Runner’s Clinic at NYDNRehab

Our State-of-the-Art Runner’s Clinic

Running is a great form of exercise, with numerous advantages for physical and mental health. For many, running provides an inexpensive and easily accessible way to manage weight, boost cardiovascular fitness and neutralize stress. But running subjects the body to powerful ground reaction forces that can potentially cause injury.

The high-tech runner’s lab at NYDNRehab uses a data-driven approach to analyze running gait in 3 dimensions, to identify mechanical deficits that can increase your risk of injury. Our state-of-the-art clinic features advanced technologies for accurate and effective gait retraining, to help you prevent injuries and improve performance. Our regenerative therapies speed up post-injury recovery, to get you back on the road ASAP.
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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Human Movement Specialist Dr. Lev Kalika

NYDNRehab clinical director Dr. Lev Kalika is an internationally recognized expert in diagnostic ultrasound imaging, with multiple research papers to his credit. Dr. Kalika has studied with some of the world’s most prestigious experts in diagnostic ultrasonography, and has attended multiple international conferences on the topic.

Ultrasound imaging has multiple advantages over other imaging tools like MRI, Xray and CT scan. The musculoskeletal ultrasound equipment at NYDNRehab has the highest resolution available in NYC, for clarity in diagnosing injuries to muscles, tendons, nerves, bones and joints.

In 70% of cases, diagnostic ultrasonography gives us insight into whether structural damage is the cause of pain and dysfunction, or if it reflects compensation patterns developed due to other issues. To make our interpretation of running gait analysis data fully diagnostic, ultrasound helps us visualize both recent structural damage and older injuries that may no longer cause pain, but still contribute to inefficient movement patterns. Only by visualizing both old and new injuries can we create a truly effective treatment plan.

Dr. Kalika is an active member of the American Institute of Ultrasound in Medicine (AIUM), and is currently developing his own unique approach to Dynamic Functional Ultrasonography.

Dr. Kalika has dedicated his life’s work to finding innovative and effective ways to treat and prevent injuries, movement disorders, and pain syndromes. With over 15 years of experience performing diagnostic ultrasonography in conjunction with 3D gait analysis, Dr. Kalika has gained extensive insight into common mechanical causes of running injuries. He has used his knowledge to develop one of the most advanced 3D running labs available in a private clinical setting.

Data-Driven 3D Gait Analysis for Accurate Results

The Runner’s Clinic at NYDNRehab features research-grade technologies for measuring and quantifying running performance data. Our advanced motion ultrasonography capabilities let us view the body’s structures in real time, while the patient is running.

Real-time ultrasound imaging paired with objective data gives us an accurate baseline overview of running gait mechanics, allowing us to customize an effective and measurable protocol for personalized gait retraining. The specific configuration of our 3D running lab is based on the latest evidence-based motion analysis research.

Conventional 2D gait analysis is generally subjective, based on observations of running gait via amateur video. Even if you add objective factors like joint angles, and spatiotemporal parameters like speed, stride length, and phases of the gait cycle, you only get a superficial overview of the subject’s gait mechanics. And unless you have a treadmill with the capacity to measure force and pressure, you cannot accurately assess foot mechanics.

While conventional analysis may be useful for suggesting basic improvements in running gait, it does not reveal critical mechanical deficits that can undermine performance and lead to injury. In many cases, runners are given generic explanations for their pain, such as weak glutes, tight hip flexors, weak or tight calves, etc. However, exercises prescribed to target those muscles often fail to eliminate pain or render satisfactory improvements in running gait.

In 95% of runners who do not experience pain while running, simply looking at gait mechanics, even with the most sophisticated equipment, is not enough to get a full and accurate picture. It is only when we visualize how the body’s structures interact during running that we get a clear idea of how to make improvements. The running lab at NYDNRehab features diagnostic motion ultrasonography, a new technology that allows us to look at muscle and joint action in real time. With motion ultrasonography, we are able to sync 3D data with high-resolution imaging, to detect issues with muscles, tendons, fascia, ligaments and joints.

This unique combination of technologies helps us to confirm our findings from 3D running analysis data, to better understand gait anomalies and how to correct them. It also alerts us to old injuries that were never properly rehabilitated, that contribute to gait anomalies. With this knowledge in hand, we are able to provide you with a comprehensive treatment plan that addresses all factors that influence your gait mechanics.

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Common Running Injuries Associated
with Gait Deficits

According to Yale Health, upwards of 50% of runners sustain injuries each year. And one study projected that up to 85% of novice runners experience a running injury while training for an event in any given year.

