Real-time Ultrasound Imaging

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



Transversus abdominis

Ultrasound Machine


Pelvis and hip

Low back, hip and pelvic injuries are 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 rehabilitate these muscles to their optimum function following low back or pelvic injury.

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 good one leg standing, walking and running)
  • Quadratus femoris (control of the hip in squatting)


Gluteus medius and minimus


Quadratus femoris


Some interesting statistics that have been published concerning low back pain:

  • 80% of people aged between 20 and 50 will experience an episode of low back pain,
  • 80% of these will recover after approximately 6 weeks while 20% will go on to develop chronic low back pain,
  • 80% of those who recover within 6 weeks will experience another episode of low back pain within 12 months,
  • after the second episode of pain, that person is more likely to experience more frequent and more severe exacerbations of pain with time,
  • research has demonstrated that correct and effective retraining of the deep stabilising muscles following an episode of low back pain, compared to patients rehabilitated with standard exercise programmes, decreases the chance of recurrence of low back pain within a 2 year period by more than 13 times.

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.

Pelvic Floor


Stabilising muscle function for recovery from neck and back injury (incl. Whiplash)

The stabilising muscles of the lumbar spine are very deep and are difficult to assess accurately. It is also difficult to learn how to exercise the muscles correctly. Real-time ultrasound imaging produces an image of the stabilising muscles on a screen and allows the physiotherapist and the patient to watch the muscles work while they are being exercised. This allows accurate and measurable assessment of the muscles and helps the patients learn how to exercise the stabilising muscles correctly.

This Clinic offers real-time ultrasound imaging of the deep stabilising muscles of the lower back to assist with the assessment and rehabilitation of these muscles following an episode of low back pain. The Clinic sends a report outlining the real-time ultrasound imaging assessment findings to the doctor and the treating physiotherapist so the exercises can be progressed appropriately and precisely to suit the condition.