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Shoulder Pain Treatment

About Shoulder Pain

Your shoulder is a complex ball-and-socket joint designed to move your arm through multiple planes of motion. Your shoulder’s diverse mobility allows you to perform a broad variety of movements and tasks, but its vast range of motion makes it the least stable joint in the human body. Because of the complex architecture of the shoulder, pain and dysfunction can stem from multiple sources.

High resolution diagnostic ultrasonography provides an invaluable tool for dynamically visualizing the shoulder’s many tissues and structures in real time. Ultrasound imaging takes the guesswork out of diagnosis and treatment, ensuring that you receive the best possible shoulder rehabilitation.

What to Expect on Your First Visit

When you arrive at NYDNRehab you will immediately see that we are different from average physical therapy clinics. Once you are checked in, you will receive the most comprehensive clinical exam available. In addition to reviewing your health history and conducting some preliminary tests, your exam will include dynamic high-resolution ultrasound imaging of your shoulder and surrounding structures.

Our high-resolution ultrasound equipment gives us crystal-clear images of your shoulder in motion, in real time. Imaging is conducted in-house, with no waiting for lab results. As a key stakeholder in your own health, we will keep you in the loop as your images appear on the monitor and encourage your feedback.

Once we have a clear picture of what is causing your shoulder pain, we will create a personalized treatment protocol based on your exam results.

Shoulder Conditions We Treat

Click here to learn more about shoulder pain treatment at NYDNRehab…

Dr. Lev Kalika

Clinical director & DC RMSK

About Shoulder Pain Specialist Dr. Lev Kalika

Dr. Kalika, clinical director of NYDNRehab, has devoted his life’s work to finding innovative and effective ways to treat musculoskeletal pain and dysfunction. Dr. Kalika has published multiple scientific articles on the use of musculoskeletal ultrasonography in rehabilitative medicine. Dr. Kalika has developed his own holistic methodology for diagnosing shoulder pain, using the highest resolution ultrasonography available. His diagnostic approach to shoulder pathology includes a dynamic exam of the scapular muscles using cutting edge kinematic motion analysis technology and ultrasound imaging. He is one of the few experts in the USA trained in scapular (shoulder blade) ultrasonography. According to Dr. Kalika, shoulder pain is too often mismanaged, focusing on the rotator cuff while ignoring the scapula. Physical therapy is most effective when the structural integrity of the scapular muscles and nerves is restored. Unless the shoulder girdle/neck complex is addressed holistically, regenerative therapies targeting the rotator cuff tendons will only render mediocre results. The NYDNRehab clinic features some of the most technologically advanced equipment available for shoulder injury rehabilitation.

Dr. Kalika studied directly under Dr. Ben Kibler, world-renowned orthopedic surgeon and pioneer of scapular dyskinesis. His diagnostic approach focuses on the structural integrity of the scapular muscles, and the nerves that innervate the shoulder complex. He addresses these issues with extracorporeal regenerative therapies and regenerative injection therapies.

Dr. Kalika was among the first in his field to become certified in dynamic neuromuscular stabilization (DNS), considered the most integrative evidence-based approach for treating shoulder pain. He worked directly with and trained under the creator of DNS, Dr. Pavel Kolar.

Dr. Kalika has revolutionized the treatment of adhesive capsulitis (frozen shoulder) by combining advanced technologies and ultrasound guided fascial plane and capsular hydrodissection. His approach to frozen shoulder syndrome has seen groundbreaking results in relieving pain and restoring shoulder range of motion. Regardless of how long your symptoms have persisted, you will see noticeable results after just the first treatment.

Dr. Kalika is at the forefront of pioneering work on fascia, the network of connective tissue that encases and connects muscles and organs throughout the body. Fascia plays an important role in stabilizing the shoulder joint and enabling nerves and blood vessels to glide smoothly among other structures.

Dr. Kalka uses high-resolution ultrasound to visualize fascia connections that affect shoulder function. He is certified in the Stecco method of fascia manipulation, an approach that targets fascia densifications that impede shoulder movement.

