Knee Pain Treatment

About Knee pain

The human knee is a complex structure, designed to withstand enormous force loads. Knee pain can be caused by a number of factors, including gait deficits and injuries anywhere along the lower kinetic chain. You can avoid surgery with accurate diagnosis and conservative physical therapy. At NYDNRehab, we know knees!

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Dr. Lev Kalika, Clinical Director, DC, RMSK

Dr.Kalika revolutionized knee 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 extremity.

Dr.Kalika’s motion and gait analysis lab at NYDNRehab is the only private lab in the US to feature research-grade technology, normally found only at top research universities, and made available to patients in our private clinic. Dr.Kalika believes that what cannot be measured cannot be treated.

Dr.Kalika’s expertise is sought for knee pain relief by professional athletes across the United States.

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Why Physical Therapy Alone May Not Resolve Your Condition

Physical therapy is a valuable and effective approach to resolving musculoskeletal pain and dysfunction, but in many cases, physical therapy does not provide a stand-alone solution. Prior to beginning physical therapy, patients often need to address underlying issues that contribute to their pain and disability.

Unfortunately, mainstream physical therapy clinics are often not adequately equipped or experienced to identify and treat complications that undermine the effectiveness of physical therapy. They often rely on one-size-fits-all treatment protocols that overlook the unique characteristics of the individual condition, opting to treat the symptoms and not the patient.

Issues that should be addressed prior to beginning physical therapy include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury
Block PT

Holistic Non-Invasive Diagnosis and Regenerative Therapy

Identifying and treating underlying issues prior to beginning physical therapy is key to getting fast and effective results. Failure to do so can completely undermine your treatment protocol, and in some cases, your condition may even worsen.

At NYDNRehab, we use a broad range of advanced technologies and innovative therapeutic approaches to resolve issues that can potentially undermine the success of physical therapy.

Our talented staff is certified in a diverse array of treatment methodologies, rarely found in run-of-the-mill physical therapy clinics. Our one-on-one sessions are personalized, based on the patient’s unique diagnostic profile.

Obstacles to physical therapy success include:

  • Scar tissue and fascia adhesions
  • Neurogenic inflammation
  • Joint edema
  • Inflamed soft tissues
  • Myofascial trigger points
  • Compressed or entrapped nerves
  • Tendons that have degenerated and lost their elastic properties
  • Compensation patterns developed post-injury

Our Awards

Why Knee Pain Treatment at NYDNRehab is Better than Conventional Physical Therapy

Many run-of-the-mill physical therapists take a one-size-fits-all approach to patient care, using antiquated timelines and cookie cutter exercises that fail to fully rehabilitate knee injuries and restore optimal movement.

At NYDNRehab, we take an individualized approach to every patient and every condition. Using advanced technologies, we are able to accurately diagnose and measure individual parameters for joint angles, force loads, muscle firing patterns and gait. We then design personalized treatment programs based on collected data, measuring progress along the way to ensure full recovery.

Knee Pain Treatment Image 1
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Our experience combining innovative treatment methods with advanced technologies makes NYDNRehab the number one choice for physical therapy, chiropractic care and rehabilitation in NYC. We use FDA approved methodologies to successfully treat a broad range of conditions. Our patients include elite athletes and ballet dancers who come to us for knee pain relief, rehab and performance enhancement.

We understand that every patient has a unique anatomy, and that each condition has unique characteristics. We tailor our one-on-one treatment plans to the individual patient, and never use cookie cutter approaches.

In addition to restoring strength and range of motion to the structures surrounding the knee, we retrain the brain-body connection, to restore optimal neuromuscular recruitment patterns that are often disrupted after an injury. By doing so, our athletes are able to return to sport safely, with reduced risk of re-injury.

NYDNRehab is the top rated physical therapy clinic for knee pain relief in NYC.

