Heel Pain

About Heel Pain

Your ankle-heel-foot complex plays a critical role in everyday movement, and heel pain can really slow you down. Because of the complexity of the foot and ankle and the huge force loads they manage, heel pain can have multiple causes, and plantar fasciitis misdiagnosis can prolong your pain while draining your bank account. At NYDNRehab, we leverage technology to ensure accurate diagnosis and provide fast-acting treatment that gets you back on your feet in record time.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Heel Pain Specialist Dr. Lev Kalika

Dr. Kalika, clinical director of NYDNRehab, has dedicated his life’s work to revolutionizing the way pain syndromes and movement disorders are diagnosed and treated. He was among the first in his field to embrace technology as a game-changer for patient diagnosis and treatment. The NYDNRehab clinic is one of the best-equipped physical therapy clinics in the world.

Dr. Kalika is an internationally recognized expert in diagnostic ultrasonography and has made multiple contributions to the scientific literature on the topic. He has multiple certifications in a broad range of treatment approaches, including dry needling, shockwave therapy, and other regenerative therapies that promote healing.

Dr. Kalika’s expertise is sought after by elite athletes, professional ballet dancers and runners, as well as physically active youth and adults in NYC. NYDNRehab is the premier clinic for heel pain in Midtown NYC.

Get the Best Heel Pain Treatment
in NYC

New Yorkers are constantly on the go, often walking for blocks on end as a routine part of daily life. But walking on concrete, especially in shoes that do not provide adequate support or shock absorption, can put you at risk for foot and heel pain. Traditional physical therapy clinics often make heel pain diagnoses based on symptoms alone, resulting in frequent plantar fasciitis misdiagnosis that delays the healing process and prolongs pain.

At NYDNRehab, we use the highest resolution diagnostic ultrasound to pinpoint the exact cause of your heel pain in real time, without having to wait for results from X-ray or MRI. Rapid and accurate diagnosis means we can get right to work with a personalized treatment plan designed just for you. Our advanced treatment technologies enable us to accelerate the healing process without drugs or surgery, to get you back to doing the things you love in the shortest time possible.

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We never use a one-size-fits-all approach to patient care. Your treatment plan is based on your condition’s unique characteristics and your individual needs. Our experienced professionals work with you one-on-one, to ensure that you receive the very best care for resolving your heel pain.

Symptoms and Causes of Heel Pain

Symptoms

  • Sharp pain at the back of the heel

  • Pain that radiates from the heel to the bottom of the foot

  • Pain that extends from the heel to the ankle and calf

  • Dull consistent pain that increases with load bearing activity

  • Pain that worsens in the morning

  • Pain at the outer or inner edge of the heel

  • Pain that intensifies after physical activity

Causes

  • Repetitive overuse during sports or exercise

  • Long hours spent walking or standing on concrete

  • Wearing shoes with too little support or shock absorption

  • Being overweight or obese

  • Faulty gait mechanics when walking or running

  • Chronic inflammation

  • Osteoarthritis

Why Accurate Diagnosis of Heel Pain is Critical

Because your heel is part of a complex system of muscles, nerves, bones and connective tissues, there can be multiple underlying causes. Many clinics take a hit-or-miss approach to diagnosis, beginning with the most common condition and re-evaluating when you don’t respond to treatment. This wastes the patient’s time and money, while prolonging your pain and disability.

At NYDNRehab, we know that physical therapy takes time, and we believe that time should not be wasted. We use the most advanced diagnostic ultrasound equipment available to visualize the structures of your foot-heel-ankle complex in real time, with the patient in motion. This enables us to identify the exact cause of heel pain, and to evaluate the extent of structural damage.

Why Accurate Diagnosis of Heel Pain is Critical
Types of Heel Pain

Types of Heel Pain

Many physical therapists are quick to diagnose heel pain as plantar fasciitis, which is the most common type of heel pain. But plantar fasciitis misdiagnosis can result in weeks or months of unnecessary pain and disability.