Some Shoulder Conditions Need Specialized Treatment

When it comes to shoulder rehabilitation, few physical therapists know how to approach chronic shoulder conditions like shoulder blade pain and scapular dyskinesis, and very few clinics feature advanced diagnostic tools like high-resolution ultrasonography.

As a life-long learner, Dr. Kalika keeps up-to-date with the most innovative approaches and technologies. He recently participated in a 3-day intensive workshop on the shoulder, and the use of ultrasound for diagnosis, rehabilitation and regenerative procedure guidance. The workshop was led by some of the world’s most renowned orthopedic specialists in shoulder and scapular dyskinesis.

Click here to learn more about Dr. Kalika's approach to shoulder pain treatment…

Accurate Diagnosis Means Successful Treatment

The complexity of the shoulder region makes it challenging to accurately identify the exact source of shoulder pain and dysfunction. A clinical exam with testing for strength and range of motion can help to narrow down possible causes, but ultrasound imaging is necessary to get an accurate diagnosis of rotator cuff dysfunction.

Diagnosis of shoulder pathology often relies on reported symptoms and findings from a clinical exam, but that approach may overlook critical aspects of your injury, resulting in mistreatment, prolonged pain, and excess medical costs. Dynamic ultrasound imaging lets us visualize the big picture in real time, with the shoulder in motion.

With diagnostic ultrasound, we can:

Compare the injured and uninjured shoulders
View nerves, muscles, fascia and bones along their entire paths
Identify fascial densifications and adhesions, and myofascial trigger points
Detect the exact site of nerve compression or entrapment
View multiple tissues and structures in a single session
Elicit patient feedback during the imaging session

In addition to high-resolution imaging, our advanced equipment has capabilities for sonoelastography to gauge muscle and tendon stiffness, and superior microvascular imaging, to detect early signs of healing and monitor patient progress.

Ultrasound imaging takes the guesswork out of diagnosis, enabling us to quickly identify and treat multiple factors that contribute to shoulder pain and dysfunction. Your on-site ultrasound exam takes place on your very first visit, in the comfort of our clinic. Quick and accurate diagnosis means you can begin therapy right away, with no wait time for lab results.

Ultrasound vs MRI for Visualizing the Shoulder

For years, MRI has been considered the gold standard for musculoskeletal imaging, but advancements in technology have made high-resolution diagnostic ultrasound the imaging modality of choice for shoulder pathology.

What makes high resolution ultrasound superior to MRI?:

Much higher resolution means ultrasound can visualize small lesions and anomalies that are often missed by MRI
Ultrasound allows for dynamic evaluation that can reveal factors like ligament laxity, nerve entrapment, and other factors affecting shoulder function that cannot be detected by static MRI
High-resolution ultrasonography can visualize nerve compressions or entrapments within the brachial plexus that are impossible to visualize with MRI

Due to the complexity of shoulder architecture, lack of accurate diagnostic imaging can result in suboptimal treatment that prolongs your pain and drains your bank account without resolving your condition.

Click here to learn more about ultrasound imaging vs MRI…

Scapular Ultrasound Detects Mechanical Deficiencies

Imaging of the scapula using high-resolution ultrasound is an important tool for observing how the scapula moves relative to the humeral head of the shoulder joint. Accurate interpretation requires a skilled clinician with a comprehensive knowledge of human anatomy. Combining scapular ultrasound with ShowMotion technology provides substantial information for comprehensive shoulder rehabilitation.

Scapular imaging is especially useful for patients with rotator cuff tears, joint hypermobility syndrome (JHS), or Ehlers-Danlos syndrome (EDS) whose joints are prone to excessive movements and instability. In such cases, the connective tissues surrounding the shoulder joint tend to be lax and weak, causing poor joint stability and increasing the risk of shoulder subluxation/dislocation.

The scapula compensates for shoulder instability by acting as a stable base for positioning the glenoid fossa, to optimize positioning of the humeral head. Dynamic scapular stabilization requires well-coordinated muscle activation patterns, especially of the rotator, deltoid, trapezius and rhomboid muscles. Scapular dysfunction can increase strain on the rotator cuff and labrum, contributing to pain and instability.