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Symptoms, Causes and Risk Factors of Knee Pain

Symptoms

  • Inflammation, pain and stiffness

  • Pain below, above or under the kneecap

  • Pain on or around the inner knee

  • Bruising and/or redness

  • Weakness and instability

  • Popping sounds or sensations

  • Inability to straighten the knee

Causes

  • Athletic injuries and trauma

  • Sedentary lifestyle and too much sitting

  • Overweight or obesity

  • Wear and tear from poor posture

  • Mechanical deficiencies in walking or running gait

  • Repetitive overuse from running, sports and exercise

  • Weakness and muscular imbalances in the lower kinetic chain

Risk Factors

  • Sedentary lifestyle

    Sedentary lifestyle

  • Obesity

    Obesity

  • Faulty biomechanics

    Faulty biomechanics

  • Gait anomalies

    Gait anomalies

  • High intensity sports and exercise

    High intensity sports and exercise

  • Excessive sitting

    Excessive sitting

  • Repetitive overuse

    Repetitive overuse

Range of Available Unique Physical Therapy Treatments at Nydnrehab

Case Study

Rehabilitative ultrasonography of quadriceps muscle

Accurate Diagnosis Means Successful Treatment

The sports medicine specialists at NYDNRehab are experts in diagnostic musculoskeletal ultrasonography. Diagnostic ultrasound not only enables the doctor to identify the structural causes of knee pain, but it allows your clinician to view the knee region in real time, with the knee in motion. In addition, 3D gait analysis helps us to identify faulty movement mechanics that contribute to knee pain.

By visualizing the knee in motion and gathering quantitative data about gait mechanics, we are able to establish a baseline against which to measure progress. Once the exact cause of knee pain is determined, an effective treatment plan can be initiated and objectively measured for effectiveness.

Knee Conditions and Injuries We Treat at NYDNRehab

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Knee bursitis
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Inner knee pain
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MCL Tears (Post- and Non-Surgical)
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Pes anserine bursitis/
tendinopathy
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Medial Retinaculum Pain Syndrome
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Plica Syndrome

We Use High-Tech Equipment for Optimal Results

Knee pain can range from mild to excruciating, and many turn to surgery as a first line of treatment. However, most non-traumatic knee pain can be eliminated through the non-invasive treatment methods we practice at NYDNRehab. We use the latest technologies and innovative therapies to treat knee pain at its source and eliminate it for good.

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

Mechanical deficiencies in walking or running gait can cause the knee to become misaligned, placing undue stress on the structures surrounding the knee and producing pain. We use our state-of-the art gait lab to analyze joint angles and force loads associated with gait, to identify and quantify mechanical deficits and retrain the way you walk and run, to eliminate pain.

Alter-G Antigravity Treadmill
Alter-G Antigravity Treadmill

Our gravity-reducing treadmill unloads the knee joint, to enable retraining of gait patterns without placing undue stress on injured structures. This approach speeds recovery by allowing gradual reloading of the knee and gradual improvement of gait patterns.

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

C.A.R.E.N’s advanced technology uses a virtual reality environment to train healthy movement patterns and enhance sports performance. Real-time feedback is provided to optimize motor patterns, retraining the brain-body connection for efficient pain-free movement.

Blood Flow Restriction Training
Blood Flow Restriction Training

BFR makes it possible to rehabilitate injured tissues using much lighter loads, by occluding the blood vessels to elicit a regenerative response in damaged cells. BFR helps prevent tissue atrophy after an injury while protecting damaged structures from overload. It speeds the recovery process for faster return to pain-free activity.

DD Robotech
DD Robotech

DD Robotech (DDR) is AI-powered robotic training equipment that provides neuromuscular and neurocognitive training for patients and athletes with pain and/or reduced mobility in the lower kinetic chain (hips, knees, ankles and feet). DDR is based on linear force impedance robotic technology.

Physical Therapy for Knee Pain
Physical Therapy for Knee Pain

Physical therapy exercises work to strengthen and rebalance the muscles that support the knee joint, taking pressure off of nerves and connective tissue, and realigning the joint for optimal function.

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Our Regenerative Therapies are Game-Changers
for Knee 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 healing by stimulating tissue repair at the cellular level. 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 defocused 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

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.


Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to lower back pain. Dry needling is an outpatient procedure that inserts non-medicated needles into the trigger point to evoke a twitch response, releasing the trigger point and immediately relieving pain. Ultrasound guidance eliminates the need for multiple insertions, reducing pain and discomfort for the patient.

Regenerative Ultrasound Guided Injection Therapies
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Ultrasound Guided 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)

More Treatment Options

Acute Knee Pain

Acute Knee Pain

The best treatment options for acute knee pain depend on the diagnosis. Patellofemoral syndrome is the most common type of acute knee pain.

