Real-time ultrasound (RTUS) is a fantastic diagnostic imaging tool that we have available here at PhysioCentral. Our physiotherapists use it to precisely evaluate a range of issues related to the pelvic floor, abdominal muscles and related structures in both men and women and children, among other musculoskeletal problems. RTUS leverages high-frequency sound waves to create live images of internal body structures. Unlike therapeutic ultrasound, which is used for healing tissues and does not produce images, RTUS offers a visual representation of the body's internal workings (muscles, fluid and other tissues), providing important insights for both clients and physiotherapists.
The information provided by RTUS makes it a very valuable tool postpartum as it allows us to precisely assess and monitor conditions like diastasis recti (abdominal separation), and support targeted pelvic floor muscle training to help enhance the efficacy of recovery exercises that we prescribe. It’s not just useful for our physios, either - by using real time ultrasound to show our postpartum clients what is happening inside, it can be very informative, insightful and motivating, all without any known adverse effects.
How Does Real Time Ultrasound Work?
In simple terms, real-time ultrasound works by using high-frequency sound waves that move into your body through a small, handheld device called a probe. As we move this probe over your skin, the sound waves travel inside and bounce back when they reach different tissues. This process creates live images of what's going on inside your body, which we can see on a monitor. This works much like a pregnancy ultrasound, except instead of visualising your baby, we are seeing and evaluating your internal structures. Think of it as a live video that shows us how your muscles and tissues are moving in real-time.
What Are The Benefits Of Real Time Ultrasound?
Real-time ultrasound is valuable both for us as physiotherapists, and for our clients. Aside from having an excellent safety record and being completely painless due to its non-invasive nature, RTUS provides us with a clear and detailed view of your muscles and tissues as they move, meaning that we can observe things like how your pelvic floor muscles contract and relax (and importantly if they’re failing to do so well), or check the separation of your abdominal muscles.
RTUS also acts as an excellent biofeedback tool for our clients. By seeing your muscles in action on the screen as you try to contract and relax, you can gain a better understanding of how to perform rehabilitation exercises correctly, meaning that you can effectively retrain and strengthen these muscles. RTUS helps bridge the gap between what you feel and what is actually happening inside your body, as there can often be a disconnect or uncertainty between different pelvic floor cues.s. With RTUS, we get to see exactly what’s happening on screen as you perform these exercises, so we can give you immediate feedback and give you confidence in your recovery and progress over time. We can also figure out the most effective pelvic floor cue that works for you!
Core training
While the term “core training” seems to be synonymous with core strengthening, there is an important first step that underpins strength training success: having sufficient motor control, and hence the right technique for muscle contraction and coordination. For example, the core muscles should tighten prior to going into any strength training movement to allow you to perform the movement safely and gain the maximum benefits. This can be observed using RTUS to check that your muscles are activating and firing the way they should be, which optimises your output while reducing your risk of injury. If any dysfunction is observed, this is where we can help retrain these muscles - and confirm appropriate muscle activation in real-time, on screen, using RTUS.
What to Expect During a Real-Time Ultrasound Session
A typical RTUS session is straightforward, comfortable and takes around 15 to 30 minutes. We recommend wearing loose-fitting clothing. You may be asked to have a full bladder, depending on the area being examined. Your physio will start by applying a conductive gel to the skin and then move the ultrasound probe over the target area to capture the right angles and view, displaying the images on a monitor for both you and us to see.
We may ask you to contract specific muscles or perform actions so we can match the movements you are making with what we’re seeing on screen. We’ll discuss all of the findings with you, carefully explaining the observed muscle movements and any identified issues. We know it can be a lot to take in - so we take the time to help you understand what you’re seeing and why, while answering all of your questions. We then use the information from the ultrasound, paired with the results of your assessment with us, to create a tailored rehabilitation plan, which may include specific exercises that we’ll talk you through and show you in the clinic so you know (and can see and feel) exactly what you’re looking for when performing these movements.
Frequently Asked Questions
Is RTUS safe for postpartum women?
Yes, RTUS is non-invasive, pain-free, and has no known side effects. It serves as a non-invasive option for women who do not want an internal pelvic exam. However, the internal pelvic exam provides the most comprehensive information on the pelvic floor.
How soon after delivery can I have RTUS?
This depends on your personal circumstances, but many women start with 6 weeks postpartum, following clearance from their midwife, obstetrician or doctor.
Do I need a referral for RTUS?
Referrals are welcome, but not required. You can book directly in with our physios across our Central and Wong Chuk Hang locations, and if RTUS is indicated to help in the assessment and management of your condition or injury, then we can use it to help you get the best clinical outcomes.