Dynamic scapular imaging lets us observe the complex interactions of the shoulder girdle kinetic chain, to pinpoint issues such as deficiencies in muscle activation, glenohumeral joint subluxation, and capsular laxity that contribute to shoulder instability. For patients with rotator cuff tears , JHS/EDS patients, scapular ultrasound can be a game-changer, ensuring they receive proper rehabilitation that enhances stability after a shoulder dislocation.

New Technologies Redefine Shoulder Diagnosis and Therapy

The complexity of the shoulder region makes it difficult for practitioners to identify the exact source of shoulder pain and dysfunction. In many cases, multiple factors come into play. High resolution ultrasound imaging is an advanced and effective diagnostic tool, especially when coupled with new technologies that dramatically enhance visualization and facilitate shoulder rehabilitation.

ShowMotion

ShowMotion is an objective tool for joint movement analysis that uses motion tracking sensors, placed on the patient’s skin to collect data about movement quality. The patient performs a series of joint-specific movements, and the data is analyzed by ShowMotion’s proprietary software and displayed on a computer screen. The collected information provides valuable insights about inefficient movement patterns, compensation patterns, and improvements in movement in response to therapy, enabling practitioners to personalize rehabilitation.

ShowMotion is similar to gait /running analysis, but for the shoulder and scapular region. This cutting-edge technology can play a key role in postural restoration. ShowMotion can also contribute to athletic performance enhancement by measuring baseline joint kinematics and tracking the athlete’s progress in response to training.

Neuralign Shoulder Pacemaker

The Neuralign Shoulder Pacemaker is a shoulder rehabilitation device with a kinematic sensor activated by movement. The patient dynamically interacts with the device to stimulate efficient muscle recruitment patterns, enhance movement quality, and restore optimal muscle balance during rehabilitation. The sensor provides objective data that practitioners can use to support decision-making and personalize shoulder rehabilitation.

The Shoulder Pacemaker can be used to target several common conditions:

Rotator cuff disorders
Scapular dyskinesis
Shoulder instability
Neck pain related to abnormal shoulder movement
Shoulder and arm pain caused by nerve entrapment

The Shoulder Pacemaker is also a cutting-edge tool for enhancing athletic performance in shoulder-intensive sports like swimming, tennis, baseball and others.

Why Physical Therapy Alone is Not Enough to Resolve Shoulder Pathology

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

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

At NYDNRehab, we use a broad range of regenerative technologies and integrative therapeutic approaches to resolve issues that can stand in the way of successful physical therapy. Our staff is certified in a diverse array of holistic treatment methodologies, and our one-on-one treatment sessions are personalized, based on your unique diagnostic profile.

Once we pre-treat your damaged tissues and eliminate compensation patterns, your shoulder complex will be ready for physical therapy.

Tensegrity is the Secret to Pain-Free Mobility

Most people take everyday mobility for granted until an injury occurs or pain sets in. Sometimes pain and reduced mobility seem to arise out of nowhere, with no apparent cause of onset. Regardless of whether your pain is caused by trauma or by something less obvious, tensegrity plays a key role.

Tensegrity refers to tensile integrity – a state where a system of individual components is held together under continuous elastic tension. In the human body, tensegrity is created by the myofascial system, the network of muscles and fascia that work together to produce, control, and guide forces, and to hold the body’s various organs and structures in place during movement.

Tensegrity can be disrupted when myofascial tissues are injured or damaged in some way. When that happens, nerves and blood vessels can become entrapped, preventing them from gliding among other structures and producing pain. At the same time, the elastic tension that governs joint alignment and controls movement becomes compromised, creating motor deficits that undermine mobility and stability.

Factors that disrupt myofascial tensegrity include:

Traumatic injury that affects multiple tissue types
Overuse injuries from sports, exercise or occupation
Old injuries that were never properly rehabilitated
Sedentary lifestyle with excessive sitting
Obesity that overloads the body’s structures
Inadequate hydration that deprives soft tissues of water needed to function
Diet high in sugar and carbs that causes myofascial tissue glycation, making it dense and sticky

Many doctors do not understand the crucial role of the myofascial system in preventing pain syndromes, movement disorders, and disease. In fact, most medical doctors have no idea how to correct myofascial dysfunction or even recognize it as a factor. They simply treat pain symptoms with medications and eventually recommend surgery.

