Tendons are made up of fibrous elastic connective tissue that is continuous with muscle tissue, connecting muscles to bones. As muscles contract, tendons pull against their bony attachments at the joint, causing the bone to rotate around the joint axis to produce movement.
During physical activity, tendons are subjected to enormous force loads that sometimes cause ruptures and overuse injuries. Tendons can be slow to heal due to their limited blood supply. If left untreated, injured tendons can degenerate over time, dramatically restricting movement.
Regenerative therapies and innovative training approaches can help to accelerate tendon healing and restore optimal function.
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Clinical director & DC RMSK
Dr. Lev Kalika is an NYC tendon doctor with over 15 years of experience treating tendinopathies, using a combination of rehabilitative exercises and regenerative technologies. He has helped hundreds of patients to rehabilitate tendon injuries, restore functionality, and return to sports.
Dr. Kalika has devoted many years of study to mastering various evidence-based diagnostic and treatment methodologies. He is a recognized expert in diagnostic musculoskeletal ultrasonography, with multiple scientific papers to his credit. He has worked with some of the world’s best radiologists in the field of musculoskeletal ultrasonography.
“My success in treating tendon pain comes from a deep understanding of tendon pathologies, and from the ability to visualize each individual tendon. No two tendons are alike in their anatomy, biomechanics and function. Most tendons are superficial structures, and are much better visualized by high resolution ultrasonography than by Xray or MRI. A distinct advantage of diagnostic ultrasonography over MRI is the ability to visualize muscles and tendons in motion.”
The high-resolution diagnostic ultrasound equipment at NYDNRehab has capabilities for sonoelastography to test for tendon stiffness, and superior microvascular imaging (SMI) to assess inflammation and detect vascular neogenesis. These two features give us an enormous advantage when diagnosing and treating tendons, giving our patients the very best results.
NYDNRehab is the clinic of choice for elite athletes suffering from tendon pain and injuries. Our innovative treatment methods and advanced technologies set our clinic apart as a world-class rehabilitation facility for athletes and non-athletes alike who want fast and effective tendon rehab. Our methodologies and technologies ensure that our patients get total and effective healing, to restore optimal performance and return to sports.
We use the most advanced technologies for thorough and accurate diagnosis. Our clinic features the highest resolution diagnostic ultrasound equipment, with capabilities for dynamic imaging during sports performance. Our advanced assessment technologies let us quantify and analyze collected data to establish a baseline and track progress.
Our personalized rehab protocols are customized to meet the unique needs of the individual patient. Whether your goal is to return to the playing field or to simply get back to normal life, NYDNRehab is the best tendon rehabilitation clinic in NYC.
NYDNRehab features research-grade ultrasound equipment with the highest resolution available in New York City. Our equipment also has capabilities for sonoelastography and superb microvascular imaging (SMI), the latest advances in tendon imaging, and not possible with other radiological modalities. We are among the first sports medicine clinics to feature dynamic ultrasonography using the USONO ProbeFix device.
ProbeFix attaches directly to the athlete, allowing us to visualize damaged tissues during sport-specific actions. ProbeFix renders accurate real-time images of the body’s structures in motion, and can even be synced with motion capture cameras to produce 3D images of muscles, fascia, bones and joints during physical activity. This game-changing technology gives us a huge advantage for diagnosing tendon injuries and restoring optimal biomechanics during sports activities.
NYDNRehab is the only clinic in New York with a fully equipped motion and gait analysis laboratory. Our motion and gait analysis technology and proprietary software lets us measure and quantify muscle and tendon function in real time.
At NYDNRehab, we are dedicated to rehabilitating your injury, not just treating your symptoms. To accurately diagnose and treat your tendinopathy, we conduct a comprehensive evaluation consisting of:For sport-specific injuries, we use the latest technologies to analyze movement mechanics and identify motor deficiencies. By eliminating movement and training errors, patients and athletes are able to dramatically improve their performance while reducing their risk of injury.
