What is Real Time Ultrasound?

Research shows that learning to recruit and strengthen ‘core’ muscles can significantly reduce the recurrence of spinal pain. Inability to activate core muscles such as transversus abdominus is also correlated with lower back pain. Real Time Ultrasound allows these muscles to be assessed and analysed during muscle activation and exercise. The ultrasound provides an image of your muscles including Transversus Abdominis (deep stomach muscle), Pelvic Floor and Multifidus (deep back muscle). You can view the cross-section of the muscles on the screen and see how they move, as they move. The physiotherapist can then instruct you on how to contract them appropriately in order to achieve optimal muscle control. This all occurs whilst you are viewing the muscles, so there is feedback in real time.


There are no known risks to diagnostic ultrasound. However, because the risk to unborn foetuses is not known, it is not advisable to have multiple ultrasounds over a pregnant abdomen.


How does it Work?

I completed a session with Rachel from Bay Active Physio last week. The Real Time Ultrasound allowed me to see clearly the seperate muscles that we colloquially refer to as our ‘core muscles’. I could clearly see my external obliques and transversus abdominus muscles. With the benefit of seeing these muscles, I was able to isolate each muscle group and understand better the appropriate muscles to focus on to achieve a stable core. 


We began with simple exercises to switch the transversus abdominus muscle on and off and then progressed to some more advanced movements which included hip flexion and extension exercises whilst maintaining the same control of my deep abdominal muscles. It is very difficult initially but even within a few minutes I could see improvement in my control. 


We then performed some exercises for the lower back in a 4 point kneeling position. Something my clients know as the “cat and camel” exercise. I was able to watch the screen again as I performed the exercise and could see the multifidus muscle mentioned above, working (or adjust my movement if it was not contracting properly).


Not only did the Real Time Ultrasound give me great feedback on the movement and control of the muscles but it also allowed me to see the size and shape of my muscles which is indicative of their strength and current levels of function. I found that it gave me confidence in my movement and reinforced some mental triggers that I can use to make sure I engage the appropriate muscles without the ultrasound.


After discussing the technology and it’s use with the team at Bay Active, I am certain that this has a significant use for patients to be further aware of their bodies. It would be of particular use to patients and clients who have recurring or chronic lower back pain. A training program can also be developed once the initial muscle recruitment patterns are rehearsed.


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