At NYDNRehab, we understand that the body’s systems work together as an integrated whole, and that treating pain is not enough to eliminate its source. We use dynamic high-resolution ultrasound to explore the myofascial system in real time. Ultrasound imaging lets us visualize muscles, fascia, nerves and other structures in motion, to identify places where tensegrity has been disrupted.

Once we identify the problem, we use the most advanced therapeutic approaches to restore myofascial integrity and promote tissue healing.

Our Regenerative Technologies
Accelerate Healing

The human body has its own innate healing mechanisms, but avascular tissues like tendons and ligaments sometimes need a nudge to accelerate the healing process. Regenerative technologies help to jump-start tendon healing by stimulating tissue repair at the cellular level. Our outpatient regenerative therapies expedite recovery with minimal discomfort for the patient.

Regenerative Therapies At NYDNRehab

SoftWave Electro-Hydraulic Shockwave Therapy

SoftWave is a groundbreaking regenerative mechanotransduction technology that accelerates tissue healing. Its patented electro-hydraulic applicator delivers high-speed soundwaves that can penetrate up to six inches in depth. SoftWave’s defocused and linear focused shockwaves recruit maximum stem cells to the treatment site to promote healing. SoftWave’s wider and deeper penetration using defocused energy is a preferred treatment option for a broad spectrum of conditions, ranging from orthopedic injuries to pelvic health. SoftWave is the only unfocused shockwave technology currently available. According to recent research, SoftWave defocused waves combined with focused and radial shockwaves have maximum regenerative potential.

Myofascial Acoustic Compression Therapy (MyACT)

MyACT is a new type of focused shockwave technology that allows for deeper compression of the focused waves. Its higher frequency allows for precise neuro modulation under ultrasound guidance, with a special linear head for treating myofascial pain. MyACT transforms the mechanical energy of shockwaves into biochemical signals that precisely target damaged tissues. Most injuries involve more than one tissue type. When used together, our advanced shockwave technologies enable us to specifically target multiple tissue types with the most effective shockwave treatment.

Myofascial Acoustic Compression Therapy (MyACT)

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 transmits high energy magnetic pulses to targeted tissues that synchronize with the body’s own magnetic fields, triggering a regenerative response. EMTT waves can penetrate deep tissues to target difficult-to-reach tendons, muscles, bones and nerves.

Extracorporeal Magnetic Transduction Therapy (EMTT)

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, sometimes called defocused shock wave therapy, is not a true shockwave. It uses mechanical pressure waves to enhance blood circulation, improving oxygen and nutrient delivery to muscle and fascia tissues, but has minimal regenerative properties.The mechanical properties of EPAT make it especially effective for fascial manipulation in combination with focused shockwaves. We combine EPAT with different types of shockwaves for holistic treatment, without additional cost to the patient.

High Energy Inductive Therapy (HEIT)

HEIT delivers high-intensity magnetic pulses to peripheral nerve tissues, to stimulate neuroplasticity. We leverage this FDA-approved methodology to treat pain and regenerate nerve fibers, for enhanced motor control.

High Energy Inductive Therapy (HEIT)

INDIBA Radiofrequency Therapy

INDIBA is a form of TECAR therapy that helps to restore the ionic charge of damaged cells, for faster injury healing and rehabilitation

NESA Neuromodulation Therapy

NESA generates a low-frequency electrical current of intermittent and cyclical stimuli that soothes hypersensitized nerves and restores optimal signaling between the autonomic nervous system and the brain. We leverage this FDA-approved methodology to treat pain and regenerate nerve fibers, to enhance motor control.

NESA Neuromodulation Therapy

Click here to learn about regenerative technologies at NYDNRehab…

We Guide Our Needling and Orthobiologic
Procedures with High-Resolution Ultrasound

Injection therapies use orthobiologic solutions that stimulate cellular repair by either nourishing or irritating the targeted cells. Dr. Kalika works with an injection specialist, providing ultrasound guidance to ensure that the injected substances hit their mark, for maximum effectiveness

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 tendon healing in chronic injuries and accelerate repair in acute injuries.

