Therapy (NMT)

About Neuromuscular Therapy

Your muscles contract in response to messages delivered from your brain via neural impulses, and messages travel to your brain from muscles via neural channels. But sometimes injury or overuse can disrupt normal neural channels, interfering with the way your brain and muscles communicate. When that happens, it can interfere with efficient movement and increase your risk of injury and disability.

Neuromuscular therapy is designed to restore optimal communication pathways between the brain and muscles by eliminating impediments to pain-free functional movement. When combined with physical therapy, regenerative therapies and fascial manipulation can help eradicate factors that disrupt neuromuscular pathways.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Neuromuscular Specialist
Dr. Lev Kalika

Dr . Kalika’s journey with myofascial pain began with an internship at Prague’s Charles University Hospital, where he studied under world-renowned pioneers in myofascial pain treatment, professors Karel Lewit, MD (the inventor of dry needling), and Dr. Vladimir Janda. He later worked with Pavel Kolar, PT, PhD who developed dynamic neuromuscular stabilization (DNS).

Dr. Kalika was among the first to be certified in DNS therapy in 2010. He later collaborated on multiple scientific studies with Dr. Rostyslav Bubnov, MD, PhD, one of the best-known scientists in myofascial pain, and the inventor of ultrasound guided dry needling. After experimenting with high resolution ultrasonography and sonoelastography, Dr. Kalika further developed and shaped his unique approach by adding fascial tissue therapy, combining the Stecco fascial approach with different forms of shockwave therapy and radiofrequency technology.

Dr. Kalika is an active member of the International Myopain Society. You can find more information about Dr. Kalika’s research here.

NYDNRehab vs Conventional Physical Therapy

There are dozens of physical therapy clinics in Manhattan, but only a handful offer the latest methodologies and technologies that put them on the cutting edge of rehabilitative medicine. Even fewer clinics provide personalized one-on-one treatment protocols based on quantitative diagnosis. Consequently, physical therapy often falls short of resolving pain syndromes or movement disorders, leaving patients without hope for full recovery.

At NYDNRehab, we embrace innovations that enhance our diagnostic capabilities and elevate the quality and success rate of patient care. Our goal is to help each patient achieve successful recovery from pain and disability, in the shortest time possible. As sports medicine specialists, we work closely with our injured athletes to ensure they are 100% ready, both physically and mentally, to return to physical activity.

Prior to beginning physical therapy, we address obstacles like entrapped nerves, adhesions and myofascial abnormalities that inhibit optimal movement. We use the highest resolution diagnostic ultrasound to identify factors contributing to the patient’s symptoms, and eliminate them using cutting edge technologies and therapies that are rarely available in private physical therapy clinics.

Once the healing process is underway, we are able to track and monitor your progress using musculoskeletal ultrasound, sonoelastography and superb microvascular imaging. Those technologies guide us in fine-tuning your treatment protocol, to ensure that your therapy is successful.

Our personalized approach to patient care, backed by evidence-based methodologies, ensures that our patients achieve success in overcoming their physical pain and dysfunction in the shortest time possible.


Symptoms and Causes of Neuromuscular


  • Muscle pain and tightness

  • Reduced/limited joint range of motion

  • Stiff achy muscles and joints

  • Muscle weakness

  • Muscle cramps


  • Ischemia (reduced blood flow) due to tight tissues

  • Myofascial trigger points

  • Nerve entrapment or impingement

  • Poor posture

  • Faulty gait mechanics

Accurate Diagnosis is Key to Resolving Neuromuscular Dysfunction

Neuromuscular conditions are often diagnosed based on symptoms alone, and treatment is then directed toward the locus of pain. But the neuromuscular system is a complex and intricate network of nerves and soft tissues, and pain in one area of the body often has its origins in a location far away.

