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Real Time Ultrasound (RTUS)


Over the last 20 years the concept of core stability has evolved dramatically and is now accepted as the underlying key to recovery from most long term back, pelvic or lower limb injuries. 

In general, your 'core' is the deep muscle group of your abdominal and pelvic region. Research shows that these muscles should act constantly to stabilise your lower back and pelvis, acting as your natural back brace.

Unfortunately, the muscles are so deep and the movements required to activate them so subtle, that it has been very difficult to retrain patients to effectively switch on their 'core'.

One should be able to isolate and activate the deep core muscles alone, before recruiting the accessory muscles such as the internal and external obliques, rectus abdominis, and lumbar paraspinal muscles.

At Back2Health Chiropractic and Sports Injury Centre we use a Real Time Ultrasound scanner (the same machine used by obstetricians when women are pregnant) to view the deep muscles, allowing us to assess your ability to activate and engage your 'core' properly. You can then see when your muscles are working, which acts as a great feedback tool to ensure that your technique is correct and that you are improving with each session. Research shows that when an individual is trained in 'core' exercises using RTUS they achieve better results.

Once you are able to activate your deep core muscles effectively, you will be able to return to your pilates, PT sessions and sport and actually activate the proper deep core muscles first rather than recruiting mainly your accessory muscles that can lead to injury and pain.

Rebates are available through your private health insurance extras cover.


Real Time Ultrasound (RTUS) for Core Strengthening, Pelvic Floor Strengthening and Back Pain

What is it?
It is the use of a diagnostic ultrasound machine, in real time, to assess muscle and ligament function within the body. All of our physiotherapists are trained extensively in the use of RTUS to assess and rehabilitate injuries, instability and weakness issues. The flow on effects are huge from even just one session of RTUS – strengthening programs such as Pilates become even more effective once those core muscles are activated properly form the start!

Who benefits from it?
Anyone who requires core stability and/or pelvic floor muscle re-strengthening, including people with:
- lower back pain
- disc or degenerative issues of the spine and hip
- gluteal tendonitis / tendinopathy
- scoliosis
- pelvic instability
- sacro-iliac joint issues
- leg and pelvic overuse injuries (e.g. osteitis pubis in athletes)
- pre- and post-natal
- Women’s Health (eg. Pelvic Floor weakness / incontinence)
- Hypertonic (overactive) Pelvic Floor

We work individually with clients to teach how to effectively switch on and off ‘core’ and pelvic floor muscles, then build up these muscles through a progressive exercise regime. RTUS is crucial in allowing us to actually see if the correct muscles are switching on, and if so, if they are switching on in the right sequence. It is also great for clients to see their muscles switch on – we find that this visual cue creates a strong image in the brain which translates well to ‘muscles memory’; i.e. clients can activate their weakened muscles much better after even one session of RTUS.

51% of women can’t exercise their pelvic floor muscles effectively when asked to verbally”, Bump et al. 1991.


Anecdotally, we find that an even higher percentage of clients with lower back or pelvic pain cannot effectively activate their core muscles with activity, leaving them at a greater risk of further injury.

What should I do beforehand? 
DON’T empty your bladder just prior to the session if you are having your core muscles assessed – we will need to look at the pelvic floor muscles through your abdomen and these are only visible when the bladder is not empty. A small glass of water 10-15 min beforehand should be enough for instance. 

What happens during a session?  RTUS requires an extended 40min session, during which our practitioner will guide the client in switching on the muscles which they wish to assess. We use normal aqueous ultrasound gel under the ultrasound head (just like a normal ultrasound during pregnancy for instance). The ultrasound is not invasive or internal – even so, we offer female practitioners for Women’s Health issues and for female clients in general.
After the session, the client will be given a set of exercises to practice activating the targeted muscles. Often a follow up RTUS session is required around two weeks later, during which time a series of treatments may be required to release muscle and joint tightness around the region.


What is the cost and how do I book in?
The cost is the same as our long consultation, as it takes a little longer than a normal session.
Rebates are available through your private health insurance extras cover.
Just call us and we’ll try to fit you in ASAP for a RTUS session – you have nothing to lose except you core or pelvic muscle weakness!

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