Alpha-2-Macroglobulin (A2M)

Alpha 2 macroglobulin (A2M) is a naturally occurring blood plasma protein that acts as a carrier for numerous proteins and growth factors. As a protease inhibitor, A2M reduces inflammation in arthritic joints and helps to deactivate a variety of proteinases that typically degrade cartilage.

Prolotherapy

Prolotherapy uses a biologically neutral solution to irritate stubborn tissues, triggering the body’s innate healing mechanisms to grow new normal tendon, ligament and muscle fibers.

Interfascial Plane and Nerve Hydrodissection

Shoulder injuries often involve fascial tissue that has become densified and/or formed adhesions, entrapping nerves and blood vessels, causing pain and restricting movement. Hydrodissection is a procedure where a saline solution is injected into densified fascia under ultrasound guidance. The solution works by separating fascial layers and freeing up entrapped nerves and blood vessels. We often use hydrodissection in conjunction with manual fascial manipulation.

More Advanced Therapies at
NYDNRehab

SM Neuromuscular Electrical Stimulation (SMNMES)

SM neuromuscular electrical stimulation (NMES) dynamically interacts with the patient during therapeutic exercises, providing real-time sensory, auditory and visual biofeedback to the patient. This breakthrough technology helps patients to recalibrate muscle actions, to optimize joint function. SMNMES has helped numerous patients to avoid unnecessary shoulder, knee and ankle surgeries, even in complex scenarios.

Ultrasound Guided Percutaneous Neuromodulation (PENS)

During PENS treatment, filament-thin needles are inserted through the skin into muscle tissue adjacent to the targeted nerve. A low frequency electrical current is then delivered via the inserted needles to stimulate the dysfunctional nerve. PENS normalizes nerve activity, improves brain plasticity and optimizes muscle recruitment patterns. This therapy is so effective that patients typically need only 4-6 treatment sessions.

Symptoms, Causes and Risk Factors of
Shoulder Pain

Symptoms

Pain in the shoulder, back and neck
Bruising
Clicking or popping noises
Grinding sensation
Muscle stiffness and weakness
Restricted overhead movement

Causes

Repetitive overhead shoulder motion
Arthritis and gout
Bone fractures
Bursitis
Frozen shoulder syndrome
Poor posture
Rotator cuff ruptures
Shoulder joint dislocation

Risk Factors

Advanced age
Repetitive occupational tasks
Overhead sports
Poor posture
Previous shoulder injuries
Metabolic disorders
Smoking
Chronic stress and systemic inflammation

Get Personalized Shoulder Therapy Designed Just for You

At NYDNRehab, we treat the whole patient, not just your symptoms. We never use one-size-fits-all rehab protocols or antiquated recovery timelines. We believe that every injury is unique, and treatment should be based on a holistic approach that factors in the patient’s unique profile.

Once we have successfully pre-treated your damaged tissues, we can begin one-on-one physical therapy to restore strength and stability, optimize mobility, and re-establish optimal neuromuscular pathways and muscle coordination patterns.

Your treatment protocol may include a combination of the following approaches:

Stecco fascial manipulation, to eliminate densifications and adhesions and restore fascia’s gliding properties
Postural restoration therapy to optimize total-body joint alignment
Dynamic neuromuscular stabilization (DNS) to restore developmental motor strategies
Integrated systems model (ISM) to optimize function and performance
Anatomy in motion (AIM) to enhance movement quality
Neurodynamics, to restore communication pathways between the brain and body
Conventional eccentric loading and strengthening exercises

Your back-to-sports protocol may include sport-specific training to optimize motor skills and restore peak athletic performance. We carefully monitor patient progress with ultrasound imaging to confirm complete recovery.

Click here to learn how DNS helps to improve shoulder function…

Our Advanced Therapies and Technologies Produce Superior Results

Conventional treatment of shoulder pathologies often involves rest, anti-inflammatory drugs, NSAIDs, physical therapy exercises, steroid injections and surgery. However, conventional approaches often fall short of restoring full function, especially for athletes and physically active patients.