Many runners ignore seemingly minor injuries, continuing to run with bandaged knees and ankles, treating residual pain with OTC solutions and basic first aid. But failing to address minor injuries can lead to major problems down the road.

Most running injuries occur in the lower extremities and involve bones and connective tissues in the foot, ankle, knee and hip. Most are due to repetitive overuse and inefficient gait mechanics.

  • IT band syndrome The iliotibial (IT) band is a fibrous band of tissue that runs along the outside of your leg, connecting your gluteal muscles to the upper portion of the tibia (shin). It can become irritated and painful, especially when running downhill. IT band syndrome is associated with friction caused by weak gluteal muscles.
  • Patellofemoral pain syndrome (aka Runner’s Knee) Runner’s knee is characterized by chronic pain at the front of the knee and around the kneecap. It can be caused by repetitive overuse, misalignment of the kneecap due to muscle imbalances, poor foot mechanics, and other mechanical deficits in your running gait.
  • Shin Splints Pain along the shin bone is usually caused by overuse. It often arises when you change or intensify your training routine. Shin splints are also common among novice runners with poor technique.
  • Stress fractures Stress fractures are small bone fractures that usually run along the grain of the bone. They often occur in the tibia (shin bone) or in the metatarsal bones of the feet from repetitive pounding on hard surfaces. Poor gait mechanics can cause stress fractures by shifting force loads to structures that are not designed to handle them.
  • Plantar Fasciitis The plantar fascia is a tough band of connective tissue at the bottom of your foot that connects your heel bone to your toes. During the gait cycle, the plantar fascia stretches and contracts, releasing elastic energy. Microtears and trigger points can arise from running that cause heel and foot pain. Because the plantar fascia has limited vascularity, plantar fasciitis can be slow to heal without intervention.
  • Achilles Tendinopathy Like the plantar fascia, your Achilles tendon stores and releases energy as it stretches and contracts during the gait cycle. The Achilles tendon can develop microtears, trigger points and ruptures from repetitive overuse. Tendons are avascular structures, meaning they heal slowly due to low blood supply. Early intervention can prevent long-term Achilles tendon degeneration.
  • Fascia densification and trigger points Fascia is a tough thin sheath of connective tissue that encases and connects muscles and organs throughout your body. Healthy fascia is elastic and slippery, enabling structures to stretch and glide as you move. Repetitive overuse can cause fascia to become dense and sticky, and lose its elastic properties. It can develop trigger points and adhesions that inhibit the free movement of nerves and blood vessels. Fascia manipulation therapy and trigger point therapy can help restore healthy fascia.

Ignoring running pain and injuries can lead to gradual degeneration of tissues and create compensation patterns that set you up for more serious injuries down the road. While pain and dysfunction in runners is not uncommon, it is neither normal nor necessary. Early holistic treatment is essential to prevent life-long problems that cause disability as you age.

WHO NEED S GAIT ANALYSIS?

  • Any runner experiencing pain or discomfort, during or after running
  • Runners who sense that their running “flow” has been disrupted
  • Novice runners who want to learn technique basics and avoid injury.
  • High school and college athletes who want to enhance performance.
  • Elite and competitive runners who want a tuneup, to maintain a competitive edge.
  • Masters-class runners who want to avoid injury and prolong their years of pain-free running.

Benefits of 3D Gait Analysis

Benefits of 3D Gait Analysis

Data gathered from 3D gait analysis quantifies and measures functional limitations, faulty mechanics, imbalances and compensation patterns that are invisible to the naked eye.

Flexible retraining programs

Our 3D system allows us to customize running retraining programs in ways that could not be achieved with 2D analysis. 2D vs 3D Walking and Running Gait Analysis

Accurate pain detection

Pain often surfaces at the site of compensation, where force loads are redistributed to make up for injuries or imbalances.

Accurate identification of underlying causes

Gait analysis data helps us distinguish compensation patterns from their underlying cause, so we can correct the deficit at its source.

High level technology

NYDN Rehab features the most advanced running and motion analysis technology in NYC. Our sports medicine specialists combine experience and expertise with sophisticated technology and software, to test, analyze and retrain running gait.

Advanced Technologies Make All
the Difference

Our 3D motion analysis system gives us a broad range of quantitative data
about your running gait:

1

Our Zebris instrumented treadmill

analyzes pressure and force related to foot mechanics.

2

Joint kinematics

measures joint angles during specific phases of the gait cycle, along with the timing of movement in bilateral joints.

