Core Muscle Retraining -
Rehabilitation Ultrasound

Physiotherapists are now using diagnostic ultrasound to assess the deep core muscles for wasting and asymmetry and to retrain correct function.

Physiotherapists are now using diagnostic ultrasound in the rehabilitation of back pain and the pelvic floor for continence issues (known as rehabilitative ultrasound imaging).

Richard completed a 6 month course at the University of Sydney (2007) in rehabilitative ultrasound.

Janine Austen has updated her skills in pelvic floor assessment and treatment including the use of ultrasound imaging.

How Do The Core Muscles Work?

Your deep core muscles normally work automatically to stabilise your spine without you having to consciously engage them. Following an episode of back pain the deep core muscles turn off and waste losing their automatic protective function. This can occur quickly and proper function may not recover when the pain has gone. Research shows this is a leading cause of the high rate of recurrence of back pain.

Ultrasound image of core musclesHow Do You Retrain The Core Muscles?

Unfortunately conventional strengthening programs like pilates and core strengthening do nothing to retrain the muscles “anticipatory role”. What’s the point of having strong muscles if they don’t work when they are supposed to, or work in the correct way?

Rehabilitative ultrasound retrains this automatic function so that these muscles work when you need them. This retraining is referred to as motor re-learning which is re-programming the muscle to work in the correct way.

As the patient can see the deep muscles contracting on the screen, ultrasound imaging is a very powerful form of biofeedback.

Does It Work?

Research has proven that specific exercises to retrain these deep muscles using diagnostic ultrasound has shown a 50% reduction in the recurrence rate of back pain compared with a control group over a 3 year period.

Who Benefits?

Anyone with back pain. Patients who are suffering repeated episodes of back pain.

Is Ultrasound Safe?

Ultrasound scanning involves no radiation and is a safe procedure. For private patients a doctor’s referral is not necessary. Workcover patients are covered with a doctors referral. Rebates are available from private health funds.

Ultrasound Imaging - Uses in Physiotherapy Practice

  • Muscle and Tendon Injuries* - Ultrasound scanning can be used to assess muscle and tendon tears and haematomas.
  • Monitor Healing - Scanning can be repeated to assess the progress of healing. Ideal in sports injuries and when assessing return to sport.
  • Back Pain - Used to assess the deep core trunk muscles for wasting and asymmetry and to retrain correct function.
  • Pelvic Floor - The correct activation of the pelvic floor can be assessed and retrained for continence issues.
  • Ultrasound scanning is at the cutting edge of physiotherapy practise. More uses for ultrasound scanning in musculoskeletal rehabilitation will become apparent as the research into its application progresses.

*Note– If necessary we will recommend referral to a radiologist for further assessment.

Four Part Program

Level one - The Learner

Isolating the deep muscles

You will see your deep muscles on the
ultrasound monitor and learn to contract them
independently of the superficial muscles.

Level two - The Novice

Control with movement

This is a little harder. You will be required to maintain an isolated deep muscle contraction while moving. You will learn about posture and spinal alignment.

Level Three - The Graduate

Reprogramming the muscles anticipatory role

This is all about timing. Applying the stabilizing deep muscle contraction at the right time when you need it.

Level Four - The Master

Automatic control

Congratulations! By the end of this stage your deep core muscles will be protecting your spine all day every day without you having to think about it. You will have automatic control.