new york city
integrative rehabilitation group

Pelvic Pain and Pelvic Floor Treatment

A New York, winner of the Patients' Choice Awards.
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About Pelvic Floor Dysfunction

Dysfunction and pain in the pelvic region can be uncomfortable to talk about, even with a doctor. People often wait until discomfort and symptoms escalate to unmanageable levels before seeking help. When they do, pelvic floor treatment often involves invasive and embarrassing manual intervention geared to hypertonic pelvic floor muscles, which is rarely the true source of pelvic pain.

To get to the bottom of your pelvic pain, you need an experienced specialist who can identify the underlying cause of pelvic dysfunction and resolve it for good.

Dr. Lev Kalika

Dr. Escudero

About Pelvic Pain Specialists Dr. Kalika and Dr. Escudero

Dr. Lev Kalika is a world-renowned expert in ultrasound guided procedures, for which he has published multiple peer-reviewed articles. Dr. Kalika has developed his own unique approach to pelvic floor treatment using ultrasound-guided dry needling, extracorporeal shock wave therapy (ESWT) and neuromodulation.
Dr. Daniela Escudero, DPT is a Certified Manual Physical Therapist who specializes in pelvic floor health, with an emphasis on functional movement and manual therapy. Dr. Escudero is dedicated to providing pelvic floor treatment that improves the quality of life of her patients.

The combined expertise of Dr. Kalika and Dr. Escudero makes NYCIRG the clinic of choice for pelvic floor physical therapy in NYC.

Pelvic Floor Dysfunction Symptoms
and Causes

Urinary and/or fecal incontinence
Constipation
Pelvic organ prolapse
Sexual dysfunction
Pelvic pain
Pelvic muscle spasms

Childbirth
Trauma
Obesity
Pelvic surgery
Nerve damage
High-impact exercise

Accurate Diagnosis is Key to Successful Pelvic Floor Treatment

At NYCIRG, diagnosis begins with a medical history and physical exam of the pelvic floor, low back, hips and pelvis. Your clinician will ask for detailed information about pregnancies, and any difficulties associated with childbearing.

High resolution dynamic ultrasound lets us visualize the pelvic region with the patient in motion, to rule out hip and low back issues, and to assess for muscular deficits, excessive force production (pressure) and trigger points.

With real-time ultrasound imaging, we are able to diagnose and treat a number of issues related to pelvic dysfunction, including:

Low back pain
Chronic pelvic pain
Hip and groin pain
Postpartum issues
Urinary and bowel incontinence
Post-surgical issues

Advanced Technologies are Game-Changers for Pelvic
Floor Physical Therapy

The human body has its own innate reparative mechanisms, but it sometimes needs a nudge to initiate the healing process. Our advanced technologies help to jump-start healing, to expedite recovery with minimal discomfort for the patient.

Focused Shockwave Therapy (ESWT)

Extracorporeal Shockwave Therapy (ESWT)

Focused ESWT technology produces high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for treating pain and reducing inflammation.

Extracorporeal Magnetic Transduction Therapy (EMTT)

EMTT transmits high energy magnetic pulses that synchronize with the body’s own magnetic fields, causing a disturbance that triggers healing. EMTT waves can penetrate deep tissues beneath the skin’s surface, to target deep pelvic tissues.

Electromagnetic Transduction Therapy (EMTT)

Myofascial Acoustic Compression Therapy (MyACT)

Our new PiezoWave shockwave machine features MyACT, 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.

This innovative shockwave technology transforms the mechanical energy of shockwaves into biochemical signals that precisely target damaged tissues. Its versatile system of controls lets us fine-tune its output levels for precise and personalized patient care. With MyACT, we are able to repair and regenerate damaged tissues by stimulating the body’s own reparative mechanisms.

NESA Neuromodulation Therapy

The NESA device generates a biphasic low-frequency electrical current that travels through autonomic neural pathways, to restore optimal neural signaling to the brain.

NESA Neuromodulation Therapy

Extracorporeal Pulse Activation Technology (EPAT)

EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues, speeding up the delivery of oxygen and nutrients to damaged tissues.

High Energy Inductive Therapy (HEIT)

HEIT uses electromagnetic fields to reactivate the electrochemical function of nerves, muscles and blood vessels.

HIGH ENERGY INDUCTIVE THERAPY (HEIT)

Localized Cryotherapy

Cold therapy has been used for centuries to treat soft tissue injuries, numb pain and reduce inflammation. Today, modern technology brings us a more efficient and effective means of leveraging cold therapy using nitrogen gas. When used with other therapies, localized cryotherapy helps to provide fast relief and speed recovery during the rehabilitation process.

INDIBA Radiofrequency Therapy

INDIBA therapy is a type of transfer of energy capacitive and resistive (TECAR) therapy that helps to restore the ionic charge of damaged cells, for faster injury healing and rehabilitation. The INDIBA CT9 converts electrical current into a stable frequency of 448 kHz that resonates with the cells’ own inherent frequency.

INDIBA Radiofrequency Therapy

Ultrasound Guided Injection Therapies

Injection therapies use natural/neutral solutions that stimulate tissue repair by either nourishing or irritating the targeted tissues. Guidance by ultrasound ensures that the injected substances hit their mark, for maximum effectiveness.

Ultrasound Guided Dry Needling

Myofascial trigger points often contribute to pelvic pain and dysfunction. Dry needling is a procedure that inserts thin 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.

Get Pelvic Floor Treatment
that Really Works

Run-of-the-mill physical therapy clinics often approach pelvic pain with invasive and embarrassing hypertonic pelvic floor treatment. At NYCIRG, we strongly believe that tight pelvic floor muscles are rarely the underlying cause of pelvic pain. On the contrary, hypertonic muscles are always secondary to other factors. Many therapists jump right into treating the symptoms, without considering the underlying cause.

In our experience, pelvic pain is multifactorial and more often originates in:

Hyperactive pelvic nerves
Walking gait deficits
Muscle imbalances in the hips and low back that disrupt the balance
between intra pelvic and intra abdominal pressure.
Fascia densifications in the abdominal wall and inside the pelvic organs

Before beginning physical therapy, we use our advanced technologies to:

modulate pelvic nerves
eliminate pelvic densifications (adhesions)
regenerate pelvic tendons and ligaments
eliminate intra-pelvic trigger points and reduce increased pelvic muscle tone

Pre-treatment of these issues paves the way for physical therapy to restore optimal function in the lumbopelvic-hip region.

Our unique approach enables us to successfully treat a broad range of
pelvic conditions, including:

Pelvic pain of unknown origins
Pelvic floor myofascial trigger points and spasms
Pudendal neuralgia (damage to or irritation of the pudendal nerve)
Vulvodynia
Urinary incontinence
Dyspareunia (painful intercourse)

Non-Invasive and Effective Pelvic Floor Treatment in NYC

Pelvic floor physical therapy aims to eliminate pelvic pain and dysfunction for good. But most conventional therapy relies on embarrassing hypertonic pelvic floor treatment that involves manual intra vaginal or intra rectal release techniques.

In our experience, invasive treatment provides only temporary relief, with no significant progress. In such cases, patients are dependent on ongoing therapy to temporarily relieve pain, without ever resolving their underlying issues.

At NYCIRG, we help our patients get long-term relief using advanced technologies and state-of-the-art physical therapy. Our treatment approach goes beyond pain management, to actually correcting the causes of pelvic dysfunction. Our track record of success in pelvic floor treatment has made NYCIRG the top-rated physical therapy clinic for pelvic pain in NYC.