Real Time Ultrasound for Pelvic Floor Muscles or Diastasis Rectus

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Real Time Ultrasound for Pelvic Floor Muscles or Diastasis Rectus

Real Time Ultrasound Imagery (RTUS) uses sound waves to provide a visual image of muscle, tissue, and ligaments in our bodies. RTUS is a not a treatment tool but is a diagnostic and learning modality, that allows the physiotherapist and visual learner a picture and active image of parts of their body and their functioning.

RTUS is a wonderful tool to view the Diastasis Rectus (DR) abdominal muscle separation that may occur because of pregnancy, trauma, birth defect and or obesity. Measurements can be taken with RTUS and an image stored to view later, to evaluate the success of the physiotherapy program provides great motivation and feedback for both the client and physiotherapist.

RTUS is painless, noninvasive and a fabulous diagnostics tool to allow physiotherapist trained in this area, a platform from which to create an individualized educational exercise or training program for our clients.

In the post-partum period, when mums are very concerned about returning back to exercise, and what kinds of eerie they should be doing – the use of RTUS allows for a clear visual image of their DR separation and from there a return to core fitness and a fun exercise program can be tailored for the client.

RTUS is also a fantastic tool to allow women to view their Pelvic Floor Muscles (PFMs) to see whether the PFMs are working affectively again and to see if any dysfunctions such as changes in muscle tone and recruitment patterns are noted.

RTUS can be used safely while pregnant, as well as after you have delivered your baby. Please come in with a semi full bladder, as this allows a clear view of the PFMs, no vaginal probe will be used. A RTUS sound head will be placed on your skin in the lower pelvic area to view your bladder and PFMs. This is completely noninvasive and painless. Everyone usually really enjoys seeing their body muscles and how they function from the outside in!

Hand pain – Occupational therapy for hand

wrist pain

Due to change in nature of work in recent times, most people working from home with different postures, uncomfortable work desks, long work hours, excessive use of phones and computers, hand, elbow pains are quite common occurrences.

Hand therapy is a specialized healthcare service provided mainly by occupational therapists which focuses on the rehabilitation of the upper limb (elbow, forearm, wrist, hand, fingers and thumb).

The hand is one of the most important parts of our bodies, responsible for completing most of our daily tasks, such as self-care, work and leisure activities. 

The aim of hand therapy is to promote healing and maximize the function of the hand and upper limb, allowing individuals to return to performing activities (e.g. work-related activities, sports and hobbies) which are meaningful to them.

For upper limb conditions or injuries that do not require surgery, hand therapy treatment may include :

  • Splinting
  • range of motion exercises
  • strengthening
  • therapeutic modalities such as wax bath therapy and ultrasound therapy.
  • post-operative management of hand and upper limb injuries.

Common conditions/injuries of hand and upper limb include:

  • Fractures and/or joint dislocations of the elbow, forearm, wrist, palm, fingers and thumb
  • Joint or ligament injuries (e.g. TFCC injury)
  • Nerve compressions, injuries and repairs
  • Tendon injuries and repairs (e.g. mallet finger, tendon lacerations)
  • Repetitive strain injuries (e.g. trigger finger, carpal tunnel syndrome, De Quervain’s tenosynovitis, tennis elbow, golfer’s elbow, tendinitis)
  • Crush injuries, nail bed injuries, finger amputations
  • Sports injuries to the upper limb
  • Pain, myofascial and overuse conditions
  • Arthritis
  • Dupuytren’s contracture

A hand therapist will customise therapy plans based on the condition, symptoms and needs. Treatment options may include:

  • Heat therapy
  • Ultrasound therapy
  • Exercises to improve joint and muscle movements
  • Management of swelling
  • Scar management and desensitization
  • Strengthening exercises
  • Soft tissue, manual and trigger point release therapy
  • Sensory re-education following nerve compression/injury
  • Pain relief/management
  • Functional retraining and preparation for return to work
  • Ergonomics advice on posture on workstation set up
  • Personalised home exercise program
  • Customized splinting services for both upper and lower limbs.

Physiotherapy for Sports injuries

There are many benefits to doing sports and physical activity and more and more people are getting into it. Be it cardio, lifting, competitive sports, almost anyone who exercises on a regular basis will develop an ache, pain or sports injury at some time or another.

Different types of sports are predisposed to certain types of injuries because of the mechanics of the movement and the repetitive strain in certain movements.

