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Peak Physiotherapy using ultrasound for real-time imaging

Whistler clinic the first to offer service



While it's been available in Europe for a decade, B.C. recently allowed physiotherapists to use ultrasound to conduct real-time evaluations of their clients' back and pelvic issues. Whistler's Peak Physiotherapy is the first in the corridor to offer this service, with three therapists certified to use the equipment.

"We're pretty excited about it," said physiotherapist Allison McLean. "You need to see it in action, but it's pretty cool."

Right now physiotherapists are only able to use the ultrasound to look at back and pelvic issues, but McLean believes that will be expanded in the future to look at joint and muscle damage. The advantage, she says, is that the physiotherapists can see muscles working in real time to gauge the extent of an injury and how muscles may be misfiring to create pain.

"If you had an injury to your spine or your pelvis, like an SI (Sacroiliac Joint) injury or you fell on your butt, it's hard to figure out what's going on with the deep muscles of the core that can kick out or become hyperactive, and can become really dysfunctional," explained McLean. "Everything fires sequentially in your core, and that sort of thing is important to address because a muscle imbalance can give you pain. Athletes and people sometimes don't use their core properly or rely on power muscles, and so their core is unstable."

Using the ultrasound, the physiotherapists can see what muscles are working and in what sequence to determine if some core muscles are being overlooked. Working with the patient they can create a program - with the patient looking at the screen as they move - to determine how to use and strengthen various muscles that stabilize the lower back.

In addition to pelvic injuries, the ultrasound can determine if women are healed enough after childbirth to exercise without an abdominal injury.

"After giving birth a women's front abdomen splits apart, and that becomes a real problem if they exercise too soon when the tissue isn't healed up or closed. You can get hernias in the front abdomen, which is a serious thing that requires surgery," said McLean.

Another use is the ability to see what's happening with the bladder and pelvic floor of individuals who develop incontinence. Most treat their condition with drugs or use adult diapers, but in many cases the issue could be helped by developing and strengthening the proper muscles.

McLean says it's been a slow process to get ultrasounds into B.C. clinics. Physiotherapists in Ontario were the first in Canada to offer the service, and also have the ability to prescribe MRI scans, x-rays and CT scans without seeing a doctor. Eventually, McLean hopes it will be possible for physios to play a greater role in diagnosing and treating injuries and weaknesses.

"We're definitely poised to be able to do it," she said. "As orthopedic physios, we're already pretty good at anatomy and we know exactly where to look when there's a muscoskeletal issue."

McLean said patients don't need a doctor's referral to use the service, but doctors can refer their patients to the clinics for an evaluation and receive a full report.

"It's really a great bio-feedback machine where you can watch yourself doing standing squats and make sure your muscles are firing properly. Most people in town are pretty athletic, and when they see it they get it. It's a no brainer."



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