Heel pain can stem from a variety of conditions, including:

  • Plantar fasciitis, where the heel and foot arch become injured and inflamed

  • Achilles tendonitis/tendonosis, where the Achilles tendon is injured, and pain radiates to the heel

  • Bone spurs, where calcium deposits on the heel bone irritate surrounding soft tissues

  • Sever’s disease, a rare condition affecting children aged 8-14 years

  • Bursitis, an inflammation of the bursa pad that provides a cushion between soft tissues and rigid structures

  • Stress fractures of the calcaneus (heel bone)

  • Inflammation of tendons in the foot, heel or ankle

  • Trigger points at the muscle-tendon junction that cause pain and dysfunction

  • Heel pad syndrome, marked by changes in the elasticity or thickness of the heel fat pad

With such a diverse range of potential conditions, you need a physical therapist who has the most advanced diagnostic tools available. A quick and accurate diagnosis that does not involve guesswork or rely on symptoms-based decision-making can mean the difference between rapid healing and pain relief, or months of prolonged pain.

Heel Pain Treatment Options

There is a broad range of options for treating heel pain, with some being more effective than others. Run-of-the-mill physical therapy clinics often rely on orthotics and taping to facilitate healing. However, those methods have a poor track record of providing satisfactory results, and patients often resign themselves to living with a certain level of pain.

At NYDNRehab, our technological toolbox gives us a variety of treatment options that are clinically proven to speed healing and eliminate pain. Your treatment plan may include:

  • Ultrasound guided dry needling to eliminate myofascial trigger points

  • Corticosteroid injections to reduce pain and inflammation

  • 3D gait analysis and retraining, to correct faulty gait mechanics

  • Physical therapy to balance muscles and restore functional movement

  • Acupressure to deactivate pressure points for heel pain

  • Regenerative therapies to stimulate healing at the cellular level

Heel Pain Treatment Options
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Regenerative Therapies for Rapid Relief
of Heel Pain

The human body has its own innate healing mechanisms, but it sometimes needs a nudge to accelerate the healing process. Regenerative technologies help to jump-start the healing process, to stimulate and speed up healing. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as 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 chronic degenerative tendon disorders and myofascial pain syndrome.


Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response. EMTT waves can penetrate deep tissues up to 18 cm beneath the skin’s surface, to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as radial shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.


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 generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.

INDIBA CT9 Radiofrequency Device

Our INDIBA Tecar therapy machine converts electrical current into a stable radio frequency current of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing. INDIBA can be used to successfully treat joint and muscle disorders, low-back pain, sports injuries, surgical incisions and various pain syndromes. Another therapeutic effect of INDIBA is extreme and prolonged cellular hyperthermia. Due to this effect, INDIBA therapy combined with manual therapy and soft tissue tissue manipulation enables instantaneous release to occur, significantly shortening the number and duration of physical therapy sessions. What is normally accomplished in two months of physical therapy can be accomplished in 3-4 sessions with INDIBA.

INDIBA CT9 Radiofrequency Device
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Ultrasound Guided Heel Pain
Injection Therapies

Injection therapies use natural/neutral solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Focused Shockwave Therapy

Platelet Rich Plasma (PRP)

PRP therapy uses a sample of the patient’s own whole blood, which is spun in a centrifuge to extract a high concentration of platelets. When injected into damaged tissues, PRP initiates tissue repair by releasing biologically active factors such as growth factors, cytokines, lysosomes and adhesion proteins. The injected solution stimulates the synthesis of new connective tissues and blood vessels. PRP can help to jump-start healing in chronic injuries and accelerate repair in acute injuries.


Proliferation Therapy, aka Prolotherapy

Prolotherapy uses a biologically neutral solution, often containing dextrose, saline or lidocaine. The solution irritates the affected connective tissue, stimulating the body’s own natural healing mechanisms to encourage growth of new normal ligament or tendon fibers.

Electromagnetic Transduction Therapy (EMTT)
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Get Personalized Heel Pain Treatment that
Really Works!

Heel pain can be debilitating, keeping you from maintaining your normal daily activities and reducing your overall quality of life. Heel pain in runners or heel pain in athletes should never be ignored. Failure to seek early treatment can cause your heel pain to degenerate into a more serious injury.

Accurate diagnosis is key to fast and effective heel pain treatment. Don’t waste your time and money on hit-or-miss approaches to heel pain diagnosis. The specialists at NYDNRehab are committed to helping our patients restore pain-free function as quickly as possible, using the most advanced technologies available. Contact us today, and jump-start the healing process so you can get back to doing the things you love.

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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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