Sports injuries result from acute trauma or repetitive stress associated with athletic activities. Sports injuries can affect bones or soft tissue (ligaments, muscles, tendons n nerves).

These Injuries can be classed as chronic or acute.

Understanding the mechanics of the body is important to know what are the optimum positions for the body to function in and the consequences if these positions are not followed through in sports and exercise.

Acute injury is due to an impact from a direct force by collision, being hit by an object or fall and if the injury is less than 2 weeks old. E.g. Sprains/strains, fractures, dislocations, hamstring tears, ACL tears.

Strained (pulled) muscles result from muscles being suddenly and forcefully overstretched.

This tears the muscle fibres, usually where they attach to the tendon. The muscle is painful and its strength is reduced.

Bruises and strains should be treated with ice to reduce the swelling

Sprains are different to strains – they involve ligaments rather than muscles and tendons.

Sprained/ twisted ankle Sprains occur when ligaments at joints get stretched and torn. A sharp twist of the foot can give you a sprained or twisted ankle. Severe sprains result in torn ligaments.

Sprains are more serious than strains, and result in considerable pain and loss of function at the joint. The symptoms are similar to a fracture or dislocation.

Sprains should be treated with ice and rest.

Chronic injury represents Tendonitis, joint instabilities, strained muscles and is generally a pain which has lasted more than 6 weeks and is caused by:

  • Overuse or repetitive stress of muscles
  • instability
  • Insufficient warm-up with lack of stretching and conditioning
  • training too hard
  • not allowing time for recovery
  • Improper sport gears or footwear
  • bad sporting technique

Common chronic sports injuries are: Tennis elbow, golfer’s elbow, carpel tunnel syndromeshin splints, general muscle ache/tightness.

Golf and tennis put a lot of strain on the elbow. In golf and tennis elbow, the tendons that attach muscles to the elbow joint become inflamed, sore and painful.

These injuries should be treated by applying an icepack and resting for several weeks.

Physiotherapy treatment will be helpful to relieve the pain

Shin splints are pains in the lower leg, caused by continuous stress over a long period of time.

Either the tendons around the tibia become inflamed, or ‘stress fractures’ develop – these are cracks along the length of the bone.

Shin splints should be treated with ice and plenty of rest. Cushioned footwear and special insoles or orthotics and strengthening exercises can help to prevent the injury returning.

General Tips to prevent injuries during sports:

  • Overuse of muscles or muscle weakness/imbalance. – Ensure your exercise program exercises all the major muscle groups working both the agonist and antagonist muscles.
  • Poor training methods – When starting a new exercise regime always seek advice from a trained professional in that field.
  • Postural defects– Hyper mobility puts you at increased risk of injury, consider leg length differences, scoliosis etc. 
  • Improper training equipment – Choose the right weight and number of repetitions for your ability.
  • Level of fitness/aging- Take in to consideration what you can realistically achieve.
  • An ideal posture –is when your joints sit and are worked in a neutral position. Poor alignment may result in frequent injuries. To train muscles most effectively you need the joints to be in their optimum alignment.

As experienced physiotherapists with sports injuries we believe:


Effective planning with your physiotherapist at Physio Asia:

  • Commences immediately following injury
  • Integrate pain relief for sports injuriesand activities accordingly
  • Stages – initial, intermediate, advanced and return to sport
  • Look for and correct any biomechanical abnormalities

Physiotherapist will advise you on:

  • Warm up
  • Stretching
  • Taping and Bracing
  • Protective Equipment
  • Suitable Equipment
  • Environmental factors
  • Appropriate Training
  • Nutrition

Why am I getting injured even though I am fit?

Sports injuries

Do you exercise regularly but find yourself sustaining injuries, aches and pains with your daily activities or sometimes even after your workout?

Injuries can push us back in our fitness journey progression. However, they can also be indicative of an existing problem or an absence in our exercise routine.

Here are some reasons why you might be getting injured even though you keep fit and exercise regularly.

1. Lack of warm up and cool down

It is not uncommon to hear recounts from patients telling me that they go for 5km runs or go to the gym after they get off from work. Diving straight in to your work outs and exercises after sitting at your desk the whole day is a precursor of an injury or strain just waiting to happen.

