Physiotherapy: "We want to be able to better illustrate prognostic statements"

Interview with Moritz Müller, MSc / trainer, SonoSkills - excellence in musculoskeletal ultrasound training


Most patients know ultrasounds from medical exams but so far, only a few people expect them from a physiotherapist. That’s something Moritz Müller of the SonoSkills Company wants to change. In his lecture at the MEDICA PHYSIO CONFERENCE, he introduces the audience to musculoskeletal ultrasound.

Image: man in a red shirt with dark hair; Copyright: beta-web/Wart

Moritz Müller; © beta-web/Wart

Mr. Müller, under the title "Making tangible objects visible", you explained how physiotherapists can also work with ultrasound devices at the MEDICA PHYSIO CONFERENCE. How does this work?

Moritz Müller: Diagnostic musculoskeletal ultrasound is not a new invention of physiotherapy. It has been used in medicine for many decades and thus has been scientifically evaluated. The idea is to utilize the method in physiotherapy to support a general physical therapy diagnosis. We want to be able to better illustrate prognostic statements and simultaneously evaluate the therapy or the course of therapy. Sonography provides additional information with regard to optimal and differentiated therapy management. After all, one thing is clear: you can initiate more specific therapeutic measures with a more accurate diagnosis and more exact medical indication.

How often do you perform an ultrasound?

Müller: In my line of work, I am usually able to sensibly use ultrasound for approximately 50 percent of patients. For instance, in the case of shoulder injuries or tendon pathology, you first perform an initial exam. During the course of the treatment, you conduct ultrasonic testing to check whether the therapy triggers positive changes from a structural or functional point of view. This could be within a few days in the case of acute inflammation of the tendon region but there could also be weeks or months between the individual exams in case of long-term follow-ups.

How prevalent is this method in physical therapy?

Müller: That very much depends on the country. This is a relatively new concept in Germany. We are actually the only facility that also teaches this concept in physiotherapy. Meanwhile, physiotherapists in the Low or Benelux Countries have already applied this method for many years. The procedure has also been firmly established in physiotherapy in England for almost 20 years. That’s why I hope that my lecture is also going to galvanize physiotherapists in Germany and revolutionize their work by using this method. After all, many patients are referred to us by their general practitioner with relatively non-specific diagnoses. This is where ultrasonic testing is very helpful. It makes a big difference whether you are dealing with a tendon pathology that is due to inflammation or calcification for example. That being said, we are not able to clearly distinguish the two with the tests that are currently available to us. This might possibly lead to an inappropriate choice of treatment that is actually not medically required. For patients, this almost certainly leads to a worsening rather than an improvement on a structural level. In contrast, sonography at the start of the therapy clearly identifies the exact condition. That’s why patients benefit from it.

Foto: Simone Ernst; Copyright: B. Frommann

© B. Frommann

The interview was conducted by Simone Ernst and translated by Elena O'Meara.