3

Kinetics

measures ground reaction forces and weight distribution.

4

Surface electromyography (SEMG)

registers electric muscle activity, to observe motor recruitment patterns and detect compensation patterns.

5

Motion ultrasonography

is a new technology that lets us visualize muscle and joint action in real time. This helps us confirm our findings from gait analysis data.

6

Proprietary custom software

collects and interprets gait analysis data and produces a personalized report.

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Regenerative Technologies Accelerate
Injury Rehab

Repetitive overuse injuries are common among runners, and early treatment is key to preventing more serious problems. NYDNRehab features a variety of advanced regenerative technologies that reduce pain and inflammation and speed up the healing process. Early intervention can prevent new and minor overuse injuries from becoming more serious conditions that keep you from running long-term.

Our regenerative treatment options

Focused Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT)

Focused ESWT is a regenerative treatment for damaged tendon, muscle and bone tissue. This technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for tendon injuries.


Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, triggering a regenerative response. EMTT waves can penetrate deep tissues to target difficult-to-reach tendons, muscles, bones and nerves.

Electromagnetic Transduction Therapy (EMTT)

HIGH ENERGY INDUCTIVE THERAPY (HEIT)

High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT stimulates the healing of nerves, muscles and blood vessels.


INDIBA Radiofrequency Therapy

INDIBA therapy is a type of TECAR therapy that helps to restore the ionic charge of damaged cells, for faster injury healing and rehabilitation.

INDIBA Radiofrequency Therapy

NESA Neuromodulation Therapy

NESA Neuromodulation Therapy

The NESA device generates a low-frequency electrical current to restore optimal neural signaling between the muscles and the brain.


Ultrasound Guided Dry Needling

Myofascial trigger points are tight muscle knots that are common in runners. Dry needling inserts non-medicated filament-thin needles into trigger points to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance ensures accuracy.

Visit Our State-of-the-Art Runner’s
Clinic in NYC

Whether you’re a novice runner or a seasoned competitor, you can dramatically reduce your risk of injuries and enhance your performance with a high-tech 3D gait analysis and gait retraining. The entire process is fun, affordable and educational, equipping you with the knowledge you need to enjoy pain-free running, now and in the years to come. Contact NYDNRehab today to schedule your 3D running gait analysis, so you can safely hit the road with confidence.

Range of Available Unique Physical Therapy
Treatments at Nydnrehab

Clinical Case Studies
NYDNRehab


Case Study: Runner’s Pain

Our Patient Our patient is a 33 year-old female runner complaining of hamstring and calf tightness, and posterior knee pain in both legs. The pain began in 2015, but she continued to run. The Challenge The patient had seen numerous running physical therapists and had undergone multiple gait analyses without any results. Five years prior […]

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    Running Analysis FAQs

    I am out of shape and new to running. My goal is to lose weight and run a 5K this year. Should I wait until I get in better shape before investing in a 3D gait analysis?
    There is no time like the present to visit our Runner’s Clinic. We will set you up for success with valuable information about running technique, training approaches and injury prevention. Don’t wait to get injured before getting a running gait analysis.
    I had a serious ankle sprain last year but it no longer hurts and my ankle seems to be fine. Could it still affect my running gait?
    <span style=”font-weight: 400;”>Just because an injury no longer hurts does not mean it is fully healed. Athletic injuries should be fully rehabilitated before you return to running. You may have developed compensation patterns that can dramatically affect your running gait and lead to future injuries. </span>
    I am a collegiate track athlete but my best time is only mediocre. Can a 3D analysis give me a competitive edge?
    <span style=”font-weight: 400;”>A 3D gait analysis can help identify motor deficits that slow you down. By fixing minor gait issues, you can significantly improve your athletic performance. </span>
    I have been running marathons for years, but lately I have chronic knee and ankle pain. How can I benefit from a 3D gait analysis?
    <span style=”font-weight: 400;”>Years of running can cause wear and tear on joints and soft tissues, and minor gait deficits can begin to amplify and cause pain. A 3D gait analysis can help you fine-tune your running technique, to eliminate pain and prolong your running career. </span>
    I am training for a triathlon but I recently developed plantar fasciitis. Is there anything I can do to speed up healing?
    Plantar fasciitis responds well to shockwave therapy and ultrasound guided dry needling, eliminating pain and inflammation and dramatically accelerating the healing process.
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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)

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    Complete tear of rectus femoris
    with large hematoma (blood)

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    Separation of muscle ends due to tear elicited
    on dynamic sonography examination

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