At Advantage Healthcare and Physiotherapy in Wynnum, Brisbane, our physiotherapists are specially trained in the use of Real Time Ultrasound (RTUS) for assessing and retraining deep muscle activation patterns. RTUS or rehabilitative ultrasound imaging (RUSI) is a powerful, non-invasive imaging tool that allows both clinician and patient to see muscle contractions/activation as they happen, providing immediate feedback and improving the accuracy of muscle retraining.
This is not a diagnostic scan for the purposes of identifying or diagnosing muscle or tendon strains, tears, tendinopathies or bursitis but as a biofeedback device to help you retrain and reactivate the correct muscles.
Why is Real Time Ultrasound Important?
RTUS is especially useful for targeting the deep core muscles, including the transversus abdominis and multifidus. These muscles can be difficult to activate correctly without visual feedback. Research shows that individuals with chronic low back or pelvic pains frequently experience poor activation of these key stabilising muscles. With RTUS biofeedback, you can see the muscle contraction on the screen as it happens. This helps confirm you are recruiting the intended muscles and reduces the risk of compensating with larger, superficial muscles.
A study by Van et al. (2006) found that real-time ultrasound biofeedback significantly improved the ability of individuals to correctly activate the lumbar multifidus muscle—an essential stabiliser of the spine. This supports the clinical use of RTUS for improving motor control retraining, particularly following injury or surgery.
Reference: Van, K., Hides, J. A., & Richardson, C. A. (2006). The use of real-time ultrasound imaging for biofeedback of lumbar multifidus muscle contraction in healthy subjects. Journal of Orthopaedic & Sports Physical Therapy, 36(12), 920–925.
View study on PubMed
When is Real Time Ultrasound used?
After Spinal Surgery
Following spinal surgery, it’s essential to restore deep core strength to support spinal stability and prevent re-injury. RTUS enables accurate retraining of core muscles by helping you visualise and correctly activate the right muscle groups from the very beginning of your rehab journey.
Lateral Hip Pain
For people with lateral hip pain, which is commonly linked to gluteal tendinopathy or trochanteric bursitis, real-time ultrasound (RTUS) can be used to assess and retrain key hip stabilisers. This includes the gluteus medius and gluteus minimus, which help control pelvis position and support hip function during walking, stairs and single-leg tasks. RTUS biofeedback provides immediate visual confirmation of muscle activation so you can learn the correct pattern and reduce compensation. Improving gluteal muscle recruitment and control can support faster recovery and better functional outcomes.
Pilates Assessments
RTUS is a valuable tool in our Pilates assessments. It helps you learn how to effectively engage your deep abdominal muscles, ensuring you’re getting the most out of your Pilates practice. This is especially useful for beginners or those recovering from injury who need extra guidance to activate the correct muscles.
Pregnancy Related Pelvic Pain
Pregnancy can place significant strain on the pelvic and abdominal muscles. RTUS is used by our pelvic floor physiotherapists to helps retrain pelvic floor and deep core muscle activation safely during and after pregnancy, supporting pelvic stability, improving comfort, and preparing your body for birth and postpartum recovery.
Back Pain
One of the most common uses of RTUS is in the management of lower back pain. With real-time imaging, our physiotherapists can teach you how to correctly activate your core stabilisers, improving your spinal support system and reducing pain over time.
Posture
RTUS can also be used in conjunction with Clinical Pilates and functional movement retraining to enhance postural control. Whether you’re an athlete, a new mum, or someone who spends long hours at a desk, RTUS-guided core training can help you build a stronger, more resilient body.