advanced equipment and skills

We have advanced equipment and assessment skills to ensure your best outcome.

Real Time Ultrasound

Research about recurrent low back pain has shown that poor functioning of the inner trunk stabilising muscles occurs following an initial episode of low back pain. Whilst recovery from the low back pain may occur, recovery of the stabilising muscle function is not always automatic (Entrez PubMed). Similarly poor pelvic floor control has been shown to be associated with urinary leakage or difficulty defecating. Loss of pelvic floor control generally occurs around the time of childbirth as well as with chronic straining to defecate and chronic cough.

Ongoing poor function of the trunk stabilising muscles leaves the spine vulnerable and predisposes the sufferer to recurrent episodes of low back pain (Entrez PubMed). Recent research suggests that continence and breathing problems have a stronger association with back pain than obesity and physical activity (Entrez PubMed).

In response, physiotherapists implement rehabilitation exercise programs to improve the control of these stabilizing muscles (Entrez PubMed, Entrez PubMed). However learning how to work these particular muscles is not easy and many people do not progress because they are unable to ‘get it.’ To facilitate the learning process and to ensure correct technique physiotherapists needed to look inside to see what was happening.

The same Real Time Ultrasound imaging that is used to look at a foetus during pregnancy, is being used by physiotherapists to assess and retrain the correct muscle action of the trunk stabilizing muscles.

Real Time Ultrasound Imaging (RTUS) allows visualisation of the movement of a muscle or organ such as your bladder as it occurs. For instance ultrasound imaging allows for the observation of a muscle or muscle groups as they contract. This is particularly of value when examining or training the deep muscles of the trunk (the Core or the Inner Unit) and the pelvic floor muscles, as they are located under the other layers of muscle and are difficult or inconvenient to feel directly.

The utilization of ultrasound to observe the real-time contraction of these deep muscles (example: transversus abdominis) is a very useful tool, and highlights the importance of quality of contraction (motor control) to the client. RTUS can also be used as an effective biofeedback tool in the re-education of core control.


Uroflow measures urine flow. This test provides useful information in most cases where there is pelvic floor related problems.

The test involves urinating into a special toilet privately. The uroflow records the volume of liquid you pass and the time it takes. This is a very useful test as you and your physiotherapist will know if your volume and flow is normal and advise you to do “voiding training” or send you back to your doctor for further testing.

Post void Residual

Real Time Ultrasound can be used after urinating to check if the urination or void was complete. At Inner Strength we estimate the left over (residual) volume.

Vaginal or Anal Examination

Adults, who have pelvic floor dysfunction and bladder, prolapse or bowel symptoms will benefit from an internal examination. This usually takes around two minutes and involves removing your underpants.
In all cases you have the right to refuse this examination.

Once your questions have been answered if you choose to have this examination you will be asked to sign a consent form.