August 3, 2026 — Despite improvements in technology and awareness, work-related musculoskeletal disorders (WRMSDs) remain one of the greatest threats to the longevity of a cardiac sonographer’s career. A new guideline published by the American Society of Echocardiography (ASE) provides evidence-based recommendations to reduce the risk of WRMSDs and strengthen the cardiovascular imaging workforce.
WRMSD injuries not only affect the individual sonographer, but also patient access to care, workforce retention and the long-term sustainability of echocardiography. “Guidelines for the Prevention of Work-Related Musculoskeletal Disorders for Cardiac Sonographers: Recommendations from the American Society of Echocardiography” outlines recommendations for education, injury prevention, and workplace culture to prioritize safety and sustainability. It includes guidance on ergonomic equipment standards, safe scanning techniques, environmental design, scheduling strategies, early symptom recognition and the integration of emerging technologies, such as artificial intelligence and wearable feedback tools.
“For too long, musculoskeletal injury has been viewed as an expected part of being a cardiac sonographer,” said Guideline Chair Ashlee Davis, chief technologist at Duke University Hospital and manager and technical director for the institution’s Cardiac Diagnostic Unit. “This guideline challenges that mindset by demonstrating that many of these injuries are preventable through thoughtful design, education and organizational commitment.”
Davis said one of the guideline’s greatest strengths is its emphasis on injury prevention as a shared responsibility.
“While individual scanning techniques and ergonomics are important, meaningful change also requires support from employers, healthcare leaders, equipment manufacturers, educators and professional societies,” she said.
Guideline Co-Chair Allyson Boyle, director of echocardiography at Atrium Health, added that the recommendations were developed by experts committed to improving cardiac sonographers’ long-term health and diagnostic capabilities.
“We hope the guideline not only raises awareness of the prevalence and impact of WRMSDs but also empowers sonographers to prioritize their health and inspires healthcare organizations to take meaningful action,” Boyle said. “Investing in sonographer safety is an investment in workforce sustainability, quality patient care, and the future of the profession.”
As echocardiography laboratories face growing patient demand amid staff shortages, WRMSDs threaten both performance and retention. ASE President Dr. Cynthia Taub, Edward C. Reifenstein Endowed Professor and chair of medicine at the State University of New York Upstate Medical University, said that the guideline reflects ASE’s commitment to protecting cardiac sonographers.
“Protecting the long-term health of cardiac sonographers is fundamental to the future of the cardiovascular imaging,” Taub said. “With this guideline, ASE is providing much needed advice to help healthcare organizations create safer, more sustainable workplaces and ensure continued access to high-quality patient care.
Acces to the Guideline
The complete guideline, along with all guidelines published by ASE, are available at ASEcho.org/Guidelines.
July 27, 2026 