Advancements in technology are changing the game in rehabilitative medicine, enabling us to accelerate healing and restore performance at an unprecedented pace. The clinic at NYDNRehab features some of the most advanced therapeutic equipment currently available, and rarely found in private clinics.

Your shoulder therapy may involve the use of high-tech equipment:

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

Originally developed to rehabilitate injured soldiers, this multifaceted system gives us a broad range of tools for assessment, feedback and performance enhancement. Dr. Kalka has integrated his own unique selection of technologies to optimize the ways in which C.A.R.E.N helps patients to achieve their goals.

Blood Flow Restriction Training (BFRT)

Rebuilding muscle strength while joints and connective tissues are still healing is a challenge for athletes who need to return to sport in the shortest time possible. BFRT enables you to increase muscle size and strength at much lower training volumes, to reduce stress on still-healing structures while rapidly restoring muscle performance.

Kineo Intelligent Load System

We use the Kineo intelligent loading system to create customized training and rehabilitation programs for our patients. With Kineo, we can customize variable load protocols for functional training, core training, agility drills and more. The Kineo variable resistance system lets us design a personalized variable load curve based on the needs of the individual patient.

Cryotherapy

Cold therapy has long been used for injury treatment and recovery from sports and exercise. Modern cryotherapy has replaced ice baths and ice packs with a dramatically faster and more convenient technology using nitrogen gas, directed via a specialized device to target injured tissues.

Our team of sports medicine professionals will develop a personalized treatment protocol for you, based on the specifics of your injury. In addition to restoring shoulder strength and range of motion, we use specialized technologies to retrain the brain-body connection, to restore optimal muscle recruitment patterns that are often disrupted after an injury. Neuromuscular feedback training helps our athletes to return to sport safely and confidently, with reduced risk of re-injury.

Preventing Shoulder Pain

Any physical activity comes with built-in risks, especially if you engage in sports or occupations that place repetitive demands on the shoulder complex. But sedentary populations are also at risk for rotator cuff and shoulder injuries due to muscle deconditioning, poor joint alignment and metabolic disorders that affect shoulder function. Repeated treatment with corticosteroid injections can increase your risk of rotator cuff injuries.

Adopt a healthy lifestyle with a whole foods diet and regular exercise
Eliminate sugars and processed foods from you diet, and achieve a healthy weight to prevent diabetes and metabolic disorders
Be mindful of your posture and avoid rounding your shoulders, especially when using electronic devices
Allow for ample recovery time between sports events and exercise bouts, 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 reduce chronic systemic inflammation
Consider a biomechanical analysis to optimize shoulder movement and improve joint alignment
Begin a balanced resistance training program to strengthen the structures that support and stabilize the shoulder complex

Get the Best Shoulder Treatment in NYC

Conventional medicine attempts to treat and manage shoulder pain symptoms without restoring optimal shoulder function. Many patients suffer through multiple rounds of steroid injections, narcotic pain medications and even surgeries before they finally come to NYDNRehab for help. With our high-tech diagnostic tools and integrative treatment approaches, we are able to get to the root cause of shoulder pathology and eradicate it for good.

The causes and symptoms of shoulder pain can vary greatly from one patient to the next, and each case requires a specialized treatment approach. We provide one-on-one Physical Therapy, custom-designed for the individual patient. Don’t waste your time and money on treatments that don’t work – contact NYDNRehab today, and get the best shoulder pain treatment in NYC!

Our Awards

Showmotion

Clinical Case Studies
NYDNRehab

Case Study: Shoulder Tendinopathy Resolved

Our Patient Our 14 year-old female patient arrived at our clinic with her mother, complaining of mild left shoulder pain. The patient was physically active and athletic. She was currently playing golf on a regular basis and desired to return to playing tennis. The Challenge A previous doctor had diagnosed her condition as subacromial impingement […]

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Case Study: Ultrasound-Guided Dry Needling Eliminates Joint Fluid, Corrects Posture and Alleviates Mechanical Overload

Our Patient Our patient was a 40-year-old female with bilateral knee hydrarthrosis (fluid accumulation) and shoulder impingement, who was suspected to have arthritis. Ultrasound imaging revealed no significant structural abnormalities in the knees. However, fluid accumulation was evident, particularly in the left knee. Accumulation of fluid detected in both knees. In addition to excess knee […]

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Case Study: Shoulder Tendinitis or Partial Thickness Tear?

