Have you heard about real time ultrasound? Real time ultrasound allows you to visualise soft tissue structures in the body. It shows you how your muscles are contracting as you are engaging them. Similar to when pregnant women check the health and growth of the unborn baby, by using ultrasound, the same can be done to check if the deep core muscles are functioning properly.

You probably already know that it’s really important to strengthen your TA and pelvic floor post-birth.  However the difficulty lies in the fact that these muscles are deep under the surface and many women struggle to activate them correctly. This is where the real time ultrasound comes handy, especially if you are a visual person. You and your therapist can see how your muscles contract and relax in real time and it might be easier for you to understand what you should do to activate these muscles correctly. It definitely helped me.

I think real time ultrasound is a great teaching tool because it can help you relearn how to use your TA and pelvic floor. Plus you can see all the layers of your abdominal muscles. However it should be noted that real time ultrasound won’t give you a full picture of your pelvic floor function and it shouldn’t be used as a standalone assessment of the pelvic floor. You still need an internal assessment as ultrasound won’t show how strong  your pelvic floor is (yes it shows it can lift and if you are contacting it correctly and how long you can hold it for but it won’t show how strong your squeeze is), it won’t show if your pelvic floor is hypotonic (you can see the lift but you can’t tell if your pelvic floor drops all the way down and relaxes fully) and also it won’t show if you have any kind of prolapse. One of my clients has just recently learned that she has stage 1 prolapse and she had no symptoms what so ever, so if she had her assessment just with ultrasound that would have been missed.

I know that some ladies feel uncomfortable with internal assessments but you have to understand that real time ultrasound won’t give you full information and as you are already paying money for your physio assessment, you might as well make it worth the money and do the full assessment. Some women’s health physios don’t even have real time ultrasound, it’s a great add on service but you will learn more about your pelvic floor function from the internal assessment.

Below are a couple of videos recorded at the Sport Focus Physio & Pilates, with women’s health physiotherapist Vanea Atwood, which show the transverse abdominis muscles and pelvic floor under the ultrasound (please note you might have to adjust quality of the videos manually).