Neuromuscular Rehabilitation in New York

Physical therapy is a way of treating injuries and conditions of the neuromuscular and musculoskeletal systems. The musculoskeletal system is the body’s network of bones, ligaments, joints, and tendons that work to achieve that movement. New York Dynamic Rehabilitation clinic (NYDNRehab), located on Manhattan’s Upper East Side, is a pioneer in specialized physical therapy, integrated physical therapy, and manual physical therapy.

Integrated physical therapy refers to a sound evaluation.

We also use manual physical therapy in the form of dynamic neuromuscular stabilization. Dr. Lev Kalika, the clinical director patterns in the brain that are in charge of motion and essentially re-trains the body in posture and movement.

We also use Computer-Assisted Rehabilitation Environment (C.A.R.E.N), a specialized physical therapy that until recently was only available in research universities and military hospitals, but is now available at NYDNRehab and a few other private locations. C.A.R.E.N is primarily used tools for accurately measuring the patient’s progress as the exercises progress.

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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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