REAL TIME ULTRASOUND IN WOMEN’S HEALTH
Learn about this diagnostic tool in women’s health
Have you ever been told that you need to strengthen your core or your pelvic floor muscles? Perhaps you have even tried to engage those muscles but found the activation hard to achieve due to not having a clear understanding of how to do it. Real Time Ultrasound solves this issue by providing instant feedback to ensure that you are activating the muscles correctly. While it is a diagnostic tool rather than a treatment, improved pelvic floor health for women, can help to reduce back pain, aid in the management of incontinence and ensure that you get the most out of your Clinical Pilates program. The aim of Clinical Pilates is to strengthen the core muscles. Many people, however, find the term ‘core’ a bit ambiguous and struggle to achieve correct activation. This is where Real Time Ultrasound can make the job much easier.
CORE STRENGTHENING: REAL TIME ULTRASOUND:
• You and your physiotherapist can see on the screen how you are engaging the muscles. As physiotherapists we often see patients engaging not only the core muscles (the deep muscles of the stomach and lower back) but also the superficial abdominal muscles. While those muscles are also important they are not going to help when it comes to core strengthening. • Your physiotherapist can teach you how to isolate the core muscles. This will then become the basis of your
Clinical Pilates program as you will be confident that you are switching on those muscles correctly during each exercise. Your physiotherapist would then reassess you at regular intervals
to track your progress and update your program accordingly. Generally, this should be done every seven weeks, especially when you are just starting your Clinical Pilates program. BACK PAIN: REAL TIME ULTRASOUND: • It is important that the correct technique is used when it comes to treating back pain. When the core is strong, any load sustained while lifting, twisting or bending will go through the core muscles, rather than the spine. It is also mandatory that the exercises are correct for you. Once again, Real Time Ultrasound can assist with this. By seeing on the screen how well the muscles work, your physiotherapist will know at which level they should work your core.
• Using the 12-point scale as an example, during the Real Time
Ultrasound assessment, it may become apparent that your core muscle strength and endurance is on the lower spectrum and that the muscles switch off as you go up the scale. In this case it’s important that you are given only low-level core exercises as during high level exercises, the load will start going through the spine, consequently hurting your back. On the subsequent reassessments you should see your core getting stronger, at which stage your physiotherapist will adjust both your Clinical Pilates and home exercise programs. MANAGING INCONTINENCE: REAL TIME ULTRASOUND: • An article on the management of urinary incontinence published in the American Family Physician showed that: “Bladder retraining and pelvic floor muscle exercises are firstline treatments for persons without cognitive impairment who present with urge incontinence… Pelvic floor muscle exercises are considered firstline treatment for stress incontinence”. • To benefit from the exercises, however, it’s important that you are engaging the relevant muscles correctly. When it comes to managing incontinence, the main muscles which need to be strengthened are the core and the pelvic floor muscles. As mentioned above, using Real Time Ultrasound in women’s health, will ensure correct activation of the correct muscles and improve pelvic floor health for women.
Real Time Ultrasound is an indispensable tool for Clinical Pilates, back pain, managing incontinence and women’s health. Your physiotherapist will tell you how it can help you improve your pelvic floor health.
Margarita Gurevich is Senior Physiotherapist and uses Clinical Pilates, SCENAR Therapy & other evidence-based techniques, including Real Time Ultrasound and McKenzie Treatment. Margarita specialises in sports injuries, women’s health (including incontinence) and gastrointestinal issues. Margarita may be contacted via her website.