Use TENS Machine for Pelvic Floor Exercise, A Complete Guide

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Pelvic floor health is a crucial aspect of overall well-being, influencing everything from urinary and bowel function to sexual health. TENS machines, known for their pain relief capabilities, have increasingly found applications in strengthening and toning the pelvic floor muscles. In this guide, we will explore the benefits, techniques, and essential tips for harnessing the power of TENS machines to effectively exercise your pelvic floor, promoting better health and enhancing your quality of life.

What are Pelvic Floor Muscles?

Pelvic floor muscles are a group of muscles that form a brace-like structure around the pelvic region. There are three main structures that form the pelvic floor muscles, including [1]:

Levator ani, which is comprised of three smaller muscles, including the pubococcygeus, puborectalis, and iliococcygeus
Coccygeus
The fascia is the lining that wraps around the pelvic region.

What do the pelvic floor muscles do?

The pelvic muscles collectively help the body with several vital functions. This includes:

Creating a bracing effect around the pelvic area during activities such as lifting and coughing
Assisting with urine and faecal continence
Providing stability to the torso and back
Supporting the organs within the pelvic region, including the bladder, rectum, and uterus (only in women).

What causes pelvic floor muscle weakness?

There are a number of reasons that commonly cause pelvic floor muscle weakness. For some people, there may be several factors, including [2]:

Obesity
Pregnancy and childbirth
Straining from long-term constipation
Neurological conditions (e.g., spinal cord injury, multiple sclerosis, etc.)
Heavy exercises, such as weightlifting or powerlifting
Ageing

Range of Weak Pelvic Floor Dysfunction Symptoms

There are a range of symptoms related to weak pelvic floor dysfunction. It’s important to understand that experiencing these symptoms does not always mean you have pelvic floor problems. Please seek the help of a specialised pelvic floor physiotherapist, doctor, or any other healthcare professional for assistance. Examples of these symptoms include [3]:

Pelvic organ prolapse, which can feel like a bulge or pressure in the pelvic region
Urinary incontinence (e.g., sudden urge, urine leakage during strenuous activities such as coughing, etc.)
Faecal incontinence
Constipation
Pelvic pain
Lower back pain
Sexual dysfunction
Increased risk of developing urinary tract infections

Traditional Kegel Exercises for Pelvic Floor Muscle Strengthening

Traditional Kegel exercises are sometimes also called pelvic floor exercises. Similar to other muscles in the body, there are pelvic floor muscles that support vital structures like the uterus, bladder, and rectum. Like other muscles, such as the biceps and quadriceps, these muscles can also be strengthened through exercise. Kegel exercises involve being able to contract the pelvic floor muscles to improve tone and strength. However, this requires consistency and conscious effort [4].

What is a TENS machine, and how can it help pelvic floor muscle recovery?

Typically, transcutaneous electrical nerve stimulation, or TENS Machine, is a medical device used to help reduce pain. It delivers electric current through the skin and into the body in order to block pain signals. Pelvic and lower back pain are some common symptoms related to pelvic floor dysfunction. Research suggests that this type of treatment can increase blood flow and block pain signals to the pelvic floor muscles [5]. Even to this day, there is yet to be a reliable way of relieving pain related to pelvic floor muscle dysfunction. TENS offers a non-invasive, self-empowering, and cheap way of doing so. There is also evidence to suggest that TENS can help reduce bowel and bladder urgency (i.e., the need to always go to the toilet) [6].

What's the best way to use a TENS machine for pelvic floor stimulation?

The best way to use a TENS machine for pelvic floor stimulation will depend on your own unique circumstances. It is always advised to seek support from a relevant healthcare professional if you are unsure. Please consider the following settings and factors when using the TENS machine:

Frequency (Hz)
Pulse width
Current (mA)
TENS machine placement and location
Methods of delivering treatment

Here are the best practices for using a TENS unit:

Using a Vaginal or Anal Probe for Pelvic Floor Stimulation

Before using the vaginal and anal probes, it’s important to prepare the following:

- Visit the toilet before use.
- Use a small amount of water-based lubricant on the probe prior to insertion.
- Select a comfortable position (e.g., knees to chest position in sidelying, etc.).
- Insert the probes in the vagina or rectum, as shown by the red arrows in the illustration below.

Electrode Pads as an Alternative to Vaginal and Anal Probes

An alternative to using the probes includes using electrode pads. The first electrode is placed between the genitals and rectum. The second is placed at the base of the spine, near the sacrum or tailbone. However, it’s important that you refer to your doctor or pelvic floor physiotherapist for further information.

