FASCIA MANIPULATION THERAPY

ABOUT FASCIA PAIN TREATMENT

The fascia is a thin tough network of connective tissue that encases the muscles and internal organs throughout your body, enabling soft tissues, bones and neural bodies to glide freely during movement. Fascia tissue is made up of multiple collagenous layers, lubricated by a liquid called hyaluronan, enabling it to stretch and glide as you move. Fascia is highly innervated, making it almost as sensitive as your skin.

Healthy fascia is slippery, smooth and flexible, but under certain conditions, hyaluronan can dry up, and fascia can thicken and become sticky. Unhealthy fascia can adhere to other structures, inhibiting movement and impeding muscle function. Thanks to a wellspring of new fascia research, we now know that fascia is one of the most significant pain generators in the human body, 5X greater than that of muscle tissue.

Fascia manipulation therapy helps to free up fascia tissue and restore its capacity for pain-free gliding among the body’s structures and organs. New technological innovations are game-changers for fascia pain treatment.

Dr. Lev Kalika

Clinical director & DC RMSK

About Fascia Specialist Dr. Lev Kalika

Dr.Kalika is one of the few practitioners to combine Stecco diagnostic methodology with high resolution ultrasonography, to get an accurate picture of fascia dysfunction. Over time, Dr. Kalika has refined his skills in visualizing key coordination points of fascia adhesions and tissue thickening.

As an expert in diagnostic ultrasonography, Dr. Kalika is able to accurately identify nerve entrapments, and to resolve fascia-nerve interference syndromes, which research has revealed to be one of the most common causes of musculoskeletal pain.

To restore the integrity of fascia and its capacity to glide, Dr. Kalika uses a combination of ultrasound guided injection therapy – prolotherapy or platelet rich plasma (PRP) – along with various types of shock waves and ultrasound guided fascia hydro manipulation.

Dr. Kalika has achieved positive results with some of the most difficult, chronic and resistive cases of fascia dysfunction, where other interventions, therapies and surgeries have failed.

Dr.Kalika is one of the few practitioners who combines Stecco diagnostic methodology with high resolution ultrasonography, to get an accurate picture of fascia dysfunction. To restore the integrity of fascia and its capacity to glide, Dr. Kalika uses a combination of ultrasound guided injection therapy and ultrasound guided fascia hydro manipulation.

Dr.Kalika has completed all levels of Stecco Fascial Manipulation since 2021-2024

Why NYDNRehab is the Clinic of Choice
for Fascia Pain Treatment

The vital role played by fascia in the integration of the various structures of the musculoskeletal system is one of the greatest discoveries of the 21st Century. Fascia research has become one of the hottest topics in musculoskeletal science, providing evidence-based information that connects the dots of previously poorly understood phenomena.

At least 50% of pain and reduced mobility is due to erosion of fascia integrity, including loss of elasticity, and tears in different types of fascia. Many practitioners mistakenly assume that pain and restricted movement are due to fascial adhesions, and treat patients accordingly. But in many cases, releasing fascia prior to restoring tissue integrity can make things worse instead of better. To restore fascia’s integrity, stability and capacity for force transfer, we need to tighten the fascia and reestablish its elastic properties.

Patients choose NYDNRehab for fascia therapy over other clinics for multiple reasons:

Personalized care

We treat the individual patient, not just their symptoms. Our personalized approach ensures you get results, based on your unique profile.

Holistic treatment approach

Your body's structures are interactive and interdependent, designed to work in harmony. Isolating one area to the neglect of the whole body is a mistake that can lead to more pain and dysfunction down the road.

Patient education

Transparency and respect make you a stakeholder in your own healing journey. We keep you in the loop during our therapies and procedures, giving you valuable insights and tools for managing your health over the long term.

Symptoms and Causes
of Fascia Pain

Symptoms

Generalized achy-ness that feels like muscle pain
Feelings of muscle stiffness
Reduced and restricted mobility

Causes

Lack of physical activity
Overuse from sports, exercise or occupation
Poor nutrition and inadequate hydration

Fascia Degeneration

If left untreated, densified or damaged fascia can begin to degenerate.
Causes of fascial degeneration:

Mechanical

Acute: sprain, fractures, direct trauma
Chronic: excessive use, posture, work, sports

Physical

Temperature: heat, cold, wind, humidity
Mental strain: anguish, conflict, depression

Chemical

Nutrition: overnutrition, unbalance, addiction
Endocrine: hormones

Infection

Metabolism

Immobilization

Development of abnormal small networks
Alteration of collagen turnover mechanics (synthesis and degradation)
Cleavage of new collagen fibers
Change in quantity and quality of amorphous substance due to reduced water and glycosaminoglycans (GAGs)

Diagnostic Ultrasound of Fascia Reveals True Source of Muscle Pain

Many practitioners base their diagnosis of fascia pain on patient feedback during manipulation. However, this approach has limitations that can lead to inappropriate treatment.

At NYDNRehab, we combine Stecco manual fascia diagnostics with high resolution ultrasonography and sonoelastography. Ultrasound imaging allows us to view the fascia in motion, in real time. Sonoelastography enables us to identify fascia tissue that has thickened and lost its elastic properties.

With these two methods, we are able to quantify fascia tissue stiffness, and trace its connections and insertions. Our high-resolution equipment gives us crystal clear images that let us differentiate thickened fascia from other conditions like fibrosis, and to assess the ability of fascia to stretch and glide.

