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.

Contact us »


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.


Restoring Mechanical Integrity is Key to
Performance Recovery

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.

Restoring Mechanical Integrity is Key to Performance Recovery

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.

Healthy myofascia depends on a number of factors, including:

  • Full-spectrum nutrition that provides building blocks for healthy tissues.
  • Adequate hydration – the myofascia and visceral organs require water for optimal health.
  • Hormonal balance — hormones are chemical messengers that play a crucial role in governing muscle integrity. For example, a poorly functioning thyroid can impact the tensegrity of your connective tissues.
  • Healthy gut microbiome — your gut is often referred to as your second brain, affecting the absorption of vital nutrients and impacting the function of your autonomic nervous system. An unhealthy gut may also host harmful parasites that cause a broad range of diseases, including cancers.
  • Spiritual wellbeing — all life is connected, and all living entities strive to achieve balance within their respective ecosystems, and in harmony with other beings. When you are angry, tense, anxious or stressed, you internalize pressure that manifests as physical pain and dysfunction. Internalized stress affects the cells’ capacity for intracellular and extracellular ion exchange that fosters the electrical balance of cells and enables tissue healing.
Healthy myofascia depends on a number of factors, including
How Does Prolotherapy Work?

Aging and harmful lifestyle behaviors profoundly impact tensegrity.

  • Reduced physical activity and loss of lean muscle tissue (sarcopenia) cause the metabolism to slow and systems to malfunction.
  • Reduced blood volume and diminished blood perfusion restrict the delivery of oxygen and nutrients to cells.
  • Nutrient deficiencies limit your capacity for tissue repair and regeneration.
  • Pharmaceuticals alter your body chemistry and affect tissues in myriad ways that impede tensegrity. For example, statin drugs prescribed to control cholesterol have neuromuscular adverse effects that include cramps, myalgia, weakness, immune-mediated necrotizing myopathy, and rhabdomyolysis.
  • Systemic inflammation arises from stress, poor nutrition, physical inactivity and inadequate sleep, undermining cellular function and creating metabolic disorders.
  • Environmental toxins from air, water, processed foods, household and institutional cleaning solutions, and personal grooming products wreak havoc throughout your brain and body, potentially causing cancers and neurodegenerative diseases.

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.

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


Active member of Interventional Orthobiologics Foundation

Beauty Icon

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.

    Fill the form

    We contact you during the day

    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
    Dr. Michelle Agyakwah DC
    Dr. Tatyana Kapustina L. Ac.

    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

    Buy now 3D Gait
    Payment Success
    Request Telehealth Request Telehealth Request in office visit Book now