Patellofemoral Pain Syndrome

About Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS), also known as runner’s knee or jumper’s knee, is a common condition among runners and athletes. PFPS is a generalized term used to describe pain at the front of the knee and around the patella (kneecap). The condition is especially prevalent in young female athletes, but it can affect anyone, at any age, including non-athletic populations of both sexes.

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Dr. Lev Kalika
Dr. Lev Kalika

Clinical director & DC RMSK

About Knee Pain Specialist Dr. Lev Kalika

Dr.Kalika has 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 extremities.

The 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. We fully analyze and quantify joint angles, ground reaction forces, muscle firing patterns, weight distribution and more, to get to the bottom of your knee pain and correct it.

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

Why PFPS Treatment at NYDNRehab is Better than Conventional Physical Therapy

Many conventional 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.

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, runners and ballet dancers who come to us for rehab and performance enhancement.

 Why PFPS Treatment at NYDNRehab is Better than Conventional Physical Therapy

Symptoms, Causes and Risk Factors of PFPS

Symptoms

  • Pain at the front of the knee and around the kneecap

  • Pain while squatting or climbing stairs

  • Pain after long periods of sitting with bent knees

  • Crackling or popping sounds or sensations in your knee

  • Pain that increases with changes in activity or playing surface

Causes

  • Repetitive overuse from sports and exercise

  • Kneecap misalignment

  • Weak or imbalanced muscles

  • Improper biomechanics

  • Unsupportive footwear and hard playing surfaces

Risk Factors

  • Participation in running, cutting and jumping sports

  • Young female athletes

  • Excessive sitting

  • Overweight or obesity

  • Changes in intensity and playing surface

Accurate PFPS 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 PFPS 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 PFPS pain is determined, an effective treatment plan can be initiated and objectively measured for effectiveness.

Accurate PFPS Diagnosis Means Successful Treatment

We Use High-Tech Equipment for Optimal Results

PFPS pain can range from mild to excruciating, and chronic PFPS is often treated with pain medications and steroid injections. 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 PFPS 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.

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 Patellofemoral Pain Syndrome

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.

Physical Therapy for Knee Pain

Ultrasound Guidance Makes Our Injection Therapies More Accurate and Effective

Ultrasound Guided Injection Therapies

Ultrasound Guided Injection Therapies

We sometimes use injection therapies to reduce pain and inflammation, or to elicit a regenerative response in damaged cells. Corticosteroids, platelet rich plasma, hyaluronic acid and other injections may be used when deemed appropriate.

Ultrasound Guided Dry Needling

Ultrasound Guided Dry Needling

Trigger points are tiny knots of muscle tissue that often form near the tendon-bone junction, causing pain and weakness. Ultrasound guided dry needling accurately targets trigger points to elicit a twitch response, instantly relieving pain and tension.

Best Patellofemoral Pain Syndrome Treatment Options

Acute PFPS

Acute PFPS

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 PFPS

  • Physical therapy is the single best choice of treatment for chronic PFPS anterior knee pain.

Chronic PFPS
Preventing Patellofemoral Pain Syndrome

Preventing Patellofemoral Pain Syndrome

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.

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 while running, 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.

Preventing Patellofemoral Pain Syndrome Image 2

Get Personalized Physical Therapy for Patellofemoral Pain Syndrome,
Designed Just for You

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.

Testimonials

author

Jonas Hoegh-Christensen About NYDNRehab clinic

Jonas Hoegh-Christensen is a famous Danish sailor who has taken part in the Summer Olympics in 2004, 2008 and 2012. He became a men’s sailing champion Finn class in London. Now, Jonas, a holder of an Olympics Silver, is getting ready for the upcoming 2016 Summer Olympics in Brazil. He is thankful to Dr. Kalika that he has managed to resolve all Jonas’s issues quickly and easily. We will cheer for Jonas and hope that this time we will not miss out on the gold.

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NY City ballet principal MeganLeCrone testimonial for her returning to dance after hip injury

Watch and hear our patient, ballet dancer Megan LeCrone, explain how her frequent injuries put her in a downward spiral that nearly ended her career. After several surgeries and fruitless therapy, Megan found our clinic and came to us for help. Dr. Kalika was able to help her restore her brain-body connection and build her strength “from the inside-out.” Her pain is gone, her injuries are rehabilitated and she is dancing better than ever. Megan continues to visit the NYDNRehab clinic for maintenance therapy and she feels great! We love our patients, and we never stop until we get to the source of their pain and disability.

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Get Pain-Free PFPS Treatment That Really Works

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.

NYDNRehab is the top rated physical therapy clinic for PFPS knee pain in NYC. We accept most health insurance plans, and we are happy to set up payment plans for our patients. Contact us today and make an appointment to get rid of your PFPS knee pain for good, so you can get back to doing the things you love.

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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)

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    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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