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Home Sports Medicine Runners Clinic Chronic Overuse / Regenerative Medicine

Chronic Overuse / Regenerative Medicine

June 28, 2024

Effective regenerative treatment for runners is one of the key directions in modern medicine science. Physical therapists today are developing new and modernizing the known ones ways of regenerative medicine. Among others, Extracorporeal Shockwave Therapy (ESWT) and Extracorporeal Pulse Activation Technology (EPAT) are the most approved and effective non-invasive methods for runners regenerative therapy.

ESWT/EPAT provides different voltage waves, which creates pressure in the stimulated area and accelerates the metabolism. ESWT and EPAT enhances blood supply, which regenerates and recovers the area of injury. These methods have received FDA approval and are successfully practicing at Dynamic Neuromuscular Rehabilitation clinic in NYC since 2007.

Chronic inflammations in professional runners occur previously inflamed areas and can make an influence tory compounds could be a treatment of choice in healing the inflamed area.

A doctor performs ESWT/EPAT on a patientAt DNR we have experience in using ESWT and EPAT for treating the following runners’ conditions:

  • Achilles tendonitis
  • Achillodynia
  • Bone non-unions
  • Bursitis (inflammation of a bursa)
  • Hallux limitus
  • Heel spurs
  • Painful trigger points
  • Patellar tendonitis
  • Plantar fasciitis
  • Rotator cuff tendonitis
  • Stress fractures
  • Stress reactions
  • Tibialis anterior syndrome
  • Various chronic enthesiopathies
  • Various sports injuries

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About the Author

Dr. Lev Kalika is a world-recognized expert in musculoskeletal ultrasonography, with 20+ years of clinical experience in advanced rehabilitative medicine. In addition to operating his clinical practice in Manhattan, he regularly publishes peer-reviewed research on ultrasound-guided therapies and procedures.

Dr. Kalika is an esteemed member of the International Society for Medical Shockwave Treatment ((SMST), and the only clinician in New York certified by the ISMST to perform extracorporeal shockwave therapy. He is also an active member of the American Institute of Ultrasound in Medicine (AIUM), and has developed his own unique approach to dynamic functional and fascial ultrasonography.

About Me Researches
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Physical therapy and rehab can be time consuming,
and a faulty diagnosis can make treatment a total waste of time.

Failure to accurately diagnose a condition in its early stages can lead to chronic
problems and sometimes devastating results

Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.

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Below is a prime example of how ultrasound can take the guesswork out of diagnosis.

Learn more »
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Accurate Diagnosis Is the ONLY way to
Successful Treatment
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A bad physical therapy experience is one of the primary causes of unnecessary surgery

At NYDNR, we believe in
medical innovation

We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.

  • С.A.R.E.N.
  • Kineo
  • Proteus shoulder arm recovery
  • Zebris
  • Manuthera 242
  • ESWT
  • Vertimax
  • Ankle Stabilizing Device
  • Blood Flow Restriction
С.A.R.E.N. С.A.R.E.N. Kineo Kineo
Proteus shoulder atm recovery Proteus shoulder atm recovery Zebris Zebris
Manuthera 242 Manuthera 242 ESWT ESWT
Vertimax Vertimax Ankle Stabilizing Device Ankle Stabilizing Device Blood Flow Restriction Blood Flow Restriction Training
  • Aplio i800
  • Vibration Platform
  • Sensa mat
  • Force Plate
  • Fascial Gun
  • ShooTools Slider
  • Redcord
  • Cryo Therapy
  • Skier's Edge
Aplio i800 Aplio i800 Vibration Platform Vibration Platform Sensa mat Sensa mat
Force Plate Force Plate Fascial Gun Fascial Gun ShooTools Slider ShooTools Slider
Redcord Redcord Cryo Therapy Cryo Therapy Skier's Edge Skier's Edge

Most importantly,

we are the only facility in the US

where structural medical diagnosis is reflected in functional treatment, and vice versa.

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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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