Ultrasound Imaging in Early Postpartum Rehab

When discussing the use of ultrasound imaging in my clinical practice, I am often asked, “What type of patient is your favorite to use ultrasound with?” This is a hard question for me to answer because ultrasound is so beneficial for several types of patients.

Ultrasound is used in a wide range of clinical scenarios, including sacroiliac joint (SIJ) and lumbar spine pain, guiding core strengthening for oncology or post-surgical patients, supporting recovery after prostatectomy, and assessing pediatric and adolescent pelvic floor function. I often highlight that ultrasound imaging is particularly valuable when internal pelvic assessments are not possible, for example, in the immediate postpartum period when pelvic rest is prescribed. In such cases, transabdominal ultrasound can help confirm whether patients are correctly engaging their pelvic floor muscles following a vaginal delivery.

A recent study in the Journal of Women’s & Pelvic Health Physical Therapy explored the use of ultrasound imaging in the early postpartum period. The study included 75 women between 0 and 5 days after vaginal delivery. Each participant took part in a single in-person session where ultrasound was used both as an assessment tool for the clinician and as biofeedback for the patient.

The study concluded that with only one session, using ultrasound as biofeedback improved contractions for participants. Vertical bladder excursion during a pelvic floor contraction was improved, especially in those patients who initially presented with paradoxical excursions, and those who suffered perineal trauma during delivery. Participants were satisfied with the experience of using ultrasound imaging and receiving early postpartum PFM rehabilitation.

This is an exciting development, especially for those of us working in hospital settings! The ability to visit patients shortly after childbirth and begin pelvic floor rehabilitation right away presents a major opportunity. It allows us to reach more patients early, provide essential education, and address potential issues before they progress. With today’s smaller, more portable ultrasound units, which can even connect to a smartphone or tablet, therapists can easily bring them onto the labor and delivery unit to examine patients within the first few days after delivery.

The Course: Rehabilitative Ultrasound Imaging: Pelvic Health & Orthopedic Topics
This course examines how rehabilitative ultrasound imaging can benefit various patient populations. You'll learn how to apply ultrasound in both orthopedic and pelvic health settings. There are two course options: a two-day version tailored for orthopedic therapists, and a three-day version designed for pelvic floor therapists, which includes deeper training on pelvic floor-specific conditions. Join me September 5–7 to learn how to integrate ultrasound imaging into your clinical practice. Satellite Options for the September 5-7 course date include:

• Rehabilitative Ultrasound: Orthopedic Topics - September 5-6
  Indianapolis IN
  Seattle WA
  Self-Hosted
• Rehabilitative Ultrasound Imaging Pelvic Health - September 5-7
  Indianapolis IN
  Seattle WA
  Self-Hosted

AUTHOR BIO
Allison Ariail, PT, DPT, CLT-LANA, BCB-PMD, PRPC

Allison Ariail, PT, DPT, CLT-LANA, BCB-PMD, PRPC (she/her) has been a physical therapist since 1999. She graduated with a BS in physical therapy from the University of Florida and earned a Doctor of Physical Therapy from Boston University in 2007. Also in 2007, Dr. Ariail qualified as a Certified Lymphatic Therapist. She became board-certified by the Lymphology Association of North America in 2011 and board-certified in Biofeedback Pelvic Muscle Dysfunction by the Biofeedback Certification International Alliance in 2012. In 2014, Allison earned her board certification as a Pelvic Rehabilitation Practitioner. Allison specializes in the treatment of the pelvic ring and back using manual therapy and ultrasound imaging for instruction in a stabilization program. She also specializes in women’s and men’s health, including conditions of chronic pelvic pain, bowel and bladder disorders, and coccyx pain. Lastly, Allison has a passion to help oncology patients, particularly gynecological, urological, and head and neck cancer patients.

In 2009, Allison collaborated with the Primal Pictures team for the release of the Pelvic Floor Disorders program. Allison's publications include: “The Use of Transabdominal Ultrasound Imaging in Retraining the Pelvic-Floor Muscles of a Woman Postpartum.” Physical Therapy. Vol. 88, No. 10, October 2008, pp 1208-1217. (PMID: 18772276), “Beyond the Abstract” for Urotoday.com in October 2008, “Posters to Go” from APTA combined section meeting poster presentation in February 2009 and 2013. In 2016, Allison co-authored a chapter in “Healing in Urology: Clinical Guidebook to Herbal and Alternative Therapies.”

Allison works in the Denver metro area in her practice, Inspire Physical Therapy and Wellness, where she works in a more holistic setting than traditional therapy clinics. In addition to instructing Herman and Wallace on pelvic floor-related topics, Allison lectures nationally on lymphedema, cancer-related changes to the pelvic floor, and the sacroiliac joint. Allison serves as a consultant to medical companies and physicians.