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Your shoulder is a complex ball-and-socket joint designed to move in multiple planes. Your shoulder’s diverse range of motion enables you to perform a broad variety of movements and tasks, but its vast mobility also makes it the most unstable joint in the human body. Because of the complex network of structures involved in shoulder movement, pain can stem from multiple causes.
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Clinical director & DC RMSK
Dr. Lev Kalika is clinical director of NYDNRehab, and author of multiple medical publications and research. He is an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine
Dr. Kalika has over 17 years of experience successfully practicing dynamic neuromuscular stabilization (DNS), one of the most advanced methods for treating shoulder pain. He learned the technique directly from Pavel Kolar, the creator of DNS, and is fully certified in the discipline.
Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. His clinic features some of the most technologically advanced equipment in the world, rarely found in a private clinic.
Dr. Kalika has revolutionized shoulder pain diagnosis and treatment by introducing high resolution diagnostic ultrasonography to visualize and objectify the functional movement of the shoulder. Ultrasound provides us with invaluable information to accurately identify and treat the underlying causes of shoulder pain, to restore normal pain-free function.
Dr.Kalika’s expertise is sought by professional athletes across the United States.
Many mainstream physical therapists take a one-size-fits-all approach to patient care, using antiquated timelines and cookie cutter exercises that fail to fully rehabilitate shoulder 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 shoulder 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 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 shoulder, 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.
Rotator cuff tendinitis
Shoulder bursitis
Impingement of the tendons, bursa or nerves
Labral cartilage ruptures
Shoulder instability
Frozen shoulder
Shoulder osteoarthritis
Postural issues that contribute to shoulder pain
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 shoulder pain, but it allows your clinician to view the shoulder region in real time, with the shoulder in motion. In addition, biomechanical movement analysis helps us to identify faulty movement and compensation patterns that contribute to shoulder pain.
By visualizing the shoulder in motion and gathering quantitative data about shoulder mechanics, we are able to establish a baseline against which to measure progress. Once the exact cause of shoulder pain is determined, an effective treatment plan can be initiated and objectively measured for effectiveness.
Pain in the shoulder, back and neck
Bruising
Clicking or popping noises
Grinding sensation
Muscle stiffness and weakness
Restricted overhead movement
Occupational or athletic repetitive shoulder use
Arthritis and gout
Bone fractures
Bursitis
Frozen shoulder syndrome
Poor posture
Rotator cuff ruptures or tendinitis
Shoulder joint dislocation
Chronic stress and inflammation
Advanced age
Repetitive occupational tasks
Overhead sports
Poor posture
Sedentary lifestyle
Previous shoulder injuries
At NYDNRehab, we use a combination of non-invasive treatment methods, aimed at reducing pain and improving shoulder mobility.
To strengthen the muscles and connective tissues that support and stabilize the shoulder joint, to improve stability and relieve nerve pain. Postural correction therapy is often necessary to help realign the shoulder and surrounding structures.
A hands-on approach can help to increase shoulder mobility and range of motion to a frozen shoulder.
We use DNS to restore innate functional movement patterns and correct motor deficiencies.
Proteus uses the latest intelligent exercise and rehab technology to quickly strengthen the shoulder complex and restore sports movements, with patented 3D resistance training and quantitative 3D measurements.
EPAT
Also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues, stimulating cellular metabolism, to speed up the healing process.
ESWT
Is 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.
EMTT
Is a new technology that transmits high energy magnetic pulses to targeted tissues at extremely high oscillating frequencies. The magnetic waves synchronize with the body’s magnetic fields, causing a disturbance that triggers a regenerative response in difficult-to-reach tendons, muscles, bones and nervous tissues.
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.
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.
The best treatment options for acute shoulder pain depend on the diagnosis. Rotator cuff issues are the most common type of shoulder conditions in people over 30.
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 rotator cuff muscles
EMTT (electromagnetic transduction therapy) for pain treatment and regenerative therapy
Ultrasound guided dry needling to release myofascial trigger points and relieve pain
Physical therapy is the single best choice for chronic shoulder pain
There are a number of things you can do to protect your shoulder joints from pain and dysfunction:
Begin a balanced resistance training program to strengthen the structures that support and stabilize the shoulder girdle complex
Avoid forward-slumping posture while using computers and mobile devices
Allow yourself ample recovery time between workout sessions, especially if you are a swimmer, or play overhead sports like tennis, lacrosse or baseball
Do yoga or other stretching exercises to optimize mobility in the shoulder complex
Take measures to manage stress and eliminate chronic inflammation
Conventional medicine seeks to treat and manage the symptoms of shoulder pain without attempting to identify the underlying cause. Many of our patients suffer through multiple rounds of steroid injections, narcotic pain medications and even surgeries before they finally come to us for help.
Our high-tech diagnostic tools and non-invasive conservative treatment methods are aimed at getting to the root cause of shoulder pain and dysfunction and eradicating it for good.
At NYDNRehab, we never take a cookie-cutter approach to patient care. The causes and symptoms of shoulder pain can vary greatly 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.
NYDNRehab is the top rated physical therapy clinic for shoulder pain treatment in NYC. We accept most health insurance plans, and we are happy to set up payment plans for our patients.
Rotator Cuff
HyunJu
YOO, PT, MPT, DPT, CPI (Licensed Physical Therapist)
Dr. Christina Pekar
DC
Dr. Michelle Agyakwah
DC
Mariam Kodsy
Physical Therapist
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.
A bad physical therapy experience is one of the primary causes of unnecessary surgery
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)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