Stecco Fascial Manipulation for Musculoskeletal Pain

Luigi Stecco, an Italian physical therapist, was a pioneer in identifying fascia dysfunction as a key underlying cause of musculoskeletal pain and disability. Based on his research, Stecco developed a methodology for fascia manipulation therapy.

The Stecco method of fascial manipulation aims to reverse fascia density and undo damage that causes pain and reduced mobility. The technique involves deep friction that heats up tissue and stimulates mechanical action, releasing the fascia layers and making them more fluid.

More About Pelvic Fascial Manipulation

The superficial fascia of the pelvic floor is a thin fibrous layer of connective tissue embedded with adipocytes – specialized fat cells – along with a complex network of lymphatic and blood vessels. The pelvic fascia plays an important role in exteroception – sensory awareness of stimuli outside the body.

Fascia tissue has a high percentage of elastic fibers and a slippery coating of hyaluronan that facilitates the gliding of nerves and blood vessels. The pelvic fascia works together with the transversus abdominis, diaphragm and pelvic floor muscles to optimize abdominal pressure, providing spinal stability. Its autonomic innervation makes the pelvic fascia sensitive to stress and changes in temperature, and it is intricately connected to the genitalia.

Pelvic fascia manipulation is often the missing link in pelvic pain treatment. Pelvic pain is mostly generated from hyperactive nerves embedded in the deep fascia of the pelvis. These include peripheral nerves like the pudendal, gluteal and cluneal nerves that glide between the pelvic floor muscles and can be released from entrapment by manipulation of the endomysium and perimysium.

Other sensory nerves and their endings inhabit the superficial fascia, such as the ilioinguinal, iliohypogastric and genitofemoral nerves. When your parasympathetic nerves are entrapped in the superficial fascia they become hyperactivated, generating pelvic pain.

The intimate connection between the deep and superficial fascia layers has been largely overlooked in conventional treatment of pelvic pain. Most doctors and therapists focus on injections to block the pudendal nerve, and on manual release of trigger points.

According to evidence-based research, pelvic fascia manipulation therapy not only releases densified layers of superficial and deep fascia, but also calms hyperactivated nerves. Other therapies, such as ultrasound-guided electro acupuncture, are often used in conjunction with fascial manipulation for the neuromodulation of hyperactive pelvic nerves.

New Technologies are Game-Changers for Fascia Pain Treatment

In addition to Stecco fascia manipulation therapy, we use focused and radial extracorporeal shockwave therapy (ESWT), along with Tecar therapy using INDIBA radio frequency technology to treat multiple physical and biological properties of fascia.

When dealing with tears or ruptures in the plantar fascia of the foot, technological interventions for fascia tear treatment can dramatically speed up the healing process, shaving weeks off your recovery time. Modern technology enhances the process of collagen remodeling and the restoration of hyaluronan fluid, making treatment much faster and more effective. In cases of fascial adhesions, we often use ultrasound guided hydrodissection, along with ultrasound guided dry needling.

Focused Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT)

Focused ESWT 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.

Tecar Therapy

The INDIBA CT9 device converts electrical current into a stable frequency of 448 kHz, designed to increase the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing.

INDIBA RADIOFREQUENCY THERAPY

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to fascia pain syndrome. Dry needling is an outpatient procedure where non-medicated needles are inserted into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Ultrasound Guided Hydrodissection

Hydrodissection is a technique for treating peripheral nerve entrapment. It uses a saline solution to separate an entrapped nerve from surrounding fascia adhesions or adjacent structures.

Get the Best Fascia Pain Treatment in NYC

Fascia pain is often misdiagnosed as muscle pain, and mistreatment can prolong your pain and disability without resolving the problem. At NYDNRehab, we use the highest resolution diagnostic ultrasonography to visualize your fascia in motion, in real time.

Once we identify the site and scope of fascia tissue dysfunction, we are able to begin procedures for restoring tissue integrity, and to perform fascia manipulation therapy using the most advanced methodologies and technologies available.

Our clinic is one of the few in the United States with the equipment and technology to provide accurate diagnosis and comprehensive fascia pain treatment. For fast and effective relief of musculoskeletal pain, contact NYDNRehab today.

Clinical Case Studies
NYDNRehab

Case Study: Postpartum Back Pain

Our Patient Our 41 year-old female patient complained of moderate to severe low back pain. She had gone through five pregnancies – two vaginal and three by C-section. Her back pain commenced about 3 months after abdominoplasty (“tummy tuck”) surgery to correct a 6 cm diastasis recti. The surgery took place 7 months prior to […]

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Case Study: Occupational Hip and Low Back Pain

Our Patient Our patient was a 55 year-old male employee of the Metropolitan Transportation Authority (MTA). The patient’s job required heavy manual labor. He came to us complaining of hip and low back pain. The Challenge The patient’s job did not allow ample recovery time for standard physical therapy and injury rehabilitation to provide significant […]

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Case Study: Patient with Facial Pain and Complex Neurological Dysfunction Successfully Treated with Alternative Therapies

Our Patient Our patient, a 28 year-old male, had been suffering for over two years with unexplained facial and upper body pain. He had seen two separate neurologists and undergone MRIs of his brain and cervical spine, with no concrete diagnosis. The patient’s symptoms included: Pains in the face, anterior neck, chest and rib cage […]

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FASCIA MANIPULATION THERAPY

ABOUT FASCIA PAIN TREATMENT

About Fascia Specialist Dr. Lev Kalika

Why NYDNRehab is the Clinic of Choice
for Fascia Pain Treatment

Patients choose NYDNRehab for fascia therapy over other clinics for multiple reasons: