Foot, Ankle and Heel Pain

About Foot and Ankle Pain

Foot, heel and ankle pain can cause serious health problems, since your feet provide the foundation for all physical activity via connection to the ground. Foot pain can cause postural and structural problems throughout your body, and also affect all other joints and muscles in the rest of your body.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Foot and Ankle Specialist Dr. Lev Kalika

Dr.Kalika revolutionized lower extremity pain treatment by introducing high resolution diagnostic ultrasonography for structural diagnosis, combined with gait and motion analysis technology to visualize and objectify the functional movement of the lower extremities.

Dr.Kalika’s motion and gait analysis lab is the only private lab in the US to feature research-grade technology, found only at top research universities and made available to patients in his private clinic. Dr.Kalika believes that what cannot be measured cannot be treated. His gait and motion analysis goes way beyond standard even 3D technology.

In addition to his academic credentials, Dr. Kalika is a Certified Biomechanist, Certified Gait Analyst, and is certified in Dynamic Neuromuscular Stabilization (DNS). He has over 15 years of experience in diagnostic musculoskeletal ultrasonography, extracorporeal shock wave therapy (ESWT) and orthotic prescription. He is an expert in ultrasound guided injections and dry needling procedures.

Dr.Kalika’s expertise is sought by professional athletes and dancers across the United States.

Why Treatment at NYDNRehab is Better than Conventional Foot and Ankle Physical Therapy

In recent years elective foot and ankle joint surgeries have become commonplace, but due to the complex structure of the feet and ankles, ankle joint replacement surgery has less optimistic outcomes than hip or knee surgeries.

The specialists at NYDNRehab believe that surgery should be the absolute last resort. We use the most advanced motion and gait analysis technology and the highest resolution musculoskeletal ultrasonography found in any private clinic in the USA. Dr. Kalika has spent many years developing his unique diagnostic approach that combines:

  • Diagnostic musculoskeletal ultrasonography

  • Integrative gait and motion analysis

  • Biomechanical analysis

  • Specialized gait physical therapy

  • Ultrasound guided procedures

  • Extracorporeal shockwave therapy (ESWT)

  • Extracorporeal Magnetotransduction therapy (EMTT)

NYDNRehab offers the most technologically advanced and comprehensive approach to foot and ankle treatment and rehabilitation in New York City. We believe that successful outcomes in musculoskeletal medicine can only be achieved via thorough examination using objective tools. It is our philosophy that what cannot be measured cannot be successfully treated.

Foot and Ankle Physical Therapy

Foot and Ankle Conditions We Treat

Ankle sprains

Arch pain

Chronic Ankle instability

Tibialis posterior tendonitis

Peroneal tendonitis

Achilles tendinitis

Heel pain and plantar fasciitis

Foot and ankle stress fractures

Shin splints and tibial stress
syndrome

Foot and Ankle Conditions We Treat

Metatarsalgia

Morton’s neuroma

Halux valgus

Halux limitus

Plantar plate tears

Flat and overpronated feet

Sesamoiditis

Pinched foot nerves

Tarsal tunnel syndrome

Symptoms, Causes and Risk Factors of Foot and Ankle Conditions

Symptoms

  • Deformities of the bones and joints

  • Instability or a feeling that your ankle is collapsing

  • Soreness and tenderness of the fascia or soft tissues

  • Numbness and tingling sensations (paresthesia)

  • Stiffness or reduced motion in the foot, ankle or toes

  • Swelling and redness

Causes

  • Overuse from sports, running or exercise

  • Trauma from sports or accidents

  • High heels or unsupportive footwear

  • Standing for long hours on concrete

  • Old injuries that were never rehabbed

  • Faulty gait mechanics

Risk Factors

  • Obesity and sedentary lifestyle

  • Advanced age

  • Working in construction

  • Smoking

  • Participating in sports

  • Diabetes and osteoarthritis

Accurate Diagnosis Means Successful Treatment

Most common foot conditions can be diagnosed with clinical history and examination. In some cases, X-ray, MRI or diagnostic ultrasonography may be required.

At NYDNRehab, our specialists use diagnostic ultrasonography to visualize tendons, ligaments, bursa, muscles and the plantar fascia of the foot. We also use sophisticated video gait analysis technology to visualize and measure: forces acting on the foot, shock absorption, foot mechanics and mechanics of the entire lower kinetic chain.

  • Real time diagnostic ultrasound imaging

  • Fully integrated computerized gait and running analysis

  • Computerized ankle stability testing with C.A.R.E.N (computer assisted rehabilitation environment)

  • Postural stability testing

  • Computerized muscle force and strength testing

Accurate Diagnosis Means Successful Treatment

We Use High-Tech Equipment for Optimal Results

NYDNRehab’s movement analysis and retraining lab features some of the world’s most advanced research-grade technologies, rarely found in private clinics. Technologies recently added to our treatment toolbox include electromagnetic transduction therapy (EMTT) and blood flow restriction training (BFRT). We are always looking for new technologies and treatment approaches, to offer our patients the very best solutions to their musculoskeletal pain and dysfunction.

Our approaches to foot and ankle treatment include

3D Gait Analysis and Retraining
3D Gait Analysis and Retraining

Mechanical errors in walking and running gait can cause foot and ankle pain. Our quantitative 3D analysis looks at joint kinematics, muscle activation patterns, weight distribution, ground reaction forces and more, to collate a comprehensive overview of your gait mechanics. Using hard data from our findings, we are able to retrain your gait with measurable results.

Load management
Load management

Traditional treatment for Achilles tendinopathy focuses on rest and stretching exercises, but current research indicates that tendons heal and regain function more quickly when treated with progressive weight loading therapy.

