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Chronic pain is often caused by tight muscles and connective tissues that keep your body’s structures from moving freely. Neuromuscular therapy (NMT) targets tight tissues and stretches them to release scar tissue and myofascial trigger points.
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Fortunately we live in an age of advanced technology. Compared to the 1980s, today’s advanced methods are able to address myofascial pain in a faster and more complete way. At NYDNRehab, manual approaches have been completely replaced with a combination of extracorporeal shockwave therapy (ESWT), ultrasound guided dry needling, and electromagnetic transduction.
The primary cause of muscular pain is hypo-perfusion of muscle tissues, meaning they are not getting enough blood. When ischemia (decreased blood flow) occurs, your muscles are forced to work under suboptimal conditions, with a limited flow of oxygen and nutrients. Muscle ischemia creates an energy crisis that compresses small blood vessels and inhibits the release of acetylcholine, causing trigger points, taught bands of muscle tissue, to develop.
Dr.Kalika is an internationally recognized expert (see bibliography below) in the field of myofascial pain, ultrasound guided dry needling and diagnostic ultrasonography. Using these highly advanced technologies, Dr. Kalika has pioneered his unique approach, which has significantly shortened the convalescent period for myofascial pain disease.
Dr. Kalika uses high resolution diagnostic ultrasonography and sonoelastography to accurately identify trigger points. With ultrasound guidance, a dry needle is injected precisely into an active trigger point for instant release. Passive trigger points are eliminated with the help of radial shockwave therapy. High frequency magnetic impulses are then applied using electromechanical transduction principles, to evoke a regenerative reaction at the cellular level.
MNT targets deep muscles and connective tissues that often lay side-by-side. The MNT therapist uses thumbs, fingers and elbows to release scar tissue and trigger points. The patient remains fully clothed, and no lotion or oils are used.
The primary cause of muscular pain is hypo-perfusion of muscle tissues, meaning they are not getting enough blood. When ischemia (decreased blood flow) occurs, your muscles are forced to work under suboptimal conditions, with a limited flow of oxygen and nutrients. Muscle ischemia creates an energy crisis that compresses small blood vessels and inhibits the release of acetylcholine, causing trigger points, taught bands of muscle tissue, to develop.
Neuromuscular therapy works by applying varying degrees of pressure to palpable taut bands in the muscles. By applying quasi static pressure to different parts of the muscle, pain receptors are inhibited, and muscle metabolism is optimized by activating muscle sensory organs. The hands of the neuromuscular therapist are trained to feel for changes in muscle tissue terrain, and to gradually eliminate muscle imbalances by applying precise manual pressure that stretches taut tissues.
is a thin tough sheath of connective tissue that surrounds your muscles, organs, blood vessels and nerves, holding them in place and keeping them from sticking together, so they can glide freely as you move.
Due to trauma or inflammation, fascia may shorten, and what was once a pain-free range of motion becomes painful and restricted (Langevin 2008). The ability of the fascia to glide normally becomes compromised, and collagen production increases, creating scar tissue.
Fascial manipulation identifies and treats abnormal adhesions that are often present with orthopedic conditions. Those adhesions can alter the way forces are transmitted through your muscles and tendons, causing recurring pain and injury.
Fascial manipulation therapy identifies a specific localized area of the fascia related to specific limited movement or pain. Once a limited or painful movement is identified, the therapist manipulates a specific point on the fascia, the adhesion disappears or decreases, force transmission returns to normal, and pain-free movement is restored.
Get all the benefits of physical therapy and chiropractic care via safe and effective online sessions, all from the privacy and convenience of your home, office or hotel room. Never miss a session, and keep moving toward your physical therapy goals.
Dr. Lev Kalika has been working to revolutionize physical medicine, rehabilitation, sports medicine and athletic performance since 1998. Having conducted multiple research studies in the field of functional musculoskeletal ultrasonography and ultrasound guided dry needling, and contributing his expertise to multiple publications, Dr. Kalika is recognized as an international expert in integrative rehabilitation, sports medicine, injury prevention, athletic performance, and ultrasound guided dry needling. NYDNRehab is considered the most technologically advanced private clinic in the US. The clinic features a range of technologies available only in the world’s top research labs, making them available for patient care, not just research.
HyunJu
YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
Dr. Christina Pekar
DC
Dr. Michelle Agyakwah
DC
Mariam Kodsy
Physical Therapist
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