Treatment options include:

  • A combination of EPAT (Extracorporeal Pulse Activation Technology) and ESWT (extracorporeal shock wave therapy) to relieve pain and balance tension in the quadriceps muscles and the patellar retinaculum.

  • Ultrasound guided dry needling

  • EMTT (electromagnetic transduction therapy) for pain treatment and regenerative therapy

Chronic Knee Pain

Physical therapy is the single best only choice for chronic anterior knee pain

Chronic Knee Pain

Preventing Knee Pain and Injury

The best way to avoid knee pain and injury is to remain physically active, moving your body in ways that recruit multiple muscle groups in multiple planes of motion. In addition, you should manage your weight and eat a nutrient-dense diet that provides the building blocks for lean muscle and connective tissue. Bone-based broth is a good dietary source of collagen, which plays a protective role in the knee joint.

If you are already physically active, you can benefit from a 3D gait analysis and/or a biomechanical analysis, to identify and correct any motor deficits that can potentially lead to knee injuries. Runners in particular can avoid knee pain by visiting the NYDNRehab Running Lab.

visiting Running Lab »
Preventing Knee Pain and Injury Image 1
Preventing Knee Pain and Injury Image 2

Keeping your hamstring and calf muscles flexible and strong, and your quadriceps strong and balanced will help you avoid knee pain. You should also maintain strong gluteal muscles and a strong core. Do not allow your foot to over-pronate, and maintain strong foot core muscles. It is critical to fully rehabilitate any injuries to the structures of the lower extremity or the low back, including old injuries that were not fully rehabbed.

Advantages of EMTT

Get Personalized Physical Therapy, Designed Just for You

At NYDNRehab, we never take a cookie-cutter approach to patient care. The causes and symptoms of knee pain can vary from one patient to the next, and each case requires a unique treatment approach. We thoroughly examine each patient and base our treatment solutions on your personal diagnosis. We provide one-on-one Physical Therapy, custom-designed for the individual patient.

Clinical Case Studies
NYDNRehab


Case Study: Knee Pain Caused by Nerve Entrapment

Our patient was a 65 year-old male complaining of medial knee pain, with a history of low back pain. He had previously undergone a lumbar discectomy where a degenerative disc had been removed at L4-L5.

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Case Study: Runner’s Pain

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.

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Get Non-Invasive Knee Treatment that Really Works!

Knee pain can be debilitating, interfering with your ability to enjoy life to its fullest. Pain medications and surgeries often fail to get to the root cause of knee pain, treating the symptoms without resolving their underlying causes. At NYDNRehab, we make it our mission to get to the source of your knee pain and correct it, so you can move freely again and enjoy life to its fullest.

If you suffer from chronic knee pain and want to find the best knee doctor in NYC, visit NYDNRehab in midtown Manhattan. Our team of knee pain specialists provide individualized treatment plans to meet the unique needs of every patient. We don’t just treat knee pain – we get to its source and restore healthy pain-free function, so you can enjoy the very best quality of life. Contact us today and make an appointment to get rid of your knee pain for good.


Contact NYDNRehab today for speedy pain relief and healing from the
best PT and chiropractic rehab clinic in NYC.

Testimonials

Anterior Knee Pain Treatment

Anterior knee pain is an injury of the knee in which pain is experienced at the front and center of the knee. It is the most common form of injury to knee in adolescents and young adults, and in both athletes and non-athletes. Over 9 percent of young, active adults have suffered from anterior knee pain, and it accounts for a quarter of all knee problems treated at sports injury clinics. It is especially common in women and is one of the more debilitating injuries of the knee; if left untreated, it can create chronic disability. Read more…

Knee Pain Treatment

Knee pain is one of the most common physical injuries and has many possible causes. For this reason it’s difficult but all the more crucial to get an accurate diagnosis for treatment for knee pain. Patients may develop knee pain as a result of arthritis, ligament injuries, cartilage injuries, dislocated kneecap, bursitis, or patellar tendinitis. Luckily there is a variety of knee pain treatment options. Read more…

Osteoarthritis knee pain treatment

Osteoarthritis knee pain can be debilitating, and we at the New York Dynamic Neuromuscular Rehabilitation have successfully treated many patients with osteoarthritis of the knee for over 15 years.

