Shockwave Therapy for
Scar Tissue

About Scar Tissue

Scar tissue is a special type of fibrous tissue that your body generates to repair damaged soft tissues. Unlike muscle tissue, which is made of contractile fibers, scar tissue is made of collagen, which has limited vascularity and lacks the elastic and contractile properties of muscle fibers.

During the healing process, scar tissue can adhere to other structures, inhibiting movement, causing pain, and preventing soft tissues from gliding smoothly among other structures. Extracorporeal shockwave therapy (ESWT) can help to eliminate scar tissue adhesions and restore pain-free functional movement.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Shockwave Specialist Dr. Lev Kalika

Dr. Kalika is an expert in extracorporeal shockwave therapy, and has published multiple scientific studies on the topic. He is highly skilled and experienced in diagnostic ultrasonography, and is considered one of the world’s top experts in ultrasound guided procedures. Dr. Kalika uses ultrasound imaging to detect scar tissue anomalies, and to guide therapeutic shockwave treatment.

Dr. Kalika has devoted his career to finding the most advanced technologies and innovative treatment approaches for resolving pain syndromes, rehabilitating injuries, and restoring pain-free functional movement. He is certified in the Stecco Method of fascial manipulation therapy, a manual approach that helps to release tissue adhesions and remodel scar tissue.

The clinic at NYDNRehab features some of the most advanced technologies available, rarely found in private clinics. Patient care at NYDNRehab is holistic and personalized, to ensure fast and effective results.

Get Superior Treatment for Scar Tissue at NYDNRehab

Get Superior Treatment for Scar Tissue at NYDNRehab

Physical therapy can help to restore functional movement after an injury or surgery, but it is not a standalone solution. Prior to beginning physical therapy, scar tissue and fascia adhesions need to be addressed, to free up soft tissues and restore unrestricted movement.

Focused extracorporeal shockwave therapy (ESWT) is an evidence-based approach for treating scar tissue. Yet many clinics only offer radial shockwave therapy, which is not a true shockwave and does not render the same results as ESWT.

Dr. Kalika’s expertise in extracorporeal shockwave therapy, along with over 20 years of experience treating and rehabilitating soft tissue injuries and movement disorders, make NYDNRehab the clinic of choice for scar tissue therapy in NYC.


Scar Tissue Symptoms and

  • Inflammation and redness
  • Itchiness
  • Sensitivity to touch
  • Limited range of motion
  • Sounds or sensations of creakiness
  • Surgery
  • Trauma
  • Sports injuries
  • Burns
  • Certain internal diseases

We Use High Resolution Ultrasound to Diagnose Scar Tissue Fibrosis and Adhesions

The chosen treatment protocol for scar tissue is largely dependent on the location and maturity level of the tissue. For recent wounds in the early phases of healing, scar tissue is still pliable and can be remodeled. Mature scar tissue is more difficult to remodel and may require a more advanced and multimodal intervention strategy.

Scar tissue is formed in four progressive phases:

Phase 1: Inflammatory phase

This phase occurs immediately after trauma and lasts between 24-48 hours. It begins with blood clotting and the migration of macrophages and histiocytes to remove dead tissue from the damaged area. The injured area is normally immobilized during this phase to prevent further damage.

Phase 2: Granulation phase

In this phase, a temporary increase in vascularity occurs, to nourish the healing tissue. The rate of scar tissue formation correlates with tissue vascularity, with tendons and ligaments requiring more time than muscle. Some limited movement is helpful in this phase, to ensure that scar tissue is laid down in patterns that do not inhibit movement as it matures.

Phase 3: Fibroblastic phase

During phase 3, the number of fibroblasts and the rate of collagen production increases. Collagen binds to itself with weak hydrostatic bonds that make it pliable, allowing for the reshaping and molding of scar tissue with minimal risk of reinjury. This stage lasts 3 to 8 weeks.

Phase 4: Maturation phase

Collagen solidifies and shrinks during this final phase, and the tissue is able to tolerate stress without risk of reinjury. Significant tissue remodeling can still take place with appropriate mobilization. Failure to mobilize scar tissue in this phase can cause cross-linking of collagen fibers and tissue shrinkage. Toward the end of this phase, mature tissue loses its pliability and becomes more difficult to remodel.

