About Functional Podiatry
Functional podiatry is an integrative approach to foot health that does not involve drugs, steroid injections or surgery. Your feet provide a foundation for all movement, and foot pain can be debilitating. But treating the symptoms of foot pain with pain medications and orthotics without identifying other causal factors is unlikely to provide long-term relief.
Foot pain can arise from multiple factors, including:
Holistic integrative podiatry recognizes that foot pain often originates from mechanical issues further along the kinetic chain, often involving knees, hips, postural habits, and inefficient gait strategies that affect the way your feet mediate force loads. The goal of functional podiatry is to eliminate foot pain by addressing all contributing factors and restoring functional movement.
Clinical director & DC RMSK
Verified Expert Profiles
Dr. Lev Kalika is a chiropractor specializing in foot and ankle conditions, an internationally recognized musculoskeletal ultrasound specialist, and an advanced gait and biomechanics expert with more than 20 years of experience diagnosing and treating complex foot, ankle, and lower kinetic chain conditions.
Dr. Kalika has spent decades studying the biomechanics of the foot, ankle, knee, hip, pelvis, and spine, with a particular focus on how abnormal movement, instability, tendon overload, nerve irritation, and fascial restrictions contribute to chronic foot and ankle pain. He is widely known for his expertise in high-resolution diagnostic ultrasound and dynamic ultrasound, which allow him to evaluate the foot and ankle in real time during movement, loading, and stress testing.
Dr. Kalika has authored scientific publications and is frequently invited to lecture at national and international musculoskeletal conferences. His clinical approach combines advanced diagnostics with individualized rehabilitation and, when appropriate, regenerative medicine.
At NYDNRehab, every foot and ankle case is evaluated in the context of the entire lower kinetic chain. This allows the team to identify not only the painful structure, but also the biomechanical reason the tissue became overloaded in the first place.
Advanced diagnostic tools include:
Treatment focuses on restoring holistic foot function, improving load transfer, reducing tissue overload, and correcting the movement patterns that contribute to pain. NYDNRehab combines sophisticated foot and ankle rehabilitation with advanced regenerative and orthobiologic treatment options.
Dr. Kalika has used diagnostic ultrasound for more than two decades to accurately diagnose and guide treatment for thousands of patients with a broad range of foot and ankle conditions, including:
Orthobiologic specialist
For patients who may benefit from regenerative injection therapy, Dr. Kalika works in close collaboration with Dr. Yuri Brosgol, MD, an experienced orthobiologic and regenerative medicine specialist. This collaboration allows NYDNRehab to combine Dr. Kalika’s advanced diagnostic ultrasound, dynamic biomechanical evaluation, and rehabilitation expertise with Dr. Brosgol’s medical expertise in image-guided regenerative injection procedures. Together, they design individualized treatment plans aimed at improving tissue healing, reducing pain, restoring stability, and helping patients return to physical therapy when pain or tissue failure has made rehabilitation difficult or impossible. Regenerative procedures may be considered for ligament injuries, tendon degeneration, chronic instability, joint irritation, arthritis-related pain, fascial restrictions, and selected nerve or soft-tissue entrapment conditions. Available orthobiologic and regenerative treatment options may include:
The goal is not simply to inject the painful area, but to identify the failed tissue, understand the biomechanical cause of overload, and combine regenerative treatment with precise rehabilitation to improve long-term function. I would avoid phrases like “damaged tissues heal without surgery” as an absolute claim. A stronger and safer wording is: “support tissue repair, reduce pain, improve stability, and help patients participate more effectively in rehabilitation.”
Mainstream podiatrists rely on XRay and MRI to diagnose foot conditions, but those modalities do not provide much insight into foot mechanics, nerve entrapment and other issues that are most often the cause of foot pain. Patients are frequently underdiagnosed or misdiagnosed, and treated with generic protocols that do not relieve their foot pain.
At NYDNRehab, we use high resolution diagnostic ultrasonography to explore the interdependent structures that impact foot function, including bones, muscles, connective tissues, and nerves. Dynamic ultrasound imaging lets us compare the injured foot with its non-injured counterpart, to confirm our findings.
