What is Real-Time Ultrasound Imaging?

Real-time ultrasound imaging (RTUI) is well known for looking at babies in utero and injured tendons around the shoulder. Physiotherapists also use RTUI to assess and retrain the deep muscles of the body that cannot be easily palpated during exercise.

Seeing is believing!

Sometimes it is hard to get the right muscle contracting in the right way. Seeing the muscle working on the screen as you contract it and relax it can make learning the correct contraction so much easier. What muscles do we assess and rehabilitate with RTUI?

Low Back and Deep Abdominal Muscles

These muscles are sometimes referred to as the “core” muscles, and are the deepest muscles supporting the low back and abdominal wall. Ideally, all of the following muscle groups should be assessed and rehabilitated to ensure ideal low back function:

• The diaphragm

• Transversus abdominis

• Lumbar multifidus

• Pelvic floor

Pelvis and Hip

Low back, hip and pelvic injuries seem to be increasing exponentially in the sporting population. Sports are getting faster and tougher and sometimes our bodies bear the brunt of this. Ensuring the deep muscles that support the hips and pelvis are working well can keep the body strong and flexible, but it is also essential to ensure these muscles are contracting optimally with the exercises you are doing.

Arthritis in the hips can also weaken the hip and pelvic muscles. Utilising RTUI to ensure you get the best out of your exercises can assist you to manage your arthritis by keeping strong and flexible.

Muscles that we image around the hip and pelvis are:

• Iliopsoas (hip flexor)

• Gluteus medius and minimus (essential for stable one leg standing, walking and running)

• Quadratus femoris (control of the hip in squatting)

Pelvic Floor

Using RTUI to assess and manage pelvic floor dysfunctions is invaluable. This method of assessment is non invasive with the probe being positioned across the lower belly. Bladder volume can be measured, and the client can watch their pelvic floor lift and fall as they contract and relax the muscles. Research has shown that 40% of people with pelvic floor dysfunction push their muscles down rather than lift the muscles upwards.

Repeating the incorrect contraction can lead to further pelvic floor problems so it is important to practice the correct pattern of contraction from the beginning. Retraining of breathing technique is always a part of pelvic floor rehabilitation as diaphragmatic breathing technique can significantly affect how the pelvic floor muscles function in day to day life.