From Pain to Perfect As A Sonographer - How Movement Training Changed My Life, Part 3 (cont)

As we talked about previously in this article series, there is a definite tasks that are “must do” for sonographers to be able to combat their pain and injury issues. All of the areas we’ve discussed; ergonomics, resistance training, improving mobility and flexibility are keys in reducing and eliminating the epidemic of injury that sonographers are plagued with.

Below are some key movements that are done on a daily basis, and ways to take care of those areas with ergonomics and exercise.

Flexion and Extension of the Neck

One of the things that you can do ergonomically is to ensure that the monitor is positioned properly. At eye level with the screen directly in front of you is optimal.

When we talk about joints and joint angles, one of the terms that we talk about is FLEXION. Flexion describes and is made possible by the decrease in the angle of the joint. Your body (Bones, muscle, connective tissue) all cooperate to move the joint into a position that is ‘flexed’. Bringing your hand to your chest, taking your trunk down closer to your legs or doing a chin tuck would be examples of flexion.

The opposite of the term flexion, would be EXTENSION. With extension you are straightening out the limb or joint. Extension increases the angle between the joint. One of the positives of our education is that many of the things we ask you to do are really very simple and can be done very quickly, even while at work. Isometric exercises are a great tool in the war on pain and injury. Isometric exercises have you offer resistance and involve contraction of a muscle group, but the muscle length remains the same. The muscle is providing resistance and doing work, even though there is no movement.

Here are some isometric exercises that offer strengthening of the head and neck.


Take and place your clasped hands on the back of your head. You want to keep your neck straight while trying to push your head backward into your hands. Your hands don’t allow any movement of the head. You want to hold for about 10 seconds and then it is important to relax for a short time, and then repeat.

  • For flexion: Place your hands on the back of your neck. Keep your neck straight and attempt to push your head backward while resisting the movement with your hands. Hold for eight to 10 seconds and then relax. Repeat for a second time (figure A).

  • For extension: Place your hands on the top of your forehead. Keep your neck straight and attempt to push your head forward while resisting the movement with your hands. Hold for eight to 10 seconds and then relax. Repeat for a second time (figure B).

Here is a great fast, easy, quick stretch that is very effective and can be done anywhere.

Chin Tuck Exercise:   You want to take your hands and place them on the back of your head. (Figure C) Now pull down with your hands. You should feel a pull and a stretch on the back of your neck. Hold for 10 to 20 seconds and repeat.

Stretching neck laterally:  Place your chin slightly forward and then using either hand pull your head toward your shoulder (Figure D). Again hold for 10 to 20 seconds and repeat. Do right and left sides.

When you are constantly twisting and turning your neck, there can be a tightness created for the very upper body including your shoulders, trapezoids, neck. The term for when the spine moves sideways is lateral flexion. An example would be having your neck move laterally towards your shoulder.

Lateral flexion:   Place your hand on the side of your head. Right hand on the lateral right side of your head. Head should be straight up in a normal position. Take and apply force with your hand into the side of your head while simultaneously keeping your head in the original starting position. Hold for 10 seconds and then repeat using left hand on left side of head.

Place your hand on the side of your head and maintain, keeping your head in a vertical, neutral position. Press your head into the hand and hold for eight to 10 seconds. Repeat this two times with each side (figure E).

If you find that during your work day you suffer from tightness and achiness in the upper body area, you will find that stretching these areas can offer enormous benefit.

Here is another quick, easy, effective stretch to alleviate tight achy muscles. Again this can be done at work or wherever and whenever this problem arises. You want to start by looking straight ahead, chin up. You want to move your ear toward the respective shoulder. You do not want to bring the shoulder up to meet the ear; ear to shoulder. Hold for 10 to 20 seconds and then repeat the other side. If you want to add load and also increase intensity take your hand and help pull into the stretch.

Many of you have probably heard of the term the ‘core’. The core of your body is where all of the movement of your body originates. The core is a very important part of the body and core exercises should be a staple in your regime. The core is the part of the body that allows for twisting and rotation. It’s imperative that your core is in great shape as this is the basis for the rest of your body. The core is really defined as the area around your trunk and pelvis. If your core is strong it aids all other areas of the body to work pain and injury free. A strong core is also necessary to alleviate back problems. It is vital to not only have a strong core with great range of motion. Your core allows you to do better movement, give your center of gravity a strong base, and give your body a stable platform from which all other movement arises. If you have a strong core the musculature in those areas (lower back, hips, abdomen) all work together so that movement can be done with multiple loads in several different planes. Your core also gives support to the spine, which is involved in nearly all movements that we do. If your core is weak and not in shape this can lead to multiple issues, namely pain and then injury.


Doug Wuebben BA, AS, RDCS (Adult and Peds) FASE is a registered cardiac sonographer who performs adult and pediatric echocardiograms. Doug is also a consultant and International Speaker on keeping Sonographers and Others doing their jobs at a high level.

Mark “Coach Rozy” Roozen M.Ed, CSCS,*D, NSCA-CPT, FTSAC, FNSCA Mark has his Masters Degree in HPERD, with emphasis in Exercise Physiology. He is a Certified Strength and Conditioning Specialist (CSCS,*D), a Certified Personal Trainer (NSCA-CPT) a Facilitator for Tactical Strength and Conditioning (FTSAC) and a Fellow of the National Strength and Conditioning Association (FNSCA). He has been in the Strength, Conditioning and Performance field for over 30 years.

Mark is also Owner and CEO of COACH ROZY, LLC, his company that does performance training, a radio show, writes a column in the local newspaper and oversees his speaking and writing. He is also Co-Founder of LIVE PAIN FREE with Doug, which works with groups, teams and corporation to help their staff and employees achieve peak levels of performance.

His other business is 911 Tactical Performance where they work with First Responders; fire, police and military to help BE FIT FOR DUTY - FIT FOR LIFE.

They can be reached to

Their website is and



We Recommend

Order Now!


cardiovascular education on demand