuries and restore optimal movement.

At NYDNRehab, we take an individualized approach to every patient and every condition. Using advanced technologies, we are able to accurately diagnose and measure individual parameters for joint angles, force loads, muscle firing patterns and gait. We then design personalized treatment programs based on collected data, measuring progress along the way to ensure full recovery.

Our experience combining innovative treatment methods with advanced technologies makes NYDNRehab the number one choice for physical therapy, chiropractic care and rehabilitation in NYC. We use FDA approved methodologies to successfully treat a broad range of conditions. Our patients include elite athletes and ballet dancers who come to us for rehab and performance enhancement.

Knee Pain Treatment

Symptoms, Causes and Risk Factors of Knee Pain

Symptoms

  • Inflammation, pain and stiffness

  • Pain below, above or under the kneecap

  • Pain on or around the inner knee

  • Bruising and/or redness

  • Weakness and instability

  • Popping sounds or sensations

  • Inability to straighten the knee

Causes

  • Athletic injuries and trauma

  • Sedentary lifestyle and too much sitting

  • Overweight or obesity

  • Wear and tear from poor posture

  • Mechanical deficiencies in walking or running gait

  • Repetitive overuse from running, sports and exercise

  • Weakness and muscle imbalances in the lower kinetic chain

Risk Factors

  • Obesity

  • Sedentary lifestyle

  • Faulty biomechanics

  • Gait anomalies

  • Excessive sitting

  • High intensity sports and exercise

  • Repetitive overuse

Accurate Diagnosis Means Successful Knee Pain Treatment

The sports medicine specialists at NYDNRehab are experts in diagnostic musculoskeletal ultrasonography. Diagnostic ultrasound not only enables the doctor to identify the structural causes of knee pain, but it allows your clinician to view the knee region in real time, with the knee in motion. In addition, 3D gait analysis helps us to identify faulty movement mechanics that contribute to knee pain.

By visualizing the knee in motion and gathering quantitative data about gait mechanics, we are able to establish a baseline against which to measure progress. Once the exact cause of knee pain is determined, an effective treatment plan can be initiated and objectively measured for effectiveness.

Knee Pain Diagnosis

Knee Conditions and Injuries We Treat at NYDNRehab

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

Knee Conditions and Injuries We Treat at NYDNRehab

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

Specialized Testing for Knee Conditions

Knee pain and dysfunction cannot be effectively resolved using only subjective clinical analysis. Without objective quantifiable data, physical therapy often addresses the symptoms without resolving the underlying cause.

At NYDNRehab, our groundbreaking motion analysis technology and high resolution diagnostic ultrasonography have enabled us to develop a battery of tests that perfectly reveal the dynamic functional pathology of the knee joint.

Our Testing Protocols Include Image

Our Testing Protocols Include

  • Single leg squat stability test with C.A.R.E.N, our computer assisted rehab environment, using perturbation and 3D motion analysis

  • Knee joint stability test using DLEST methodology on C.A.R.E.N

  • KINEO Intelligent load muscle strength assessment

  • Surface EMG to test muscle activation patterns

ACL stability testing and training

  • 3D SEBT ( star excursion banner test) for assessing the involvement of the knee joint and musculature in postural stability

  • 3D gait or running analysis

  • 3D kinematic joint angle analysis during a squat, lunge, drop jump and pelvic-on-hip rotation

ACL stability testing and training
Neuromotor brain-muscle testing Rotec for:

Neuromotor brain-muscle testing with
DD Robotech for:

  • Proprioception

  • Tracking ability

  • Force sense

  • Critical power

  • Reactive power

  • Flexibility

We Use High-Tech Equipment for Optimal Results

Knee pain can range from mild to excruciating, and many turn to surgery as a first line of treatment. However, most non-traumatic knee pain can be eliminated through the non-invasive treatment methods we practice at NYDNRehab. We use the latest technologies and innovative therapies to treat knee pain at its source and eliminate it for good.

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 pain.

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.

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.

DD Robotech
DD Robotech

DD Robotech (DDR) is AI-powered robotic training equipment that provides neuromuscular and neurocognitive training for patients and athletes with pain and/or reduced mobility in the lower kinetic chain (hips, knees, ankles and feet). DDR is based on linear force impedance robotic technology.

Percutaneous Functional Neuromodulation (PFN)
Percutaneous Functional Neuromodulation (PFN)

PFN is a new methodology for pain control and muscle recruitment training to help restore quadricep strength and function. PNF works by delivering electrical signals that activate the nerve, creating a biochemical reaction at the neuromuscular junction that essentially rewires the nerve-muscle connection. PNF is also one of the best noninvasive pain management tools available for ACL physical therapy and rehabilitation.

Physical Therapy for Knee Pain
Physical Therapy for Knee Pain

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.

