The Future Is Now: “Software that can show how your muscles are working in real time” with Dr. Lev Kalika and Fotis Georgiadis
…We would be able to see exactly why the person is not using certain muscles and what to do to force the brain to include this muscle into the muscular synergy that is required.
I had the pleasure of interviewing Dr. Lev Kalika, the owner of New York Dynamic Rehabilitation & Physical Therapy (NYDN Rehab) in New York City. He is known for revolutionizing how muskuloskeletal and motor disorders are treated by introducing Dynamic Neuromuscular Stabilization (DNS) and groundbreaking technology to the United States, such as CAREN (Computer Assisted Rehabilitation Environment). He is an expert in the conservative treatment of back, hip, knee and shoulder pain, as well as sports injury disorders. Dr. Kalika’s physical therapy and overall fitness/wellness expertise has been featured in NBCNews.com, Reader’s Digest, The Huffington Post, Forbes, Thrive Global and much more.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
In 1993, I left Odessa and moved to the U.S. to continue my medical studies. At one point, I developed mysterious chest pains that baffled several doctors. A friend recommended that I see a chiropractor (D.C.). So, I took this advice, and after several sessions, my condition began to improve. In that moment, I realized chiropractic methods appealed to me more than conventional allopathic medicine because it addressed the cause of the pain rather than its symptoms.
After that realization, I moved to Chicago where I enrolled in the National College of Chiropractic. While exploring various programs geared to help advance my studies, I noticed very little literature was published on the subject of the CNS (Central Nervous System) in most American chiropractic postgraduate programs. There were courses on conventional medical neurology and orthopedics, but none on the functional type of medicine that I wanted to learn.
So then, I decided to go to Prague, Czech Republic to receive a fellowship in Manual Medicine in Motol Hospital under world-renowned Professor Karel Lewit, MD. Later on, I studied in Charles University (also in Prague) with another world-famous neurologist professor, Vladimir Janda, a man who was widely hailed as the world’s leader in ‘rational therapy’ in musculoskeletal medicine and rehabilitation. Thereafter, I met Prof. Pavel Kolar, a European sports celebrity doctor and developer of the DNS (Dynamic Neuromuscular Stabilization) method of treating musculoskeletal disorders. Observing Kolar’s treatment techniques and procedures and seeing how instantaneous the results were, Lev had little doubt what his next step would be: Become a master of doing DNS.
Can you share the most interesting story that happened to you since you began your career?
My NYC clinic — New York Dynamic Neuromuscular Rehabilitation & Physical Therapy — houses CAREN, Computer Assisted Rehabilitation Environment, which only exists in two U.S. locations (NYDN Rehab being one of them; also being the only private practice to house CAREN). CAREN is like a big virtual reality room and game, but for reading and improving your health. The most interesting story was trying to find a space that could fit and install CAREN into a space in Manhattan.
When I bought CAREN, I did not understand all the difficulties and expenses it would take to find a rental property that would have all the technical and spatial parameters it required. It would certainly fit into most of first floor commercial spaces, but I was not able to afford this kind of rent. Luckily, I found a space which had required 18 feet ceilings in Bryant Park. And fortunately, the landlord was a good guy and I didn’t have to deal with a corporate system. But then something else happened which was very scary. I was not aware that the platform emits a lot of vibration, which could potentially break down the floor underneath and fall through the ceiling below on to the company of 100 people. I wanted to hire engineering companies that could calculate whether the floor would withstand this kind of vibration, but these types of engineers cost nearly the amount of the equipment. But then there was GOD. My wife’s distant relative from Sydney was in town for a couple of days. He was an engineer who built the Sydney Opera House, and his expertise is exactly what I needed. He provided the calculations, and I was very lucky…
Can you tell us about the “Bleeding edge” technological breakthroughs that you are working on? How do you think that will help people?
