Sports Medicine Doctor NYC

Introduction

Given the rise in amateur sports participation in the last few decades and the increasingly active lifestyles of many Americans, it’s no surprise that neuromuscular and orthopedic disorders are the most commonly reported health complaints in the country today.

The neuromuscular system is a bodily system created by the cooperation of the nerves and muscles as they work together to enable movement; the musculoskeletal system (or locomotor system) is the body’s system of bones, muscles, and associated tissues. The increase in complaints has led to a surge in the use of physical therapy, which seeks to rehabilitate the body by repairing the neuromuscular and musculoskeletal systems. New York Dynamic Rehabilitation Clinic, led by Dr. Lev Kalika, is a center for orthopedic and sports physical therapy located in Manhattan that specializes in the treatment of musculoskeletal disorders and back-to-sports physical therapy.

Dr. Kalika has been fiercely passionate about the science of body mechanics since his student days in Odessa in the 1980s. When he realized the scarcity of materials on the subject in his hometown, he taught himself English so that he could better understand human body motion, the Central Nervous System (CNS), and the interactions of the various muscle groups with the rest of the body. Later, when he was studying in Prague, he taught himself the Czech language as he studied under renowned professor Karel Lewit, MD and Professor Vladimir Janda, a pioneer in musculoskeletal rehabilitation, and met Professor Pavel Kolar, the founder of the dynamic neuromuscular stabilization (DNS) method of treatment. On seeing the efficacy of DNS to treating problems of the locomotor system, Dr. Kalikadetermined to bring this method of sports physical therapy to New York.

Dr. Kalikamaintains that proper treatment begins with right diagnosis. Here in our sports performance physical therapy clinic we ensure accurate diagnosis by conducting a number of different tests in combination with a comprehensive clinical examination.

One such test is technological gait analysis, a method of evaluating the patient’s biomechanical movement profile by observing and measuring his or her movement. As the patient walks in place along a specialized walkway, markers on the body, in conjunction with force plates on the floor below, monitor and record motion using a multi-camera motion-capture system. This information is sent to a nearby computer, which immediately processes and analyzes the data, ultimately producing a video report. In the end, the patient and physician are made aware of any movement dysfunction. The examination will also reveal the time estimated for complete recovery. In addition, the physician will explain mistakes made in training that may be having an impact on the patient’s running, correct wrong ideas about running, and show, based on the patient’s individual makeup, how he or she should be running.

The goals of technological gait analysis are to (a) identify the causes of pain; (b) figure out the best plan for recovery given the nature of the injury and the patient’s individual needs; and (c) accelerate rehabilitation. If all these things are accomplished, it will have the effect of eliminating deficiencies, strengthening the patient, and maximizing performance in a timely fashion. NYDNRehab has made gait analysis a vital element of sports and orthopedic physical therapy,Together gait analysis and ultrasound technology can provide clear pictures of the inner organs. Ultrasound may present a clear plan for treatment by giving sharp images of internal organs with the assistance of high-frequency sound waves.

treating amateurs and professionals of all ages, from athletes with balance and instability problems to recreational sports players and non-athletes with knee, foot, ankle, and other musculoskeletal conditions.

In some cases gait analysis may be used in conjunction with musculoskeletal ultrasound technology to provide a clearer picture of the inner body. While gait analysis is beneficial in understanding function and dysfunction in the various parts of the body, diagnostic ultrasound may be useful in establishing a clear plan for treatment. This it does by providing sharp images of the internal organs with the assistance of high-frequency sound waves to isolate the roots of pain and swelling. By providing real-time images of what’s going on inside the body, diagnostic ultrasound provides physicians a safe and accurate blueprint to the best form of treatment for the individual patient.

After the patient’s gait has been analyzed and aberrations isolated by our sports physical therapy and rehab specialists, several different approaches may be recommended depending on the needs of the patient. One approach is DNS, which Dr. Kalikastudied extensively while living in Europe and brought back to the United States. During his years of study he was certified in DNS and Vojta therapy. Both are manual physical therapy methods involving the stimulation of the motor control system in the brain to retrain a patient in right posture and movement. NYDNRehab was the first clinic on the East Coast to provide DNS. However, as the treatment has caught on in other parts of the U. S., it has begun to transform the practice of physical therapy in sports medicine.

Other methods of sports physical therapy used at our outpatient clinic include chiropractic medicine and, most importantly, Computer Assisted Rehabilitation Environment (C.A.R.E.N). After moving to America in the mid-1990s, Dr. Kalika developed a mysterious chest condition that baffled his physicians and showed no signs of improving until he visited a chiropractor. It was through this experience that he realized the extraordinary potential of chiropractic methods, which address the causes of pain at their roots. While doing his postgraduate studies in chiropractic medicine, Dr. Kalikadiscovered that there were few studies on the role of the nervous system in American medicine. He sought to correct this imbalance by combining treatment of the nervous system with chiropractic methods in sports rehabilitation and physical therapy.

Acquired by the clinic in 2011, C.A.R.E.N is a recently developed technology that makes re-training in symmetry and weight-bearing enjoyable, even effortless. The patient is placed in a harness on a platform in front of a large screen. The screen presents a virtual-reality situation which the patient must navigate. While the patient is participating in these immersive, Matrix-like simulation games, C.A.R.E.N is taking advantage of the brain’s neuroplasticity to transfer skills in an unusually fast and direct way. While conventional running physical therapy can only instill strength and endurance, C.A.R.E.N instills these and much more: an improved sense of balance, symmetrical weight-bearing, and awareness of limb position. Additionally, it trains the runner by challenging his or her muscles in all plains of motion. NYDNRehab is currently the only outpatient clinic in New York City to offer a C.A.R.E.N lab. Between this and the other treatments and technologies offered, it has become one of the leading physical therapy clinics in New York.

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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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