Ultrasound Guidance Makes Our Injection Therapies More Accurate and Effective

Ultrasound Guided Dry Needling

Ultrasound Guided Dry Needling

Trigger points are tiny knots of muscle tissue that often form near the tendon-bone junction, causing pain and weakness. Ultrasound guided dry needling accurately targets trigger points to elicit a twitch response, instantly relieving pain and tension.

Ultrasound Guided Injection Therapies

Ultrasound Guided Injection Therapies

We sometimes use injection therapies to reduce pain and inflammation, or to elicit a regenerative response in damaged cells. Corticosteroids, platelet rich plasma, hyaluronic acid and other injections may be used when deemed appropriate.

More Treatment Options

Acute Knee Pain

Acute Knee Pain

The best treatment options for acute knee pain depend on the diagnosis. Patellofemoral syndrome is the most common type of acute knee pain.

Treatment options include:

  • A combination of EPAT (Extracorporeal Pulse Activation Technology) and ESWT (extracorporeal shock wave therapy) to relieve pain and balance tension in the quadriceps muscles and the patellar retinaculum.

  • Ultrasound guided dry needling

  • EMTT (electromagnetic transduction therapy) for pain treatment and regenerative therapy

Chronic Knee Pain

  • Physical therapy is the single best choice for chronic anterior knee pain.

Chronic Knee Pain
Preventing Knee Pain and Injury

Preventing Knee Pain and Injury

The best way to avoid knee pain and injury is to remain physically active, moving your body in ways that recruit multiple muscle groups in multiple planes of motion. In addition, you should manage your weight and eat a nutrient-dense diet that provides the building blocks for lean muscle and connective tissue. Bone-based broth is a good dietary source of collagen, which plays a protective role in the knee joint.

If you are already physically active, you can benefit from a 3D gait analysis and/or a biomechanical analysis, to identify and correct any motor deficits that can potentially lead to knee injuries. Runners in particular can avoid knee pain by visiting the NYDNRehab Running Lab.

Keeping your hamstring and calf muscles flexible and strong, and your quadriceps strong and balanced will help you avoid knee pain. You should also maintain strong gluteal muscles and a strong core. Do not allow your foot to over-pronate, and maintain strong foot core muscles. It is critical to fully rehabilitate any injuries to the structures of the lower extremity or the low back, including old injuries that were not fully rehabbed.

Professional associations and memberships

Dr. Kalika is currently a certified member of:

imcg1

American Institute of Ultrasound Medicine

imcg2

Active member of ISMST

International Society of Extra Corporeal Shockwave Therapy

imcg3

Active member of GCMAS

Gait and Clinical Movement Analysis Society

imcg4

Active member of NASS

North American Spine Society

imcg5

Active member of IADMS

International Association of Dance Medicine and Science

imcg6

Active member of Virtual Rehabilitation Society

imcg7

Active member of ASRA

American Society of Regional Anesthesia and Pain Medicine

Get Personalized Knee Physical Therapy, Designed Just for You

We understand that every patient has a unique anatomy, and that each condition has unique characteristics. We tailor our one-on-one treatment plans to the individual patient, and never use cookie cutter approaches.

In addition to restoring strength and range of motion to the structures surrounding the knee, we retrain the brain-body connection, to restore optimal neuromuscular recruitment patterns that are often disrupted after an injury. By doing so, our athletes are able to return to sport safely, with reduced risk of re-injury.

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Get the Best Knee Physical Therapy in NYC

NYDNRehab is the top rated physical therapy clinic for knee pain in NYC. We accept most health insurance plans, and we are happy to set up payment plans for our patients. Schedule a consultation today, and see why the specialists at NYDNRehab are the best knee pain doctors in NYC.

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    Dr. Lev Kalika
    Dr. Lev Kalika

    Clinical director & DC RMSK

    Research at NYDNRehab

    Ultrasound evalution of medial knee pain patterns for targeted dry needling Ultrasound evalution of medial knee pain patterns for targeted dry needling

