Real Time Ultrasound

Real Time Ultrasound (RTUS) is a tool that is being used by progressive physiotherapists as a safe and cost effective method to enhance both the assessment and training of the trunk 'core' muscles.

RTUS allows both the patient and the physiotherapist to view the contraction of the muscles as it happens.

Consequently, RTUS can be used as both as an assessment tool and as a form of visual feedback. This is often very helpful when first learning these skills, as the muscles are deep and otherwise it can be difficult to know if you are doing the exercises correctly.

Being able to see the muscles work as it happens provides direct and immediate feedback and enhances learning. RTUS has been shown to increase the rate of learning the skill, and also retention of learning of the skill. Often it is worthwhile to repeat the RTUS to check on accuracy and the progress that you have made over a period of time.

Real Time Ultrasound can be helpful in the following situations:

• Acute and chronic low back pain sufferers
• Sacroiliac and pelvic pain
• After surgery, especially back, abdominal or pelvic surgery
• After childbirth
• To help with recovery from some sports injuries
• To help with injury prevention
• To help achieve best performance of core muscles in sport
• For anyone whose lifestyle requires them to lift repetitively or has large amounts of manual labour

If you are doing Pilates, the Real Time Ultrasound assessment will often be a part of your initial assessment, as part of the process of learning how to use your deep stabilising or ‘core’ muscles.

After having done the Real Time Ultrasound, then the next step is:

You will only get out of it what you put into it. The aim is to get to a point where you can initiate these muscles without too much thought, so that you can switch on your core as part of preparing to do a movement, exercise or just while sitting at the computer.

In short, you want it to be a natural part of your movements and postures, which inevitably takes practice.

It isn’t unusual to feel unsure about how well you are doing the exercise initially, so let your physiotherapist know, as it is easy to repeat the RTUS if necessary and make any corrections to your technique. After all, you want to do the exercise accurately, and you want to know that you are doing the exercise accurately.

To get an image of transversus abdominis, you are lying on your back with your tummy exposed, and the probe is put just above your hip bone, and in the centre of your tummy.

To get an image of your pelvic floor, you are lying on your back too, and the probe is put on your tummy and angled down in the direction of your pubic bone.

To get an image of multifidus, you are lying on your tummy and the probe is put on your back muscles.

In summary, Real Time Ultrasound helps:

• to achieve correct activation of your core stability muscles
• to better understand the way that the deep stabilising system works
• to reduce risk of recurrent injury
• to significantly improve recovery time
• achieve a quick return of normal function