Sports Injuries Treatment in NYC


Hamstring strain in runners is one of the most common injuries that not only occur often but have a high risk of 30% for re-injury and a long recovery period. The biceps femoris(shown above)(1) is most susceptible to injury because it undergoes the most negative work in the second half of a leg swing. With men athletes being more prone to pulled hamstrings during running than woman we should analyze the risk factors that are involved, how to prevent re-injury, treatment options, effects on performance, and finally more chronic cases.


Tendonitis is probably not the most accurate term to describe this condition. The ending of the word itis implies that there is inflammation. However this is very far from the truth. There is non inflammatory swelling (thickening) and degenerative process in the tissue of the tendon. This occurs due to repetitive overuse, poor ankle stability, and poor proprioception. Sometimes this disease can be misdiagnosed as an ankle sprain.


Shin splits are typical categorized as an overuse leg injury. This is because they are usually seen in runners and athletes who increase their running or activity. It is a pain on the lower part of the leg located next to the shinbone (tibia). It is caused by stress on the shinbone and tissue that attaches the muscle to the bone. Another name for shin splints is medial tibial stress syndrome. Shin splints are very common in both new and experienced runners. They can be caused by many different factors but luckily most people experience a full recovery after the proper shin splint treatment plan.


Achilles tendinopathy, one of the most common causes of heel pain, is a degenerative condition in which the largest tendon of the body, the Achilles tendon, endures a strains from running, walking, jumping, or strenuous exercise.

While tendinopathy of the Achilles tendon affects both active and inactive individuals, it is most prevalent in athletes, research show 24% of whom will develop this condition. An estimated 50% of runners will Achilles tendinopathy pain at some point in their running career. However, it is also common among people who aren’t athletes or runners: in one study of 58 patients, nearly one-third did not engage in sport related activites.


Probably one of the most common complaints among sports men and women is the knee pain. Strenuous exercise and extra stress added on the lower extremities causes added wear and tear to the knee ligaments. The most common of the injuries to the knee is the anterior cruciate ligament injury, and can happen during both cardio and weight training exercises. Statistically, each year in the United States, well over 200 thousand people suffer an injury to the anterior cruciate ligament, with approximately half of those cases requiring knee reconstruction.



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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