    Knee Pain Specialist FAQs

    My doctor ordered an MRI for my knee pain, but it didn’t show anything wrong with my knees. What’s going on?
    An MRI can sometimes be useful for detecting damage to the structures surrounding the knees, but structural damage is not always the cause of knee pain. Many things can cause knee pain, including inflammation, trigger points, instability in the knee joint, poor gait mechanics and more. We use real-time diagnostic ultrasound to get to the bottom of knee pain. Our joint pain specialists can help to sort out the underlying cause of knee pain, and prescribe a treatment protocol to eliminate it.
    I was diagnosed with knee osteoarthritis, and my doctor prescribed pain meds and anti-inflammatory drugs. Is there any hope of reversing my knee OA so I can get off the meds?
    Knee OA is caused by deterioration of the knee cartilage. While the condition cannot be completely reversed, it can be successfully managed by a joint pain specialist, without drugs. Our regenerative therapies can help restore some of the cartilage and bone tissue affected by OA, and physical therapy can dramatically improve mobility and reduce pain and stiffness.
    I tore my ACL in college, but it was a small tear, and surgery was not recommended. Now, 20 years later, I am having knee pain and my knee “locks out” unexpectedly. Is it too late for surgery?
    In addition to surgery being costly and risky, there is no guarantee that it will eliminate your pain and instability. The joint pain specialists at NYDNRehab have an arsenal of tools to help increase mobility and stability of your knee, and eliminate pain. Your treatment may include shockwave therapy, dry needling, gait retraining, physical therapy and other innovative therapeutic options.
    I am a marathon runner and have completed several races, but my right knee started hurting after my last race, and it’s getting worse. Will I have to quit running altogether?
    For runners, knee pain often stems from inefficient gait mechanics. At NYDNRehab, our joint pain specialists offer a 3D running gait analysis that looks at all aspects of your running technique. Unlike run-of-the-mill gait assessments that are observational, we use high-tech equipment to identify gait anomalies that are invisible to the human eye. Our 3D capabilities let us examine gait mechanics in the transverse plane, where most running injuries occur. We follow up our analysis with gait retraining that relies on quantitative data to perfect your running gait and enhance your overall running performance.
    My daughter is an NCAA basketball athlete, and the trainer says she has Jumper’s Knee. What is it, and what can be done to heal it?
    Jumper’s Knee is actually a repetitive use injury called patellar tendonitis. It affects the patellar tendon that connects your knee cap to your tibia (shin bone). The condition is common in jumping sports like basketball and volleyball. While basic first aid in the early stages consisting of rest, ice, compression and elevation is often enough to get rid of Jumper’s Knee, many athletes find it difficult to stay off the court long enough for it to fully heal. Failure to properly treat Jumper’s Knee can cause ruptures of the patellar tendon that can lead to a degenerative condition called tendinosis. The joint pain specialists at NYDNRehab use regenerative therapies to accelerate tendon healing, along with a thorough rehab program to prepare the athlete to return to sport.
    I work at a computer all day, and it’s been years since I’ve done any serious exercise. Why is my knee hurting when I’m sedentary all day long?
    Sitting for extended periods causes some muscles to become weak and lax (hip extensors), while others become overly tight (hip flexors). Over time, this fosters joint misalignment that affects your gait. Physical therapy with a joint pain specialist, coupled with gait analysis and retraining, can help rebalance your muscle tension and restore optimal joint alignment, reducing load on the knees. Staying physically active and taking short breaks from sitting throughout the day can help prevent knee and back pain.
    I gained a lot of weight during the COVID lockdowns and I want to get back in shape, but my knees hurt. Is it OK to exercise with stiff and achy knees?
    Many people are afraid to exercise with stiff and painful knees, but exercise is often the best solution for knee pain. The human body is designed to walk, so a simple walking program is a good place to start. If you have access to a swimming pool, walking laps in the pool will unload your knees while the resistance of the water strengthens them. Before beginning an exercise program, you should see a joint pain specialist to rule out any structural issues that may underlie your knee pain. You should also consider physical therapy to prepare your body for more vigorous exercise.
    The doctor says my elderly mother has a torn meniscus. Is there anything besides surgery that can help it heal?
    Meniscus tears are somewhat common in older adults who are sedentary. At NYDNRehab, our joint pain specialists use non-invasive regenerative technologies to promote meniscus healing. Physical therapy can help your mother to strengthen the structures that support the knee, to prevent future injuries and improve her mobility, for a better overall quality of life.
    What could cause knee pain in someone who is young and healthy, and gets regular exercise?
    The knee joint is a complex structure, so many things can contribute to knee pain, even in healthy people. A joint pain specialist can help you identify the underlying cause of your knee pain and provide treatment to eliminate it. At NYDNRehab, we use high resolution diagnostic ultrasound imaging to view the knee joint in real time, with the patient in motion and providing feedback. You become an active participant in your own diagnosis and treatment, rather than a passive subject.
    Is physical therapy for knee pain covered by my health insurance?
    At NYDNRehab, we accept most types of health insurance. When your insurance plan does not cover the cost of your treatment, we are happy to work with you to set up a convenient payment plan. We believe that lack of insurance coverage should not stop you from seeing a joint pain specialist when you need one.

    Lev is a renowned lecturer on various sports medicine topics, and has been featured on the lecture circuit both in the US and abroad. His particular areas of expertise include sports medicine, diagnostic musculoskeletal ultrasonography, dry needling, virtual reality rehabilitation and technological innovations in rehabilitative medicine.

    Board Certifications

    • Registered Musculoskeletal Sonographer

    • Advanced Functional Biomechanist

    Education and training

    • National University, Chicago, USA

    • Charles University, Prague, Czech Republic

    Our Specialists

    Dr. Mikhail Bernshteyn MD (Internist)
    Dr. Michael Goynatsky DPT
    Dr. Daniela Escudero DPT
    HyunJu YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
    Dr. Christina Pekar DC
    Dr. Michelle Agyakwah DC
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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)

    image

    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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