Right now, I am working on integrating HBM (HUMAN BODY MODEL) with SEMG (Surface electromyography) and M-mode ultrasound into my clinic. HBM is a software that belongs to the unique CAREN technology I have. This software can show how your muscles work in real time if you are within CAREN, which includes two force plates and state of the art motion capture. HBM is the only software in the world that can show how muscles work in real time. Since HBM is based on mathematical model of muscle length, joint angles and forces, it is not 100 precise. However, if SEMG is synced with it, it would add 100 precision to this. We would then be able to see exactly why the person is not using certain muscles and what to do to force the brain to include this muscle into muscular synergy that is required.
How do you think this might change the world?
Not only would this allow doctors and therapists to diagnose, but it would also take the guesswork out of physical therapy to choose which exercise is better. It will also give us objectivity and monitoring of patients progress. The M-mode ultrasonography added to that will be more for research purposes, but can also be used as a feedback training, because patients need to see whether each contraction really targets the right muscle part. The HBM does not allow that , but you could change the probe location and visualize particular art of the muscle.
It is a scientific and practical breakthrough because muscles do not work as a whole, as they are described in anatomy books, but rather as certain parts, depending on the task.
Keeping “Black Mirror” in mind can you see any potential drawbacks about this technology that people should think more deeply about?
Yes, there would be potential dangers if there were not multiple protective measures taken. First of all, the patient is in a special harness that protects from any unexpected movements. This technology was initially invented for people with traumatic brain injury, so there are triple safety measures. The system automatically shuts off any unexpected movement; and that switch is duplicated by another preventive in case the first one fails. On top of that, the operator and therapists have their own shut off switches, so there is no chance for injury or even a scare.
Was there a “tipping point” that led you to this breakthrough? Can you tell us that story?
Well, the story is simple. There are many technologies that are great, but for protection and financial gain services, these technologies are not made to work with each other. Also, sometimes it is technically very difficult to make them recognize each other. It takes a lot of work to do. If the company does not have a lot of clients who are interested, they are not going to invest the time and money into development. I bought CAREN 5 years ago, and it is a product created for military medicine and research, but the goals I have are practical usability in the clinic. Finally this year, many software components of this equation were released and now it is happening.
What do you need to lead this technology to widespread adoption?
It is a difficult question because in research, technologies are mostly post processing and require man power and time. In the clinic, you don’t have this luxury, and therefore, you need a model that gives desired results. The development can then happen if the cost and demand match.
What have you been doing to publicize this idea? Have you been using any innovative marketing strategies?
Not really. I am a clinician and my goal is to help people and publish research.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
Yes, there are few. There are researchers I met along my journey who became friends.One guy is a young physical therapist and biomedical engineer from Holland. He has his Ph.D in research with CAREN. And the other is a famous scientist from Ukraine who helps me turn my clinical ideas into scientific research. And of course, my wife, who nurtures me to help me be who I am.
How have you used your success to bring goodness to the world?
We regularly take some people and give them free treatments. I am also becoming a US representative to EPMA — European Society of Preventive and Predictive Medicine — where I plan to share my experience so the type of clinic I have will be a reality for every working physical therapist.
What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)
1. Success is a long road with many doors. Once you finish a route in the best possible way, the new door will open up and take you on another journey.
2. Never ever judge your success by the financial benefits you get from it. There are many constituents to success, and they cannot and should not be measured by financial benefits you get.
3. Success does not come to mediocre people. Try to be extraordinary, but stay humble. Being arrogant closes many doors.
4. Never stop at what you have accomplished. The journey is never ending
5. The best reward is seeing how far you have come.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂
I am already in a process. We are working on the project of creating functional sonography, which exists but is very limited. We believe that sonography is a third hand physical therapists can use. Right now PTs all over the world are just starting to use musculoskeletal sonography to create structural diagnosis, but we believe sonography can be used for seeing people’s function in real time. If this ever becomes mainstream, it is a huge thing for people with pain.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“What gets measured gets improved.”
Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say? He or she might just see this if we tag them 🙂
In order to be successful, you need to try hard and work hard, but in order to be extremely successful, you need to be passionate about what you do and forget about the financial benefits. They will just come along. You also need to love the people you are doing it for.
How can our readers follow you on social media?
Everyone can follow NYDN Rehab on:
Thank you for all of these great insights!
The Future Is Now: “Software that can show how your muscles are working in real time” with Dr Lev… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.