Real Time Ultrasound

 

Education and Assessment of Core Muscle Activity

More than 80% of people will experience some lower back pain (LBP) in their lifetime. Although some cases resolve within 4 weeks, 84% of patients will have another episode within 1 year. Without specific core muscle training, research has shown that within three years recurrence rates are as high as 75%1.

Why don't my muscles stabilise my spine?

  • Injury, pelvic pain, surgery and pregnancy all lead to the deep "inner unit" or "core" muscles becoming impaired.
  • Evidence shows within 24 hours 80% of people with LBP will develop muscle wasting in their deep back muscles1.
  • The problem is with muscle control - not strength2 and poor co-ordination leaves you unable to draw in the abdominal wall effectively4.
  • Large trunk muscles compensate by becoming overactive, but are unable to protect the small segments of the spine.

But I have done lots of sit ups and strength training!

  • You may resume normal activities but the muscles do not1.
  • They no longer activate before movement and the contraction is brief and irregular8.
  • Unfortunately, traditional rehabilitation focuses on the large 'global' trunk muscles - at the expense of the deep 'local' core muscles7.
  • Specific education directed at the activation of the core muscles is the only way to ensure the muscles automatically switch on before and stay activated during movement.

How will using Real Time Ultrasound help me?

  • Specific training of transversus abdominis and multifidus has been shown to improve pain and function in patients with lower back pain6.
  • Research shows that specific excercise therapy plus medical management and resumption of normal activity is more effective in reducing LBP recurrences than medical management plus resumption of normal activity alone1.
  • This allows you to see which muscles are impaired and learn how it feels to activate the correct muscles, efficiently - using the transversus abdominis (TA), multifidus, the diaphragm and pelvic floor in synergy.

Real time ultrasoundReal time ultrasoundReal time ultrasound

 

 

What is RTU?

  • RTU involves the use of soundwaves to produce a picture of muscles and tissues on the screen > you can watch the abdominal contraction as it happens.
  • A physiotherapist trained in the use of Real Time Ultrasound will make an initial assessment (45mins) - there may be follow up appointments.
  • Wear comfortable, loose clothes & the examination will be over your lower stomach and back only.

References

  • Hides JA, Jull GA, Richardson CA. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001.
  • Jull GA, Richardson CA. Motor control problems in patients with spinal pain: a new direction for therapeutic exercise. J Manip. Phy. Ther. 2000.
  • Hodges PW. Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Exp Brain Res. 2001.
  • Hodges P, Richardson C, Jull G. Evaluation of the relationship between laboratory and clinical tests of transversus abdominis function. Physio. res. Int. 1996.
  • Hides J, Stokes M, Saide M, et al. Evidence of lumbar multifidus muscle wasting ipsilateral to symptons in patients with acute/subacute low back pain. Spine. 1994.
  • Kiadny B, Fischer FC, Haase L. Evaluation of specific stabilizing exercise in the treatment of low back pain and lumbar disk disease in outpatient rehabilitation. Z Orthop Ihre Grenz. 2003.
  • Jemmett RS. Rehabilitation of lumbar multifiduse dysfunction in low back pain: strengthening versus a motor re-education model. Br. J. Sports Med. 2003.
  • McMeeken JM, Beith ID, Newham DJ, Milligan P, Critchley DJ. The relationship between EMG and change in thickness of transversus abdominis. Clin Biormech. 2004.