Sitting for long hours causes our muscles to get shortened and stiff. Warm ups help to increase the circulation to our muscles and warms it up, making them more elastic and ready for them to work more efficiently which helps to prevent injuries.

A proper warm up only takes about 10-20mins. You can start off with a slow 5-10min walk, jog or cycle, followed by a series of dynamic stretching exercises to get your joints mobile and well stretched out for the exercise ahead. Performing static stretches BEFORE your physical activity can actually cause reduction in muscle strength as your muscles are not yet warmed up to be stretched to its limits and can potentially cause injuries.

Static stretching is best for AFTER your work outs when you are COOLING DOWN. At this stage, your muscles have been contracting and are coursing with warm blood and nutrients. Static stretching helps to lengthen your muscles and restores them back to its natural length and speeds up recovery time. If this step is skipped, your muscles can remain in that shortened contracted length, resulting in tightness and pulling on other structures in your body, changing the biomechanical alignment of your body. Hence the importance of cooling down is as important and vital as warming up before your work outs for injury prevention

2. Muscle Imbalances

No one has the perfect body, but it becomes an issue and a precursor to injuries when there are distinct muscle imbalances in your body.

A left to right muscle imbalance can be easily identified. Usually our dominant hand or leg will be slightly stronger and we might be weaker and tighter on the other side. These imbalances will cause our bodies and joints to take on different stresses during exercises. This can result in one sided pains/injuries initially. If we don’t correct this imbalance, the joints in your body would continue to take on more stress and be prone to repetitive wear and tear and injury.

Other kinds of imbalances involve global muscles and stabilizers. Global muscles are larger muscle groups which produce a greater force but fatigue easily, whereas stabilizers do not produce great force but are enduring muscles. When our stabilizers are weak, our global muscles tighten up to compensate for the lack of the ability to contract over a long period of time. As mentioned earlier, tight muscles are a precursor for injuries. Therefore, with these kind of imbalances, it is important to consult a physiotherapist that can get you on the right track to strengthening your stabilizers and releasing those tight global muscles.

3. Poor Form

Poor form can be a result of muscle imbalancespoor body awareness, or the lack of knowledge on the exercise you are doing. Performing the exercises with a poor form will most definitely lead up to an injury. Talking more on biomechanical alignments, our weight distributes and our joints are built to take on weights. However, when you perform exercises in a poor form it leads to a change in your biomechanical alignment and force distribution in your body. This causes increased stress and strain on different joints and muscles groups which will result in sprains, tears and degeneration over a period of time.

Thus, it is important to get yourself educated with the knowledge on performing your exercises correctly. Be it walking, running, squats or lifting weights, a physiotherapist can advise and equip you with knowledge and the technical skills you need to prevent such injuries when you exercise.

Now that you know what are the common causes that leads up to an injury even though you exercise regularly, be sure to make these corrections as soon as you can and seek help to prevent yourself from getting hurt!

Rane Ng


Physio Asia Therapy Centre

Blocked Breast Ducts

Blocked breast ducts are not only an inconvenience, as they can dramatically slow down the flow of your breast milk, but they can be incredibly painful as well. The cause of blocked ducts is plentiful, however a few of the main causes maybe and are not limited to:

  1. A poor latch of your baby on the breast and hence poor emptying of your breast
  2. Excessively thick / fatty milk constituency
  3. Inexperience with the various positions of breast feeding -may lead to poor latching
  4. Fatigue of the mother
  5. Low hydration and poor supply of milk
  6. Over supply of milk

Physiotherapy working in conduction with a good Breast Lactation Consultant, may assist in successfully clearing blocked reast ducts. A noninvasive physiotherapy modality such as Ultrasound is often a key to successfully clearing blocked ducts.

Therapeutic ultrasound uses sound waves to create a ripple effect that passes through the breast tissue and ducts and hence clear the blockage in the blocked milk ducts.

Ultrasound is painless, and affective. Depending on the extent of the blockage of the breast duct, Treatment sessions may need needs to be 30 – 45 minutes in duration and may need to be applied over 1-3 sessions to clear the blocked ducts. Treatment sessions are most affective when applied daily or 1 day apart.

Often a combination of the ultrasound treatment plus soft tissue massage, rest, and good hydration, support good milk flow. Please address block ducts sooner rather than later to avoid further complications such as Mastitis. Mastitis can be very painful and make a new mum feel very unwell.

