new york city
integrative rehabilitation group

Shoulder Specialist in NYC

A New York, winner of the Patients' Choice Awards.
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About Shoulder Pain and Dysfunction

Your shoulder’s unique ball-and-socket architecture enables you to move your arm through multiple planes of motion, but the mobility it affords also makes the shoulder joint the most unstable joint in the body. Add to that the complex network of nerves, blood vessels, muscles and fascia that govern shoulder movement, and you have the potential for pain and dysfunction to arise from multiple sources.

High resolution diagnostic ultrasonography provides an invaluable tool for dynamically visualizing the shoulder’s 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.

Dr. Lev Kalika

About Shoulder Pain Specialist Dr. Lev Kalika

Dr. Kalika, clinical director of NYCIRG, is both a practitioner and a scholar, with multiple peer-reviewed studies to his credit. He believes that shoulder pain treatment is often mismanaged, focusing on the rotator cuff while ignoring the scapula. For effective and lasting results, the shoulder girdle/neck complex must be addressed holistically.

Dr. Kalika studied directly under Dr. Ben Kibler, world-renowned orthopedic surgeon and pioneer of scapular dyskinesis. Dr. Kalika’s diagnostic approach to shoulder pathology includes a dynamic exam of the scapular muscles, combining motion analysis technology with high-resolution ultrasound imaging. His diagnostic approach focuses on the structural integrity of the scapular muscles and the nerves that innervate the shoulder complex.

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. His approach to frozen shoulder syndrome combines advanced technologies and ultrasound guided procedures, and addresses densified fascial planes that inhibit shoulder function.

Accurate Diagnosis is Key to Successful Shoulder Treatment

At NYCIRG, diagnosis begins with a medical history and physical exam of the shoulder complex, followed by an exam using high-resolution diagnostic ultrasonography to visualize the shoulder’s structures in motion.

With real-time ultrasound imaging, we are able to differentiate between various issues that contribute to shoulder pain and dysfunction, such as:

Fascial densifications and adhesions
Myofascial trigger points
Entrapped nerves and blood vessels
Rotator cuff pathology
Overuse injuries
Bursitis
Arthritis
Frozen shoulder syndrome
Shoulder dislocation
Bone spurs
Post-surgical issues

Diagnostic ultrasound enables us to:

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

Your ultrasound exam takes place on your first visit, in the comfort of our clinic. Dr. Kalika is an expert in high-resolution ultrasound imaging, using the most advanced imaging technology currently available. On-site imaging combined with Dr. Kalika's expertise means quick and accurate diagnosis, with no waiting for lab results.

New Technologies Redefine Shoulder Diagnosis and Therapy

The complexity of the shoulder region makes it difficult 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, allowing for personalized rehabilitation.

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.

Advanced Technologies are Game-Changers
for Successful Shoulder 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.

SoftWave Electro-Hydraulic Shockwave Therapy

Focused Extracorporeal Shock Wave Therapy (ESWT)

Focused ESWT is used as a 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 healing response. EMTT waves can penetrate deep tissues to target difficult-to-reach tendons, muscles, bones and nerves.

Myofascial Acoustic Compression Therapy (MyACT)

Focused Extracorporeal Shock Wave Therapy (ESWT)

SoftWave Electro-Hydraulic Shockwave Therapy

SoftWave is a groundbreaking mechanotransduction technology that delivers high-speed soundwaves to injured tissues. SoftWave’s defocused and linear focused shockwaves promote healing in a broad spectrum of shoulder conditions.

Myofascial Acoustic Compression Therapy (MyACT)

MyACT is a new type of focused shockwave technology that allows for deeper compression of the focused waves. 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.

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. 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.

NESA Neuromodulation Therapy

Hands-On Therapies Help Restore
Unrestricted Shoulder Range of Motion

Stecco Fascial Manipulation

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.

The Stecco approach is a special technique used to target myofascial trigger points and restore the gliding properties of densified fascia, Stecco therapy is an integral part of our multifaceted approach to myofascial pain and dysfunction. Dr. Kalka is certified in the Stecco method of fascia manipulation, and uses it to target fascia densifications and nerve entrapments that impede shoulder movement.

Dynamic Neuromuscular Stabilization (DNS)

DNS is a holistic treatment approach that taps into your primal developmental software to help restore efficient movement patterns and optimize pain-free shoulder function. Your shoulder joint depends on local stabilizing muscles, tendons and ligaments, as well as coordination of both local and distal muscles, to maintain a neutral position of the humeral head in its socket. As a highly mobile joint, the shoulder relies heavily on both local and global stabilizers to assist in force transfer while protecting shoulder architecture.

Dynamic neuromuscular stabilization helps to optimize shoulder function by correcting joint misalignment and restoring coordinated muscle recruitment patterns that have been lost over time. Dr. Kalika learned DNS directly from its creator, Dr. Pavel Kolar, and was one of the first practitioners to introduce DNS to the US rehabilitative community.

Symptoms, Causes and Risk Factors of Shoulder Pain

Symptoms:

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

Causes:

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

Risk Factors:

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

Get the Most Advanced Therapy for Shoulder Pain in NYC

The conventional reductionist approach to shoulder pain is to treat structures in isolation, often overlooking key factors that contribute to shoulder pathologies. Patients often suffer through multiple rounds of steroid injections, narcotic pain medications and even surgeries before they finally come to NYCIRG for help.

Our advanced diagnostic tools and integrative treatment approaches help us to accurately identify and treat the root cause of shoulder pain and eradicate it for good. Our personalized one-on-one treatment protocols are custom-designed for the individual patient.

You don’t have to live with shoulder pain and dysfunction. Contact NYCIRG today, and get advanced shoulder therapy that really works!