Ultrasound scanning is hard on your body, very hard. Ask any sonographer who has been scanning for any length of time and they will tell tales of arm pain, shoulder pain, wrist pain, upper back pain, or neck pain. These ailments can be agony as well as career limiting if not dealt with and kept to a minimum through proper body mechanics while scanning.

Some sonographers like to sit on a high stool while scanning while others like to stand. It is a personal choice, and I have scanned both ways at different times in my career. I much prefer to stand rather than to sit. I feel I move around the patient better and get more optimal positioning of my body for whatever part I am scanning. Some feel scanning is hard on their feet and legs and prefer to sit, others change depending on what exam they are performing. The size of the patient also makes a difference. I feel I have more power to push into a large patient if I am standing and can utilize more strength from my core, not just my scanning arm.

Whichever way you choose, make sure you are standing or sitting up straight. No bending forward or slouching. Place yourself as close to the unit as possible, so that the hand that is running the controls rests comfortably on the keyboard. This way you can easily reach every key on the unit and the monitor. Place the patient so that the body part you are scanning is at your side, and the table is as close to you as possible. Your scanning hand should not be in front of your body or behind. Be especially mindful of not rotating your arm behind you while performing transvaginal and venous leg exams. Place the table height so that you are scanning comfortably; too low and your arm will be nearly straight while scanning, too high and your shoulder will be in an awkward position. The height should allow your elbow to be bent to about ninety degrees. If possible, roll the patient on their side when scanning the side away from you, this way you will not be awkwardly stretching yourself across their body. When you roll the patient away from you, have them move back toward your body–they have a tendency to want to position themselves at the opposite edge of the table. Do not scan with your body leaning sideways as if you are chasing them across the table. Always remember to keep yourself as upright as possible.

You don’t know how many times I have left a student scanning with them in proper position only to come back later and find them standing or sitting in a completely awkward way. They will have positioned their feet nearly at the end of the bed, their body pitched forward, bent in half at the waist, left arm stretched out in front, right arm contorted out to the side placing their shoulder in a position that no human shoulder was ever meant to hold. They look as if they should be in a yoga class or playing a game of twister. I tell them their bodies will never last a lifetime of holding these poses for thirty to forty-five minutes at a time. It just is not possible. If you find yourself getting so uncomfortable while scanning that your body aches, check your position. Straighten up. Relax your shoulders; they are probably up around your ears. Notice how hard you are gripping the transducer. There is a tendency to place a death grip on it when you are learning to scan as if you are afraid it will jump out of your hand and run away. Relax the muscles in your scanning arm, in your typing arm. Every so often, consciously remember to check your body. And remember to breathe. I find students holding their breath almost to the point of passing out. Breathe in, breathe out.

There are other things to be aware of as well. The weight of the cord constantly pulling on your wrist often causes carpal tunnel symptoms. There are devices made to strap around your wrist and hold the cord so that the weight is lessened, but I have not seen these widely used in the field. I have tried them, and they do work but seem cumbersome to take on and off. I prefer to trap the cord between my hip and the table, leaving enough cord to be able to move the transducer around the body. This is possible when scanning while standing, but not so much while sitting. Almost all sonographers who scan sitting down will place the cord on their lap or around their neck to lessen the weight. Do whatever works to keep that drag off your wrist.

Moving and lifting patients is another area where you can seriously hurt yourself or others if not done properly. Learn how to move patients safely, how to help them on and off the table if they need help, and when to get help. Be sure to ask for help if needed. Never attempt to lift an incapacitated patient by yourself, you may both end up injured.

If you encounter a patient who is disabled, ask them how you may best help them. Explain what position you need them to be in, on the table laying on their back, for instance, then ask them what you need to do to help them get in that position. They deal with their disability every day, and chances are they know best what help they need if any. Do not just assume you will need to lift a wheelchair bound person onto the table, many are capable of doing it themselves. Also do not assume that just because the last wheel-chair bound person you came in contact with could, the next one will as well. Every person is different, and they know their limitations. Listen to them, and then act accordingly.

A piece of advice I can offer is to get a massage. I know they are expensive, but oh, so worth it. If your community has a massage school, all the better. You can usually get massages there for a very reasonable price. If not and you cannot afford massages on a student’s budget, take a long hot bath at the end of your day and teach your partner how to release the tension in your arms, shoulders, neck, and back. Or make friends with a good therapist and offer to cook them dinner in trade. I am convinced that monthly massages have been key to my ability to continue to practice for nearly thirty years, and hopefully will keep me going for another twenty. Well, maybe fifteen, or ten, or five, or however long I need and want to work.