Real-time ultrasound imaging is currently used extensively in medicine. It provides a safe, cost-effective and readily accessible method of examination of various organs and tissues. One area where ultrasonography has proved to be useful is investigation of musculoskeletal pathology. Tissues that can be imaged include muscles, tendons, joints, ligaments and bursae. One of the most useful features of real-time ultrasound imaging is that movement of anatomical structures can be observed as it actually occurs. This has allowed development of a new application of real-time ultrasound imaging for rehabilitation that involves observation of muscle contraction to provide feedback. An ability to image deep muscles is an advantage of the technique, and use of ultrasound imaging has been successfully incorporated in assessment and facilitation strategies for neck, back, shoulder, knee and a variety of other pain sources. It is a remarkable tool when used in conjunction with IMS (dry needling) to target deep structures that that can often be the cause of altered function and/or pain.