A deeper look into Real-time Ultrasound

If you have attended PMPP for an initial Pilates assessment, you have probably seen the effects of your pelvic floor muscles (PFM) and transversus abdominus (TA) in action! Here at PMPP we use Real Time Ultrasound (RTU) as a tool for biofeedback and muscle training.

What does that mean?

It means that we use a machine to image certain muscles as you use them. This allows you to visualise your own anatomy; making sure you are turning on the correct muscles. RTU is a great tool for your Physio too. It allows us to get a better look at your muscle size & quality. We can see how well you can isolate and hold contractions and co-ordinate breathing with these muscles – which is important and sometimes harder than you think!

How does it work?

Real time ultrasound works by sending sound waves into the body via a transducer head (or probe). Different tissues of the body (bone, muscles, tendon, liquid etc) reflect these waves differently and bounce back to the machine to form a picture. Many images are taken per second allowing us to see real time movement, like a video camera. To assess your PFM contraction we place the transducer head over your low abdomen, above your pubic bone, to get a picture of your bladder. As the PFM are very deep this is the best non invasive way of assessing them*. We then watch for the effects on the bladder. As you ‘lift up’ your pelvic floor, your bladder should lift up too. If you don’t get a ‘lifting up’ then your Physiotherapist can coach you until you achieve the right contraction. Because we use the bladder to watch the PFM work, we ask that you avoid emptying the bladder immediately before your appointment. Ideally, void one hour before and then drink about 500ml before you come to see us. 

Your TA are located under your external and internal obliques, to the outside of your rectus abdominus (six pack). These muscles should turn on with your pelvic floor muscle contraction. We can watch them slide and thicken as they contract. If you have forgotten about emptying your bladder before your visit, the good news is we can still get a great view of these muscles! We can also use the RTU to look at muscles around the hip, gluteals and back if needed. 

Diagnostic Ultrasound

As Physiotherapists, we don’t diagnose pathologies using the ultrasound machine (visualising and confirming tears, tendinopathies, infections etc). Our role with this machine is to teach you muscle activation. However, that doesn’t mean we are not interested! Some of our staff have attended courses in Ultrasound Imaging, but we have a lot of learning and practice to do. So, for now, we will leave the Diagnostic Ultrasound to the Sonographers but hopefully in the future Physiotherapists can help to diagnose with Ultrasound too! In the meantime you can take advantage of our RTU skills for the management of back pain, pelvic instability, incontinence or pre and post natal exercise. You can even just check in and see how your PFM and TA are doing with your Pilates exercise. Contact reception on 9681 7255 to make an appointment.

To visualise the pelvic floor requires an internal or transperineal scan, your Physiotherapist can refer you to a specialist if this is required


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