New York Dynamic Neuromuscular Rehabilitation & Physical Therapy
Groin pain is a common complaint in athletes, especially in sports like hockey, soccer and football that involve pivoting, twisting and rapid directional changes. Chronic groin pain can interfere with performance, and can take an athlete out of the game for extended periods of time. In some cases it may become a career-ending injury. Treating […]
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Runners’ feet take a pounding, and over time the plantar fascia and its associated structures may become damaged with microtears, bone spurs or stress fractures. Correct diagnosis and treatment are key to full performance recovery. In its early stages, plantar fasciopathy usually presents as heel pain. Careful assessment will distinguish plantar fasciopathy from other causes […]
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Chronic low back pain (LBP) can range from a mild annoyance tor and keeps them home from work. However, low back pain is a symptom, not a disease, and it may have many causes. While some low back pain may have a detectable cause such as a herniated disc or stenosis, the most common […]
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The shoulder is a complex joint, with multiple structures surrounding the joint and governing movement. Because of the complexity of the shoulder region, diagnosis of the source of shoulder pain is challenging. Here is what we know:
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Muscle pain is a highly common affliction, especially if you are physically active. In fact, muscle pain may become such an integral part of your active lifestyle that you simply ignore it, brushing it off as a natural consequence of staying in shape. However, chronic and debilitating muscle pain is not normal, nor should it […]
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Your rotator cuff is the group of four muscles that cause your should joint to rotate internally (toward your trunk) and externally (away from your trunk). When the rotator cuff muscles and other muscles associated with them get out of balance, either from under- over- or misuse, they begin to cause pain in your shoulder […]
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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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