Repetitive use injuries are common in athletes and physically active people. They arise over time from microtrauma to soft tissues when they are forcefully loaded again and again, without adequate time for recovery.
When overuse injuries cause chronic tendon damage (tendinopathy) or damage to the boney insertion sites of tendons and ligaments (enthesopathy) they can begin to degenerate, causing reduced performance, chronic pain, and physical dysfunction.
Prolotherapy is an evidence-based therapeutic treatment approach used to stimulate the healing of chronic soft tissue injuries and restore their functional capacity.
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The clinic at NYDNRehab features the highest resolution ultrasound equipment available for diagnosis and treatment. In addition to rendering crisp and clear images of chronic soft tissue injuries, our equipment empowers us to test tendon elasticity via elastography, and to detect early signs of tissue healing via superb microvascular imaging (SMI). The use of ultrasound guidance for our injection therapies ensures that the patient receives the most accurate treatment, with minimal discomfort.
The integrity of your body’s structures and their capacity to align and interact at optimal levels is dependent on tension generated from your muscles and fascia. Your skeleton provides a structural framework for your entire organism, but without tension produced by muscles and fascia pulling against rigid bones, you would collapse in a motionless heap.
However, tension generated by soft tissues is not enough to achieve optimal movement integrity — myofascial tension must be tuned and balanced by strong and elastic tissues that glide freely among other structures. When the capacity of muscles and fascia to stretch, contract and glide is impeded, imbalances arise that undermine movement mechanics, causing pain and dysfunction.
Tensegrity describes a state of optimal mechanical function, where joints are perfectly aligned and move freely through their functional range of motion, while at the same time being stabilized and supported by tension generated from healthy myofascial tissue. Compression is the enemy of tensegrity, preventing interdependent tissues, organs and structures from moving and gliding in harmony.
Loss of tensegrity, aka dystensegrity, is mostly mechanical in nature – the myofascial network is designed to mediate load transfer and distribute force loads among muscles, ligaments, bones and viscera during physical activity. However, unhealthy cells from poor nutrition, inadequate hydration, prescription drugs and environmental toxins can also undermine myofascial tensegrity.
Myofascial tensegrity cannot be accurately assessed via a clinical exam, or with X-ray or MRI. Only diagnostic ultrasonography can give us real-time imaging of the myofascia in motion, in real time. Ultrasound lets us detect and measure fascia densifications and adhesions that contribute to dystensegrity. Sonoelastography gives us capabilities for measuring tension within myofascial tissues.
Physical activity is essential to achieving and sustaining balanced myofascial tension, and athletes and physically active people rely on tensegrity for peak performance.
But physical training alone is not enough to achieve tensegrity.
At NYDNRehab, we treat the whole patient, not just their symptoms. When the body is in an unhealthy state, tissue healing is impeded, and physical therapy can only achieve suboptimal results. For athletic populations, addressing all the factors that undermine tensegrity is essential for injury rehabilitation and restoring peak performance.
Our holistic and personalized approach to patient care addresses the many issues that undermine tensegrity. Our high-resolution diagnostic ultrasound equipment gives us crystal-clear images of your myofascia in motion. Our regenerative technologies provide us with the tools we need to restore baseline health, so we can effectively treat your injuries, pain and dysfunction, and restore fluid pain-free movement.
Chronic soft tissue injuries are often misdiagnosed, leading to inferior treatment approaches that waste time and cost money, while the tissues continue to deteriorate. At NYDNRehab, we know that the rehabilitation of chronic injuries takes time, and we believe that time should not be wasted.
We use the highest resolution diagnostic ultrasonography to visualize your injured tissues in real time, with the patient in motion. Ultrasound lets us zero in on the damaged tissues to identify their nature, severity, and scope. It also equips us with sonoelastography to distinguish tendinopathy from tendinitis, and superb microvascular imaging, to monitor the healing process.
Dr. Kalika’s expertise as a prolotherapy specialist in NYC has helped dozens of runners, athletes, and physically active New Yorkers to fully recover from chronic soft tissue injuries and return to their favorite physical activities.
Dense tissues like ligaments and tendons that have a high collagen fiber content and low vascularity are vulnerable to chronic overuse injuries because their limited blood flow stalls the recovery process.
Runners, athletes in jumping and cutting sports, swimmers, tennis players and weight lifters all experience overuse injuries from time to time. But when an injury goes untreated for too long, damaged tissues can degenerate, losing their functional properties of elasticity and tensile strength.
Prolotherapy is performed by injecting a neutral irritant solution into damaged tissues. The harmless solution is most often salt water, sugar water, or a phenol-glycerine-glucose blend (P2G). The injected solution works by irritating the tissue, and sparking the immune system to initiate tissue repair and regeneration.
While prolotherapy is sometimes performed “blind” by delivering multiple injections to the general area of degeneration, ultrasound guidance ensures that the needle precisely hits its mark, successfully delivering the irritant while avoiding potential nerve damage.
Unlike Xray or MRI, ultrasound imaging takes place in real time. During the prolotherapy procedure, the patient becomes an active participant in their own treatment, able to provide verbal feedback and change positions as needed, to ensure spot-on results.
The accuracy of ultrasound guided needling therapies reduces the number of injections needed, and spares the patient from excessive discomfort.
Dr. Kalika is currently a certified member of:
American Institute of Ultrasound Medicine
Active member of ISMST
International Society of Extra Corporeal Shockwave Therapy
Active member of GCMAS
Gait and Clinical Movement Analysis Society
Active member of NASS
North American Spine Society
Active member of IADMS
International Association of Dance Medicine and Science
Active member of Virtual Rehabilitation Society
Active member of ASRA
American Society of Regional Anesthesia and Pain Medicine
American Academy
Association of Orthopedic Medicine
Active member of Interventional Orthobiologics Foundation
Busy New Yorkers often put off seeing a heel pain doctor until the pain begins to interfere with their lifestyle. But postponing treatment can exacerbate your injury and lead to long-term disability. You don’t need to live with heel pain when the best heel pain doctor in New York is just around the corner. Contact NYDNRehab today, and get rid of your heel pain for good, so you can get back to your active New York lifestyle.