The signs of Mastitis are:

  1. Pain in the breast or at the blocked duct or arm pit
  2. Redness around or near the blocked breast duct
  3. Heat of the breast or blocked area
  4. You may feel unwell with flu like symptoms and or a fever that arises suddenly
  5. Milk flow slows down or stops
  6. If you have any signs of Mastitis please ask your General Practitioners (GP) advise as soon as you notice any of the above signs and start antibiotics immediately.

Ultrasound may then be applied to your breast 1 – 3 days after you start your antibiotic treatment.

Happy Breast-Feeding Ladies!


Decompression Therapy for Spine is your answer for non-surgical relief of lower back pain, sciatica, pinched nerve, neck pain and degenerated / herniated disc disease. With specific targeting for spinal levels, separate lumbar and cervical decompression programming, it is highly effective treatment for Back and Neck Pain.

This type of decompression can be done in different positions including one side bending or rotated position to achieve maximum corrective pulls.

The different patterns of pull are designed to facilitate Anti-inflammatory effect for healing, Decompressive effect on disc and reducing pressure on the compressed nerve and Spinal mobilization effect for reducing stiffness.

How does it work?

Decompression Therapy for Spine is performed on a specially designed table in either a face up or face down position. You are fitted with a harness attached to the computer controlled traction which is programmed to deliver a gentle stretching force to the spinal vertebra.

Vacuum or pumping effect

Stretching and relaxing the spine in a controlled manner causes a pumping action that helps to resupply the disc with nutrients and blood to help the disc heal (often lost in damaged and degenerative disc conditions). Thus creating negative pressure in the disc (decompression) that can help the drawing in of a bulge and help take pressure off a “pinched” spinal nerve. This will also help to mobilize the stiff spine.

What other treatment is involved in addition to Spinal Decompression?

In addition, it may include any of the following therapies as indicated by your condition: – electrical stimulation, ultrasound therapy, short wave diathermy, cold laser therapy, spinal mobilization and active exercises. 

Core muscle strengthening (SCORES)

We also need to focus on rehabilitating the structures supporting the disc in order to keep the pain from returning. Improving spine flexibility and muscle control is vital for spinal health.

A program of focused rehabilitative exercise with Stabilizer Pressure Biofeedback may begin during or after your Decompression Therapy. Through a series of specific controlled exercise techniques (often targeting the deep abdominal muscles) the Biofeedback monitors n Real time ultrasound for the correctness and effectiveness of your exercise performance by providing you continual visual feedback.

Long term pain relief

Post treatment you will be taught a home-based exercise program that will help to bring your spine back to full health. This exercise program may include postural advice, resistance training, Stabilizer/ Exercise ball /other “core” exercises.

How often do I take the treatment? 

It depends on the complexity and extent of rehabilitation needed. Decompression is usually performed 2-3 times a week for 5-12 sessions and your response is continually evaluated and change in frequency may be recommended accordingly.

If you suffer from chronic, debilitating, low back or neck pain, our physiotherapy practice is dedicated to offering the latest and state-of-the-art therapy, call us today to make an appointment.

For Further details on Decompression Therapy, please call us at 67364142.


Radial shock wave is a non-invasive treatment helps with Pain Relief, increasing metabolism, increasing the circulation and restoring a normalized muscle tone. It is very effective on tissues/ muscles with trigger point and/or increased tension.

A glimpse of how it is done


Shock wave therapy for knots on upper trapezius

How are shockwaves generated?

Shockwaves are generated from a projectile mechanically hitting a transmitter, which in turn produces a series of low energy acoustic (sound) waves. These waves are applied to the skin via a gel medium. The waves then travel downwards into the deeper tissues, providing effective fast pain relief.

How do shockwaves help?

Shockwaves accelerates the healing process by activating the body’s healing mechanism. They stimulate the metabolism and enhance the blood circulation. This in turn helps the damaged tissue to heal and gradually regenerate.

What happens during and after a shockwave procedure?

During the session, patients can feel a strong tapping sensation with each shock wave but the treatment only lasts a few minutes. Patients feel a significant difference after a session of shockwave. However, they may experience temporary soreness or tenderness for a few days following the procedure, as the shockwaves stimulate an inflammatory response, which in turn aids the body’s natural healing process.

Routine activities can be resumed after each treatment. If there is excessive soreness or discomfort in the area cold packs can be used, though it is better to let the body’s inflammatory response aid in the healing of the tissues that have been treated. Concurrent physiotherapy is important to address the underlying injury.


