Shoulder Pain

About Shoulder Pain

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.

Dr. Lev Kalika

Clinical director & DC RMSK

About Shoulder Pain Specialist Dr. Lev Kalika

Our clinical director Dr. Lev Kalika has authored multiple medical publications and research articles on the topic of rehabilitative medicine. He is an international expert in the field of rehabilitative sonography, ultrasound guided dry needling and sports medicine.

Dr. Kalika believes that 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 scapular muscles and nerves is restored, and that regenerative therapies for rotator cuff tendons yield only mediocre results if the shoulder girdle/neck complex is not addressed holistically.

Dr. Kalika has developed his own holistic methodology for diagnosing shoulder pain, using the highest resolution ultrasonography that yields images superior to MRI. Diagnosis includes a dynamic exam of the scapular muscles using motion analysis and ultrasound imaging of the scapular muscles.

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 therapy and regenerative injection therapy.

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

Dr. Kalika works with athletes, runners, dancers and mainstream clients to relieve pain, rehabilitate injuries, enhance performance and minimize the risk of injuries. The NYDNRehab clinic features some of the most technologically advanced equipment in the world, including high resolution ultrasound, rarely found in private physical therapy or medical clinics.

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

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

Why Shoulder Treatment at NYDNRehab is Better than Conventional Physical Therapy

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.

Shoulder Conditions We Treat

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

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 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.

Accurate Diagnosis Means Successful Treatment

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

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

Risk Factors

Advanced age
Repetitive occupational tasks
Overhead sports
Poor posture
Sedentary lifestyle
Previous shoulder injuries

We Use Innovative Therapies and High-Tech Equipment for Optimal Results

At NYDNRehab, we use a combination of non-invasive treatment methods, aimed at reducing pain and improving shoulder mobility.

Physical Therapy Exercises

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.

Manual Therapy

A hands-on approach can help to increase shoulder mobility and range of motion to a frozen shoulder.

Dynamic Neuromuscular Stabilization (DNS)

We use DNS to restore innate functional movement patterns and correct motor deficiencies.

Proteus Collinear Resistance

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.

Our Combined Regenerative Technologies
Bring Fast Therapeutic Results

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 Shockwave Therapy

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.

Electromagnetic Transduction Therapy (EMTT)

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.

HIGH ENERGY INDUCTIVE THERAPY (HEIT)

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

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

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.

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.

Best Treatment Options

Acute shoulder pain

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

Chronic shoulder pain

Physical therapy is the single best choice for chronic shoulder pain

Preventing 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

Get Pain-Free Shoulder Treatment That Really Works

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.

Range of Available Unique Physical Therapy
Treatments at Nydnrehab

Research at NYDNRehab

Conference: EFIC Congress 2019 – Pain in Europe XIAt: Valencia, Spain DRY NEEDLING UNDER ULTRASOUND GUIDANCE TRIGGER POINTS IN NECK AND SHOULDER EFFECTIVE OR DIFFERENT TYPES OF HEADACHE

PRECISE 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 PRECISE DRY NEEDLING OF TRIGGER POINTS IN NECK, SHOULDER AND PTERYGOID MUSCLES IS EFFECTIVE TO TREAT MIGRAINE AND HEADACHE AND RESTORE POSTURE