This field of ultrasound guided dry needling is not based on the concepts of acupuncture . Acupuncture is performed by inserting needles superficially into body’s channels in order to harmonize energies in the body by stimulating body’s meridians Functional guided dry needling is predicated upon evidence-based Western medical knowledge and the rules of anatomy and physiology.The needles are inserted deeper based on anatomy visualization under ultrasound.
In 1997 Dr.Kalika personally learned dry needling from Karel Lewit ( the founder of dry needling method) himself when he moved to Prague.In 2006 Dr.Kalika became a member of ISMST (international society of medical shockwaves) further progressing his knowledge in treatment of myofascial pain by using extracorporeal shockwave technology.In 2014 Dr.Kalika became interested in ultrasound diagnosis of trigger points and conducted multiple studies in Europe delivering this method for the first time in NYC. At NYDNRehab we use very comprehensive approach by combining functional guided dry needling, extracorporeal shockwave therapy, neuromuscular manual therapy and ontogenetically based physical therapy approach for treatment of myofascial pain.
The human foot design is unique in the animal world. From the evolutionary standpoint human foot is a highly innovative anatomical structure that had developed to serve as the main weight receptor of the newly achieved bipedal support base. It evolved to be the most durable anatomical formation in the entire human body. Aside from the time of infancy when the body is horizontally aligned, the foots intricate structures provide, in conjunction with the ankle bones and powerful connective ligaments, the perfect biomechanical apparatus for ambulation or bipedal locomotion.
The human foot however was not designed to be operated on high heels and used excessively on hard unyielding surfaces. Evolution knows no asphalt nor does it wear Prada. Outside of direct trauma, arthritis and conditions caused by structural misalignments, all foot/ankle problems are caused by what is generally termed overuse but should rather be called abuse. Today foot and ankle pain has become one of the most common musculoskeletal afflictions facing ever increasing number of people.
Historically foot and ankle conditions had been treated without much regard to the structures higher up in the kinetic chain. The treatment was mostly palliative and passive. Doctors would inject steroids into the painful areas and prescribe orthotics in the hope to re-align different parts of the foot into more anatomically functional apparatus, all this with limited success.
In the past decade, due to technological advances, novel approaches regarding foot and ankle pain treatment has been established. We are now entering the era when new unorthodox yet scientific analytical methods of diagnostics are being developed. Unlike any static radiology tests, such as MRI, Ultrasound or X-ray, these new technologies generate dynamic picture giving us direct evidence as to where exactly the problem originates.
Conventional radiological modalities do reveal structural abnormalities in the tissues. The fact however is, that structures that look abnormal on the radiological images does not necessarily equate to pain. New technologies allow us to observe the anatomy of the foot and ankle in motion, giving us opportunity to pinpoint the origin of the problem at its core and address it there for the optimal effect.
In all fairness, commonly used medical testing techniques can locate sensitive or painful tissues. But, as we know, in neuromuscular system most of the time pain is irradiated from other locations and therefore finding painful fibers is only a part of the puzzle. The doctor needs to have a broad view of the entire area in motion in order to be able to identify the pathology of the movement itself. With the new emerging technology the aberrant movement is diagnosed with precision allowing us to pinpoint the cause.
One such new technological advancement is Gait Lab. Gait Lab is a combination of high speed motion video cameras, surface electromyography with force plates or the pressure-registering treadmill and marker-capturing software. Gait Lab examination provides an extremely complex and sophisticated interpretation of all forces exerted and distributed during movement, such as gait or running.
This type of analysis can diagnose precisely the nature of the probe, which always has its origins in movement and not only provide clinician with complex computerized data set, but most importantly can suggest type of intervention. For example it can prove or disprove efficiency of orthotics as well as suggest proper exercise routine, monitorit and give patient feedback about his or her performance and progress in care.
Unfortunately at this time this advanced technology is not widely available in clinical practice as it is in academic research. However it will not be long until this type of intervention is going to gain its due popularity.
At Dynamic Neuromuscular Rehabilitation we have been fortunate t o use Gait Lab equipment for treatment and diagnosis to the advantage of our patients.
We successfully integrate conventional clinical examination of the foot and ankle complex, such as Diagnostic Ultrasound, X-rays and Nerve Conduction studies, with the newest technology to reach the most precise diagnosis and implement the optimal intervention for people suffering from foot and ankle pain.
We are also proud to be among the first to use the AlterG gravity reduced treadmill for treatment of foot and ankle conditions.
We have one of the longest experiences with ESWT (Extracorporea Shockwave Therapy) for treatment of foot and ankle tendon-bone disorders, such as:
We are successfully using our comprehensive approach for treatment of such disorders like:
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Research at NYDNRehab