Shockwave Therapy is used in the treatment of many musculoskeletal conditions, primarily those involving connective tissues such as ligaments and tendons. It is an effective treatment method for a number of conditions, a few of which are listed below: 


  • This is an absolute contraindication for treatment to the stomach. However, treatment to the ankle in pregnancy would be acceptable.
  • Clotting disorders/patients on anti-coagulants. Shockwave can cause bleeding for these patients.
  • Joint replacements: Shockwaves can potentially loosen joint implants.
  • Shockwave can increase cell production and thus they are not applied to areas of infection.
  • Cancer: Shockwave to cancerous tissue could encourage cell growth in cancer tissue.
  • Corticosteroid injection: Shockwave is not recommended at the site of treatment for six weeks as steroid injections tend to weaken the area.

You can consult one of our Physiotherapist if you suffer from a condition that might need treatment with a shockwave. Call us for an appointment or send your queries to:

Customised Orthotics or insoles at Physio Asia in Singapore

At Physio Asia we don’t just to help you get rid of the present pain by just managing your symptoms but also find long term solutions to help you stay fit and pain free.

In simple terms, orthotics are special shoe inserts that are custom made to support the natural shape of the foot, align the hip, knee and ankle in order to improve the posture. 

Foot acts as the base on which the whole body rests. It is very important to have the foot in an anatomically and biomechanically right position, which is called the neutral position of the foot. 

The parts of the foot, which consists of the fore foot, mid foot and the hind foot, should be aligned well so as to counter the ground reaction forces, frictional forces and the body weight. 

It is estimated that up to 85% of the population suffers from excessive pronation and related conditions. Dysfunction of the lower limb should be attributed to two factors: 

  • Slight bowing of leg when approaching the ground during the gait cycle
  • Biomechanical deformity factors

When these two factors combine, excessive pronation often results which contributes to:

  • mal-tracking & misalignment of the knee and hip joints
  • over compensation of the lower back muscles
  • Joints on heel and rear footare more mobile and require more muscle work to maintain stability compared to a supinated foot position

Supination or under pronation of the foot occurs when the body weight falls on the outer edges of the feet. In a normal gait cycle, the foot should roll inward (pronate) so as to facilitate the toe off. 

Excessive supination and excessive pronation lead to problems with the body’s alignment resulting in pain in the feet, knees, hips and back

Function of Orthotics
Re-aligning the lower limbs to the neutral calcaneum stance position (neutral position of the foot) using the orthotics along with the treatment program assist in correcting foot function and can provide relief from painful biomechanical complaints like Bunions, Plantar fasciitis, Heel spurs, knee pain, osteo-arthritis, lower back pain.   

How is it done?

  • Measurements are taken by the Physiotherapist at Physio Asia. 
  • Examination of the foot is done in and off weight bearing position. 
  • Fore foot, mid foot and hind foot alignments are taken into consideration in relation to hips and pelvis.
  • Shoe insolesare customized in the same session, heat-moulded according to the foot position to get the best fit.
  • Insoles can be done for sports or work shoes as well as heels for ladies. 
  • These can be moved between similar pair of shoes too. 
  • Patients are called for review after 2 weeks and 4 weeks of using the orthotics

Call us for an appointment or send your queries to:

3 D Gaitlab for Running injuries and pain physiotherapy

Is running becoming difficult? Not able to find answers to the pain in your hips, knees, shins or feet? Is the pain not getting better despite going through rehabilitation, change of footwear, using orthotics and other interventions?

The solution to the problems above is ‘RIGHT DIAGNOSIS’.

Right diagnosis helps in zeroing in on the root cause and problem areas so that the appropriate and correct treatment can be administered according to your needs.

At our clinic, apart from doing regular assessments, our 3D Gait system provides a comprehensive data analysis of your posture and movements in standing, walking and running. It is an innovative system that assesses how the pelvis,  hips, knees and ankles rest and move in the different functional activities. It allows us to accurately and objectively detect normal and abnormal movement patterns, which can cause or lead to an injury, treat the issue and conduct a reassessment and record your recovery progression.

Having the right diagnosis the first and most important step in your recovery process.

Book an appointment with us to find out more and experience this for yourself!

Call us for an appointment or send your queries to: