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New York Dynamic Neuromuscular Rehabilitation & Physical Therapy

Assessment and Diagnosis of Plantar Fasciopathy in Runners

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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November 13, 2017

The Case Against Valsalva Pushing in the Second Stage of Labor

Natural childbirth is as old as time itself…if it weren’t, none of us would be here! For most of human history, childbirth has been the purview of women, mostly midwives and female relatives, who assisted a laboring mother as she did what comes naturally. However, shortly after World War II, that all changed as modern […]

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November 13, 2017

Diagnosis and Treatment of Plantar Fasciitis Heel Pain

If you are a working person who is used to persisting foot aches. Connecting the toes and the heel, plantar fascia lets you jump up and walk staircases, absorbing impact forces and shock along the way. Plantar Fascia Inflammation. Reasons Repetitive use, overuse, continuous misco injuries caused to complications. Other things that will promote PF […]

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October 29, 2017

What Causes Non-Specific Low Back Pain and How is It Diagnosed?

  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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October 27, 2017

What to Do About Chronic Elbow Pain

For all its complexity, your elbow is a fairly rugged joint that can withstand high repetitive force loads. Nevertheless, overuse from sports like tennis or golf, repetitive occupational use, or carrying heavy loads with an extended elbow can all lead to debilitating chronic pain that is difficult to get rid of. When you are experiencing […]

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October 25, 2017

Steroid Treatment for Tendon Pain: Help or Hindrance in Rehab?

Tendinopathy is a condition common to overburdening of a tendon. When an athlete or other patient seeks traditional medical attention for tendon pain, the first line of treatment is often corticosteroid injections (CSI) to reduce inflammation and ease discomfort. Oftentimes, steroid injections are given in conjunction with physical therapy, to help the patient withstand the […]

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October 19, 2017

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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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