Our state-of-the-art running analysis lab enables us to identify biomechanical and neuromuscular deficiencies that are invisible to the naked eye, and to distinguish between injuries and compensation strategies.
Data from gait analysis equips us to design effective treatment strategies that address the source of tendinopathy, retraining the athlete to run more efficiently, prolong their running career, and prevent future injuries.
Real-time force plate analysis enables the athlete to see where their mechanical deficiencies lie, so they can focus on correcting them. The therapist analyzes the data to create a rehab training protocol, to strengthen weak muscles, improve motor coordination and refine the athlete’s jumping technique.
The clinic at NYDNRehab features an impressive array of technologies and therapies to treat tendinopathies. Our personalized approach lets us customize your treatment plan to ensure your tendon tissues are fully rehabilitated.
As part of your progressive tendon rehabilitation, we correct mechanical deficiencies and restore coordinated messaging between your brain and muscles. Our end goal is to restore functional levels of pre-injury performance.
Conventional treatment for tendinopathy focuses on rest and stretching exercises, but current research indicates that tendons heal and regain function more quickly when treated with progressive weight loading therapy. For athletes looking to return to sport, load management using advanced technologies is a true game changer.
The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.
Focused ESWT is used as a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for chronic degenerative tendon disorders and myofascial pain syndrome.
EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.
Extracorporeal Pulse Activation Technology (EPAT)
EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.
HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.
Extracorporeal Pulse Activation Technology (EPAT)
Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.
PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.
Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.
Most tendon injuries result from repetitive overuse, from sports, exercise or occupation. Failure to allow time for full recovery post-exercise can increase your risk of tendon injuries. Tendons may also sustain damage from acute trauma.
If you have chronic pain that never goes away or has gotten worse, it’s a good idea to see a tendon specialist. Failure to treat a ruptured tendon could result in degeneration of the tendon tissue that reduces performance and causes undesirable compensation patterns.
Tendon injuries that were never properly rehabilitated can cause additional problems anywhere along the kinetic chain. Regenerative therapies have the potential to stimulate tissue healing, even when the injury is several years old.
At NYDNRehab, we use the most advanced, highest resolution ultrasound imaging available. Ultrasound lets us visualize the tendon in real time, with the patient in motion. Compared to Xray or MRI, ultrasound gives us crystal clear images that help us locate and identify the exact site of tendon injury.
At NYDNRehab, we have a broad range of methodologies for tendon injury treatment. Your protocol may include eccentric loading, blood flow restriction training, ultrasound guided dry needling, regenerative injection therapies, shock wave therapy, neuromotor feedback training, and more.
Prior to getting back on the playing field, you should make sure your tendon is completely healed. At NYDNRehab, we work with our athletes to ensure the tendon is completely rehabilitated. We also address compensation patterns developed as a result of your injury, and reestablish optimal muscle firing patterns to reduce your risk of re-injury.
When a tendon tears away from the bone, it must be surgically re-attached, followed by intensive physical therapy to restore its mechanical properties and strength. The clinic at NYDNRehab features some of the most advanced technologies available for rehabilitating tendon injuries.
Absence of pain is not always an indicator that the tendon is functioning properly. If the pain returns once you cool down, it may indicate more serious damage. Running on a ruptured tendon can make it worse. Best to see a specialist.
While tendons are extensions of muscles, their tissues become increasingly collagenous as they approach the bone. The denser tissue has lower vascularity, meaning the supply of blood and nutrients is diminished. Regenerative therapy can help increase circulation in the tendon and jump-start the healing process.
We use high-resolution ultrasound technology to assess your progress, with the help of superb microvascular imaging (SMI) and sonoelastography. SMI lets us detect the faintest activity in micro vessels , which indicates that healing is taking place. Sonoeslastography lets us test the elastic properties of your tendon, to confirm improved function.