At NYDNRehab, we use high resolution diagnostic ultrasound to visualize scar tissue in real time, to detect areas of abnormal collagen modeling and adhesions, and to identify areas where scar tissue restricts functional movement.

We Use High Resolution Ultrasound to Diagnose Scar Tissue Fibrosis and Adhesions
Shockwave Therapy is Safe and Effective for Scar Tissue Treatment

Shockwave Therapy is Safe and Effective for Scar Tissue Treatment

ESWT has been shown to significantly improve multiple scar tissue parameters, such as height, pliability, vascularity, and pigmentation. Its mechanism of action is to reduce the fibrous component of scar tissue by regenerating and remodeling affected tissues.

ESWT has been shown to significantly improve multiple scar tissue parameters, such as height, pliability, vascularity, and pigmentation. Its mechanism of action is to reduce the fibrous component of scar tissue by regenerating and remodeling affected tissues.

  • Neovascularization
  • Release of growth factors such as TGF-1, VEGF
  • Stimulation and proliferation of fibroblasts
  • Stimulation of mesenchymal stem cells
  • Antibacterial effects
  • Promotion of local circulation
  • Suppression of pro-inflammatory mediators
  • Direct effect on peripheral nerves

Additional Treatment Options for
Scar Tissue

In addition to shockwave therapy, your treatment protocol may include physical therapy and other therapeutic approaches, to reduce pain and restore pain-free movement.

Stecco Fascia Manipulation Therapy

The Stecco Method of fascia manipulation is one of the most effective methods for releasing adhesions and remodeling scar tissue. It is a specific technique of manual therapy that targets fascia, the thin layer of connective tissue that encases muscles, tendons and organs. Scar tissue often interferes with the ability of fascia layers to glide freely among muscles, nerves and other structures.

TECAR Therapy

TECAR Therapy

TECAR therapy dramatically speeds up tissue healing by normalizing electrical charges within damaged cells. When combined with Stecco manipulation therapy, TECAR works to accelerate tissue healing and restore its integrity.

Ultrasound Guided Hydrodissection

Hydrodissection is a technique for treating peripheral nerves entrapped by scar tissue. It involves injecting a saline solution under ultrasound guidance, to separate entrapped nerves from surrounding scar tissue and adjacent structures.

Ultrasound Guided Hydrodissection

Get the Most Advanced Scar Tissue
Treatment in NYC

If left untreated, scar tissue can cause pain and severely restrict your ability to move freely. Scar tissue should be addressed as early as possible after an injury or surgery, to minimize restrictions and adhesions, and to optimize tissue remodeling.

At NYDNRehab, we use the most advanced technologies and therapeutic approaches to limit scar tissue damage and release adhesions that impair movement. If you were never treated for scar tissue after a recent injury or surgery, or if an old injury has restricted your mobility, contact NYDNRehab today, and get moving again with scar tissue therapy.

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    Shockwave Therapy for Scar Tissue FAQs

    Is shockwave therapy for scar tissue painful?
    Shockwave therapy is a safe and effective non-invasive therapy that is administered via the skin’s surface. The procedure itself is not painful.
    What are the risks and side effects of focused shockwave therapy?
    The most common side effects of focused shockwave therapy are mild and temporary bruising, swelling, pain, numbness or tingling in the treated area. Recovery time is minimal, and there are no long-term risks.
    How many shockwave sessions will I need to treat my scar tissue?
    The number and frequency of ESWT sessions will vary, depending on the extent and severity of scarring, the tissues affected, and the prevalence of adhesions. Working with an experienced clinician using ultrasound guidance will minimize the number of shockwave procedures and speed up your recovery time.
    Can shockwave therapy help with scarring from liver cirrhosis?
    Yes, recent research shows that low energy ESWT helps to ameliorate liver fibrosis and improve hepatic function.
    I have scarring and pelvic adhesions after my C-section. Can shockwave therapy help?
    Shockwave therapy is an effective approach for handling superficial and deep pelvic post-Cesarean section scarring. It helps to accelerate scar tissue healing, heal abdominal muscles, prevent excessive scarring and discoloration, and improve the feeling and appearance of older scars.

    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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