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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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Clinical director & DC RMSK
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.
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.
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
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
Obesity
Sedentary lifestyle
Faulty biomechanics
Gait anomalies
Excessive sitting
High intensity sports and exercise
Repetitive overuse
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 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 (Post- and Non-Surgical)
MCL Tears (Post- and Non-Surgical)
Pes Anserine Bursitis / Tendinopathy
Medial Retinaculum Pain Syndrome
Plica Syndrome
IT Band Syndrome
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.
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
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
Proprioception
Tracking ability
Force sense
Critical power
Reactive power
Flexibility
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.
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.
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’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.
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 (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.
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 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 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
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.
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
Physical therapy is the single best choice for chronic anterior knee pain.
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.
Dr. Kalika is currently a certified member of:
American Institute of Ultrasound Medicine
Active member of ISMST
International Society of Extra Corporeal Shockwave Therapy
Active member of GCMAS
Gait and Clinical Movement Analysis Society
Active member of NASS
North American Spine Society
Active member of IADMS
International Association of Dance Medicine and Science
Active member of Virtual Rehabilitation Society
Active member of ASRA
American Society of Regional Anesthesia and Pain Medicine
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.
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.
Clinical director & DC RMSK
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.
Registered Musculoskeletal Sonographer
Advanced Functional Biomechanist
National University, Chicago, USA
Charles University, Prague, Czech Republic
HyunJu
YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
Dr. Christina Pekar
DC
Dr. Michelle Agyakwah
DC
Mariam Kodsy
Physical Therapist
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.
A bad physical therapy experience is one of the primary causes of unnecessary surgery
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)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
