Looking for a Prolotherapy Specialist in NYC?

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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Top-Rated Prolotherapy Specialists in Manhattan

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.

Accurate Diagnosis Means Superior Results

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.

Accurate Diagnosis Means Superior Results
How Does Prolotherapy Work?

How Does Prolotherapy Work?

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.

Ultrasound Guidance is a Game-Changer

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.

Ultrasound Guidance is a Game-Changer

Professional associations and memberships

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

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Why Patients Trust NYDNRehab for Heel
Pain in NYC

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.

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    Dr. Lev Kalika
    Dr. Lev Kalika

    Clinical director & DC RMSK

    Our Specialists

    Dr. Mikhail Bernshteyn MD (Internist)
    Dr. Michael Goynatsky DPT
    Dr. Daniela Escudero DPT
    HyunJu YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
    Dr. Christina Pekar DC
    Dr. Michelle Agyakwah DC

    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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