New York Dynamic Neuromuscular Rehabilitation & Physical Therapy
The feet play a foundational role in every sport or physical activity, acting as critical stabilizers and contributing to upward and forward propulsion. Even swimmers use their feet as propellers and rudders, translating force from powerful kicks and ankle motion into forward momentum. The plantar fascia is a key structure that gives the human foot […]
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Short on time? Here’s what matters most: A network of soft-tissue connections, including the myodural bridge and the vertebral dura ligament (VDL), links the muscles and ligaments of the upper neck to the dura mater, the protective membrane around the brain and spinal cord. This adds an important layer to how we understand neck […]
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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
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