Eccentric strengthening
Eccentric strengthening

Current research suggests that eccentric tendon loading, where the muscle is lengthening, is the most effective treatment for relieving pain and restoring Achilles tendon function.

Blood Flow Restriction Training
Blood Flow Restriction Training

BFR makes it possible to strengthen and rehabilitate injured tissues using much lighter loads than conventional resistance training. BFR helps prevent tissue atrophy after an injury while protecting damaged structures. It speeds the recovery process, for faster return to pain-free activity.

C.A.R.E.N(Computer Assisted Rehabilitation Environment)
C.A.R.E.N
(Computer Assisted Rehabilitation Environment)

C.A.R.E.N immerses patients in a virtual reality environment while their motion is captured by 12 infrared cameras that provide 360º real-time feedback. Used for both diagnosis and treatment, C.A.R.E.N provides precise therapeutic strategies based on muscle activation patterns, eliminating human error.

Biofeedback Motor Control Training
Biofeedback Motor Control Training

This groundbreaking approach for patients with lower extremity pain and dysfunction uses force plate technology to measure the direction and magnitude of ground reaction forces during movement. Muscle activity in the area of injury is carefully evaluated, and adjustments are then made to improve function and eliminate errors in movement.

Our innovative specialized approaches
Our innovative specialized approaches for testing and retraining include:
  • Dynamic neuromuscular stabilization (DNS)

  • Kineo intelligent loading for AI muscle testing and retraining

  • Proteus motion 3D collinear resistance

  • Force plate jumping and rate of force development analysis and retraining

  • SEBT (star excursion banner testing) state-of-the-art motion and kinematic analysis of postural stability and retraining

  • Myolux ankle stability and proprioception testing and retraining device

  • AIM (anatomy in motion)

  • FMS (functional movement systems)

  • ISM (integrated system model)

  • Contextual rehab

Regenerative Technologies for Foot and Ankle Physical Therapy

At NYDNRehab, we use a combination of treatment approaches for foot and ankle pain, based on the specific needs of the individual patient. We combine regenerative shock wave therapy with electromagnetic transduction therapy to relieve pain and stimulate healing. Our regenerative technologies and innovative therapeutic approaches make NYDNRehab the premier clinic for treatment of pelvic pain in New York.

This proprietary technology is based on a unique set of pressure waves that stimulate the metabolism, enhance blood circulation and accelerate the healing process. These non-invasive outpatient procedures represent breakthrough treatment options for pelvic pain and dysfunction.

Extracorporeal magnetic transduction therapy (EMTT) is a new technology that transmits high energy magnetic pulses to targeted tissues at extremely high oscillating frequencies, to trigger a regenerative response.

Extracorporeal shock wave therapy (ESWT) uses high frequency sound waves to stimulate the body’s own reparative mechanisms.

When combined, ESWT and EMTT work together to revitalize damaged cells and instigate healing, for immediate therapeutic results, including significant pain relief and regenerative effects on the pelvic floor muscles.

In addition, we use Ultrasound Guided Dry Needling as an effective technique for releasing painful trigger points buried deep in muscle tissues. Ultrasound imaging is used to locate the trigger point and visualize the dry needling procedure. Dr. Kalika is an expert in this discipline, and has contributed to several peer reviewed studies on the topic.

Regenerative Technologies for Foot and Ankle Physical Therapy
Preventing Foot and Ankle Pain

Preventing Foot and Ankle Pain

If you are physically active in sports, dance or exercise, your risks of foot and ankle injuries are higher than average. Wearing supportive footwear, giving your body adequate recovery time, and fine-tuning your motor mechanics can reduce your risk.

Occupations that require you to spend long hours on your feet, such as restaurant work, retail, and industrial work, require supportive and protective footwear appropriate for your occupation. Elevating tired feet and soaking them in Epsom salts at the end of a long day can help reduce the risk of overuse syndromes like plantar fasciitis.

A thorough gait analysis can help you identify and correct inefficient gait patterns that can contribute to foot and ankle pain.

Get Personalized Foot and Ankle Physical Therapy, Designed Just for You

NYDNRehab’s approach to foot and ankle treatment combines manual foot manipulation, foot-specific myofascial release, lower kinetic chain exercises, acupuncture and ESWT. Our non-invasive conservative approach is superior to steroid injections and corrective orthotics because we treat the underlying cause of the condition, not just its symptoms.

Our treatment approaches are both integrative and functional. Rather than using orthotics to change the way your foot makes contact with the ground, we correct your walking gait to restore function, making your foot adaptable to the ground once again, and to the forces associated with walking and running.

Our treatment is based on the diagnostic results of sophisticated personalized gait analysis. We never use a one-size-fits-all approach to patient care. We understand that every patient has a unique anatomy, and that each condition has unique characteristics. We tailor our treatment plans to the individual, with one-on-one physical therapy that really works!

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Get the Best Foot and Ankle Physical Therapy in
NYC

NYDNRehab is the top rated physical therapy clinic for foot and ankle pain in NYC. We accept most health insurance plans, and we are happy to set up payment plans for our patients. Schedule a consultation today, and see why the specialists at NYDNRehab are the best foot and ankle doctors in NYC.

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    Dr. Lev Kalika
    Dr. Lev Kalika

    Clinical director & DC RMSK

    Our Specialists

    HyunJu YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
    Dr. Christina Pekar DC
    Dr. Michelle Agyakwah DC
    Mariam Kodsy Physical Therapist
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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)

    image

    Complete tear of rectus femoris
    with large hematoma (blood)

    image

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

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