Our doctors and staff are careful to devise treatment plans that are specific to our individual patients. In order to successfully treat our patients, we must take their age, gender and living situation and overall health into account. An otherwise healthy 60 year old who’s used to playing sports can’t be treated the same way as a 70 year old who’s been obese for most of her life and has developed co-morbidities besides arthritis. But no matter, who the knee arthritis patient is, they can depend on the skill, compassion and years of experience of our medical staff. Read more…

Knee Pain Specialist NYC

Our treatment of knee joint pain begins with complete ultrasonographic and dynamic evaluation of the kinetic chain of the lower extremity by technological Gait analysis which includes the hip and the foot. The hip and foot misbalance directly affects the knee since foot placement and hip alignment determines movement at the knee. In such cases, repairing movement dysfunctions of hip and foot will reduce stress overload to the knee and encourage its tissue healing. This strategy is combined with direct treatment of the injured knee tendons and other affected tissues. Read more…

Meniscal Tears

Meniscal tears are a common cause of knee pain. Typically, athletes who play contact sports, are most at risk for meniscal tears. However, anyone at any age can suffer from a torn meniscus. In fact, about one-third of people over 50 will suffer a torn meniscus, with meniscal tears being more common in men than in women. Men are around two and a half to four times more likely than women to develop a torn meniscus. Read more…

Research at NYDNRehab

Knee Pain FAQs

I’ve had chronic knee pain for over a year. Do I need knee surgery?
In most cases of knee pain, surgery is unnecessary, and research shows that surgery can even do more harm than good. It is always best to try conservative care first, like physical therapy, to correct the factors that underlie knee pain.
I think I have Runner’s Knee — how do I fix it?
Runner’s knee, aka patellofemoral pain (PFP) syndrome, is a common condition in runners. It is most often caused by faulty gait mechanics when running. PFP is often treated with standard first aid, along with stretching and strengthening exercises. However, research indicates that gait retraining is the most effective way to eliminate Runner’s Knee.
Is there an effective non-surgical treatment for knee osteoarthritis?
Knee osteoarthritis is marked by deteriorating bone and cartilage in the knee joint. Regenerative therapies like extracorporeal shockwave therapy (ESWT) are proving effective for knee OA treatment. One scientific article found that ESWT helps to modify the effects of OA progression on cartilage and bone alterations, as well as reducing pain and reducing joint stiffness.
Do I need physical therapy after my ACL reconstruction before I return to my sport?
Yes, you definitely need a sports physical therapist to rehabilitate your injury before returning to the playing field. Studies show that even after the most advanced surgical interventions, the risk of re-injury is high if a sports injury is not properly rehabilitated.
Can anything other than surgery be done for a torn meniscus?
Yes, studies suggest that the outcomes of conservative rehabilitation for meniscus tears are equal or superior to surgical outcomes, especially in patients over 40, a demographic where meniscus tears are common.
I ruptured my patellar tendon while playing tennis. Will it heal on its own?
If you intend to remain physically active, you need to fully rehabilitate your injury. It will not heal properly if you just ignore it. Studies show that blood flow restriction (BFR) training is highly effective for rehabilitating patellar tendinopathy.
My doctor can’t find the source of my knee pain. What are some possible causes of knee pain?
The knee is a complex joint made up of multiple structures. The knee is designed to withstand massive force loads, but many things can go wrong to cause knee pain. Inefficient gait mechanics is a common cause, along with being overweight and out of shape. We use diagnostic ultrasound imaging to get to the source of knee pain, followed by a personalized treatment plan based on your results.
What type of non-surgical options are available for knee pain?
There are many treatment options for knee pain other than surgery, and most of them yield similar or better long-term outcomes. Treatment options for knee pain may include regenerative therapies, physical therapy, feedback training and gait retraining.
What is Jumper’s Knee and how is it treated?
Jumper’s Knee is a form of patellar tendonitis, an overuse injury common in athletes who play basketball, volleyball and other jumping sports. One recent study found that ultrasound guided dry needling can be highly effective for treating Jumper’s Knee. Dr. Kalika is an expert in dry needling procedures using ultrasound guidance.

Our Specialists

Dr. Mikhail Bernshteyn MD (Internist)
Dr. Michael Goynatsky DPT
Dr. Daniela Escudero DPT
Dr. Michelle Agyakwah DC
Dr. Tatyana Kapustina L. Ac.
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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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