A 3D gait analysis enables us to measure gait in the transverse plane, where most gait injuries occur, and gives us objective data on joint angles, weight distribution, muscle firing patterns and other metrics that influence gait efficiency. We also conduct a biomechanical analysis of your foot and lower kinetic chain to observe how various structures interact.
We use the collected data to establish a baseline, set goals, and monitor the effectiveness of your treatment plan, to ensure that progress is being made and healing is taking place.
Patients often come to NYDNRehab after multiple failed attempts by mainstream doctors to resolve their foot and ankle pain.
In many failed cases, Dr. Kalika has found that:
Medical doctors are often stymied by musculoskeletal pain and dysfunction because their training does not encompass biomechanical analysis or rehabilitative solutions. Instead, they default to prescription medications, steroid injections and orthotic devices. Those solutions may temporarily alleviate pain, but they cannot restore mechanical function. When all else fails, doctors often recommend foot surgery, which has a poor track record of success.
Holistic podiatry not only examines the locus of pain, but also explores other interdependent structures that impact foot function. In many cases, foot pain originates from mechanical dysfunction farther along the kinetic chain, and faulty gait mechanics are often to blame for foot pain. When viewed through an integrative lens, your foot pain can only be resolved when all contributing factors are identified and addressed.
At NYDNRehab, we always begin with a conservative approach to plantar fasciitis treatment, but the secret to our success is precision. We have a 100% track record of success in treating plantar fasciitis, thanks to the combination of extracorporeal shockwave therapy (ESWT) and ultrasound guided dry needling (USDN).
A recent research publication in Nature cites Dr. Kalika’s own research, highlighting USDN as a top-tier evidence-based solution for plantar fasciopathy, and ranking it alongside ESWT and PRP as a primary intervention. To quote the article:
“Current therapeutic approaches for plantar fasciopathy include targeted mechanotherapy, optimized ESWT protocols, ultrasound-guided delivery of orthobiologics (e.g. leukocyte-rich PRP), and precision physical therapies. Furthermore, studies demonstrate the diagnostic and therapeutic value of ultrasound elastography and US-guided interventions for pain modulation. Ultrasound-guided dry needling of myofascial trigger points has been established as a primary intervention option for plantar fasciopathy.”
For patients, our multimodal approach to plantar fasciitis means quick pain relief, fast recovery, and longer-lasting outcomes. In our experience, combining modalities with precision guidance creates the best results.
Prior to beginning restorative therapy, it is important to pre-treat the affected tissues, to eliminate factors that contribute to pain and inhibit movement. Pre-treatment serves to reduce pain and inflammation, and restore functional range of motion.
Regenerative technologies like extracorporeal shockwave therapy (ESWT), to eliminate inflammation, reduce pain and stimulate tissue healing.
Ultrasound-guided dry needling, to eliminate myofascial trigger points that cause pain and inhibit movement.
Nerve hydrodissection, to free up nerves entrapped by adhesions and scar tissue and restore smooth gliding.
Ultrasound guided PRP and/or Prolotherapy injections, to trigger and accelerate healing of muscles, tendons and nerves at the cellular level.
The goal of functional podiatry is to identify all factors that contribute to your foot pain and eliminate them, without drugs, steroid injections or surgeries.
Your feet and ankles enable locomotion and provide stability for your entire body, while sending messages to your brain about your body’s position in space. During physical activity, your feet absorb and mediate force loads multiple times your body weight. Protecting your feet from injury can enhance your performance, reduce your risk of injury, and help you sustain a healthy lifestyle.
There are several things you can do to avoid foot pain:
If foot and ankle pain is keeping you from living your best life, it’s time to do something about it. The holistic podiatry specialists at NYDNRehab have an impressive track record of helping hundreds of patients like you to overcome foot pain. Don’t waste your time and money on faulty diagnoses and cookie-cutter treatment plans that target your symptoms without fixing the underlying cause of pain. Contact NYDNRehab today, and get fast and effective holistic podiatric care that really works!
These case studies reflect real clinical conditions evaluated at NYDNRehab using advanced diagnostic methods and individualized rehabilitation strategies. All cases are evaluated and managed by Dr. Lev Kalika and the NYDNRehab clinical team.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.
A bad physical therapy experience is one of the primary causes of unnecessary surgery
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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