At NYDNRehab, we use the most advanced technologies to locate and identify the underlying cause of neuromuscular pain and dysfunction. In addition to a thorough health history and physical exam, we use high-resolution diagnostic ultrasonography to visualize the muscles and nerves in real time. We often follow up with high-tech 3D gait analysis, biomechanical analysis, and a battery of tests and assessments, to get a full picture of your condition.

Once your diagnosis is complete, we use your unique profile to create a personalized treatment plan, just for you.

 Accurate Diagnosis is Key to Resolving Neuromuscular Dysfunction

How We Treat Neuromuscular Disorders

Patients often come to us with pain that interferes with normal movement. Prior to beginning physical therapy, we address underlying issues such as entrapped nerves, adhesions and scar tissue, myofascial trigger points, gait and/or biomechanical anomalies, and other issues that stand in the way of successful physical therapy.

Initial treatment methods may include:

  • Ultrasound guided dry needling
  • Dynamic neuromuscular stabilization (DNS)
  • Stecco method fascial manipulation
  • Ultrasound guided injection therapies
  • Regenerative therapies
How We Treat Neuromuscular Disorders
 Once impediments to free movement have been eliminated, we are able to begin physical therapy.

Once impediments to free movement have been eliminated, we are able to begin physical therapy.

Your physical therapy protocol may include:

  • Gait analysis and retraining
  • Postural correction training
  • Neuro-motor feedback training
  • Strengthening exercises
  • Range-of-motion exercises

Regenerative Therapies Pave the Way to
Successful Results

The neuromuscular system is driven by electrical impulses, and the body has its own magnetic fields. Electromagnetic pulses and frequencies coming from outside the body can have a profound impact on human cellular biology. New regenerative technologies are able to harness those energies and direct them toward injured and dysfunctional tissues, to stimulate a healing response at the cellular level.

Focused Extracorporeal Shock Wave Therapy (ESWT)

produces high frequency sound waves to stimulate the body’s reparative mechanisms. It is especially effective for degenerative tendon disorders and myofascial pain.

Extracorporeal Magnetic Transduction Therapy (EMTT)

transmits high energy magnetic pulses that synchronize with the body’s own magnetic fields, triggering a regenerative response.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues.

High Energy Inductive Therapy (HEIT)

uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes.

NESA Neuromodulation Therapy

NESA Neuromodulation Therapy

uses a biphasic low-frequency electrical current to emit a series of intermittent and cyclical stimuli, to calm hyper-excited nerves and restore optimal neural signaling to the brain.

INDIBA Radiofrequency Therapy

uses electrical current to increase the exchange of ions in damaged cells.

INDIBA Radiofrequency Therapy

Ultrasound Guided Injection

Injection therapies like platelet rich plasma (PRP) and prolotherapy 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.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

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.

Proliferation Therapy, aka Prolotherapy

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.

Electromagnetic Transduction Therapy (EMTT)
Prolozone Therapy

Ultrasound Guided Dry Needling

targets myofascial trigger points that often contribute to neuromuscular pain.


injects a biologically neutral solution to irritate affected tissues, stimulating the body to grow new normal ligament or tendon fibers.

Ultrasound Guided Dry Needling
Stecco Method Facial Manipulation Therapy

Stecco Method Facial Manipulation Therapy

uses deep manual friction to reduce the density of damaged tissues, freeing up tissue layers and making them more fluid.

Dynamic Neuromuscular Stabilization (DNS)

taps into your body’s inherent developmental movement patterns, to restore functional movement and promote mobility and stability.

Dynamic Neuromuscular Stabilization (DNS)

Get the Best Neuromuscular Physical Therapy in NYC

Your body is designed to move freely, without pain or disability. Daily activities, lifestyle habits, trauma, sports, exercise and occupation can all contribute to neuromuscular disorders than interfere with pain-free movement. Neuromuscular therapy can help to restore unrestricted movement, so you can enjoy the very best quality of life.

You don’t have to live with neuromuscular pain and disability. Contact NYDNRehab today, and let a certified neuromuscular therapist help to restore fluid pain-free movement.

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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)


    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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