Physical Medicine and Rehabilitation

Nov. 15, 2013

Many women who have been through pregnancy are familiar with low back pain. For some, that pain can last after childbirth and be severe enough to require physical therapy. One tool Mayo Clinic physical therapists use frequently with postpartum patients is rehabilitative ultrasound imaging (RUSI). The technology, which is safe and radiation-free, allows a patient to look at a screen and see her abdominal muscles during a physical therapy workout.

"Pregnancy-related back pain affects between 50 and 75 percent of all women. Our goal is to identify the potential source of the pain and help women return safely to physical exercise," says Kathryn (Kathy) R. Cieslak, P.T., D.Sc., OCS, of Mayo Clinic's Department of Physical Medicine and Rehabilitation. "We can see which muscles are having trouble contracting, and we can modify the exercises to target specific muscle groups."

Cieslak presented details about her use of the technique during the 2013 American Physical Therapy Association conference in Atlanta.

Key points about postpartum back pain

• Many types of back pain can be resolved by improving core strength, but many women exercise after childbirth without properly isolating and targeting the key core muscles.
• RUSI enables women to see the muscle groups as they're being worked out. The tool, which is being incorporated into treatment more frequently by physical therapists throughout the country, helps women understand the muscle groups better and focus attention on those that need to be engaged.
• With improved ability to isolate specific muscle groups, women develop techniques and exercise habits that help resolve back pain and enable them to resume activity.
• RUSI has helped a variety of patients who needed to develop improved core strength. Cieslak recently used RUSI to guide a patient's physical therapy after he underwent extensive abdominal surgery known as the Whipple procedure.