Our Patient Our patient is a 55 year-old male with sharp pinpoint anterior shoulder pain, aggravated when lifting with resistance, and when raising the arm above 90 degrees. The Challenge The patient had gone to physical therapy elsewhere, with no tangible results. He then went to a pain management doctor who referred him for an […]

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How can I tell if my shoulder pain is just post-exercise soreness or a more serious injury?

Post-exercise soreness will go away after a few days. If your pain persists, you should see a shoulder specialist. There is no way to fully understand what is going on without ultrasound imaging.

How long will it take for my shoulder injury to heal so I can get back to working out?

Your rate of healing depends on the type and severity of your injury, and other factors unique to your condition. We personalize our treatment protocols based on your individual patient profile. Our regenerative technologies dramatically speed up the healing process, and ultrasound imaging confirms when your injury is fully healed.

Will my shoulder injury heal on its own if I don't overuse it?

While your damaged tissues will eventually heal on their own, you may develop scar tissue and muscle imbalances that reduce your shoulder mobility and stability. It’s best to fully rehabilitate your shoulder injury with the help of a professional.

Why does advanced age increase the risk of shoulder injuries?

Most people become less active over time, and many acquire metabolic disorders as they age. Lifestyle factors, including nutrition and exercise, play a role. Research shows that certain medications like statin drugs, often prescribed to older adults, are associated with a greater risk of tendinopathy. Staying active and adopting a healthy lifestyle can decrease your injury risk and improve your overall quality of life.

How does metabolic disease increase the risk of shoulder injuries?

Metabolic diseases like diabetes and hypertension are closely linked to obesity and other lifestyle factors. According to research, obesity increases the risk of shoulder tendinopathy due to excess mechanical stress. Metabolic disorders include chronic systemic inflammation that promotes shoulder osteoarthritis and impairs healing.

Certificates and Continuing Education

Research at NYDNRehab

2024Lai, Canhao, et al. "Metabolic Syndrome and Tendon Disease: A Comprehensive Review." Diabetes, Metabolic Syndrome and Obesity (2024): 1597-1609.

June 2023 Prospective double blinded placebo controlled trial of high energetic magneto transduction therapy in shoulder joint enthesiopathies

November 2023Conditions that mechanically block shoulder movement and can be evaluated using ultrasound – considerations for dry needling under ultrasound guidance

December 2022Comparison of Extracorporeal Shock Wave Therapy and Ultrasound-Guided Shoulder Injection Therapy in Patients with Supraspinatus Tendinitis

October 2020PRECISE DRY NEEDLING OF TRIGGER POINTS IN NECK, SHOULDER AND PTERYGOID MUSCLES IS EFFECTIVE TO TREAT MIGRAINE AND HEADACHE AND RESTORE POSTURE October 2020 Cephalalgia 40(S1):109-110

September 2019 DRY NEEDLING UNDER ULTRASOUND GUIDANCE TRIGGER POINTS IN NECK AND SHOULDER EFFECTIVE OR DIFFERENT TYPES OF HEADACHE

2023Giri, Ayush, Deirdre O'Hanlon, and Nitin B. Jain. "Risk factors for rotator cuff disease: a systematic review and meta-analysis of diabetes, hypertension, and hyperlipidemia." Annals of Physical and Rehabilitation Medicine 66.1 (2023): 101631.

Physical therapy and rehab can be time consuming,

and a faulty diagnosis can make treatment a total waste of time.

Failure to accurately diagnose a condition in its early stages can lead to chronic
problems and sometimes devastating results

Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.

Below is a prime example of how ultrasound can take the guesswork out of diagnosis.

Learn more »

Accurate Diagnosis Is the ONLY way to

Successful Treatment

A bad physical therapy experience is one of the primary causes of unnecessary surgery

At NYDNR, we believe in

medical innovation

We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.