Setting the Pulse Rate (Frequency) for Pelvic Floor Muscle Stimulation

The optimal pulse rate will be determined by the area being targeted and what you’re trying to achieve. Typically, the treatment frequency is between 10 and 50 Hz [7]. Lower frequencies tend to relax overactive pelvic floor muscles, while higher frequencies help with the contractions of these muscles.

Setting the Pulse Width for Pelvic Floor Muscle Stimulation

The importance of pulse width has yet to be fully determined for pelvic floor stimulation. Higher pulse widths will target deeper structures. 200 µs is recommended for most treatments. However, it’s important to speak to your healthcare professional for further clarification [7].

How Often or How Long Should You Use Your TENS Machine for Pelvic Floor Muscle Stimulation?

The duration and timing of your TENS machine will vary depending on the desired effect. Research has shown that using the TENS device for 20–30 minutes for five sessions a week was sufficient to notice an improvement [5] [8].

Using Caremax TENS machine for Pelvic Floor Exercise

We provide a comprehensive packaging solution for Pelvic Floor Exercise. Discover the most sought-after products below essential for effective TENS therapy treatment.


Caremax 2.0 Classic TENS machine	Caremax 2.0 Pro TENS Machine


Caremax Vaginal Probe	Caremax Anal & Vaginal Probe

Other Home Exercises to Strengthen Pelvic Floor Muscle

Pelvic floor muscles are located deep in the abdomen and can be difficult to strengthen. Kegel exercises are a proven way of strengthening this area [9]. It is advised to seek the assistance of a pelvic floor physiotherapist if you’re a beginner.

Where and when to not use TENS machines

While the TENS machine is generally safe to use, there are circumstances and regions where careful attention is required. Situations and areas to avoid using the TENS machine include [10]:

Overly damaged skin (e.g., wounds, cuts, etc.)
Altered sensation (e.g., tingling, areas with reduced sensitivity, etc.)
Around swollen areas, near cancers or clots,
Areas exposed to radiotherapy or radiation
If you have a seizure condition
Bleeding (e.g., haemorrhoids, rectal bleeding, etc.)
During bladder or vaginal infections

Additionally, individuals in the following situations should avoid or speak to their GP about using the TENS unit: during pregnancy, people with implanted devices (i.e., pacemakers, neurostimulators, etc.), those with cognitive or mental challenges, if you’re using a pessary, after a hip replacement, and those who cannot consent to treatment.

Are there any risks of side effects when using a TENS machine?

The primary side effects typically experienced involve skin irritation and unusual sensations in the treated area. However, more severe adverse reactions can arise if the TENS unit is misused, employed in unsafe locations, or administered to unsuitable individuals. Less common side effects encompass the development of rashes, heightened pain, seizures, interference with implanted medical devices, strokes, blood clot formation, skin damage, and burns. Should you observe any side effects, it is crucial to halt the treatment and promptly consult your physician for medical guidance.

References

TeachMeAnatomy. (n.d.). Pelvic Floor Muscles. Retrieved from: https://teachmeanatomy.info/pelvis/muscles/pelvic-floor/
https://www.ingentaconnect.com/content/ben/cwhr/2021/00000017/00000003/art00004
National Institute of Child Health and Human Development. (2022.). Pelvic Floor Disorders: Symptoms and Causes. Retrieved from: https://www.nichd.nih.gov/health/topics/pelvicfloor/conditioninfo/symptoms
Park, S. H., & Kang, C. B. (2014). Effect of Kegel exercises on the management of female stress urinary incontinence: a systematic review of randomized controlled trials. Advances in Nursing, 2014, 1-10.
Sharma, N., Rekha, K., & Srinivasan, J. K. (2017). Efficacy of transcutaneous electrical nerve stimulation in the treatment of chronic pelvic pain. Journal of mid-life health, 8(1), 36.
Slovak, M., Chapple, C. R., & Barker, A. T. (2015). Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder. Asian Journal of Urology, 2(2), 92-101.
https://www.pelvicfloorexercise.com.au/resources/post/electrical-stimulation-pelvic-floor
Ghaderi, F., Bastani, P., Hajebrahimi, S., Jafarabadi, M. A., & Berghmans, B. (2019). Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial. International urogynecology journal, 30, 1849-1855.
Harvey, M. A. (2003). Pelvic floor exercises during and after pregnancy: a systematic review of their role in preventing pelvic floor dysfunction. Journal of Obstetrics and Gynaecology Canada, 25(6), 487-498
.University of Iowa Health Care. (2018). Pain Medicine Patient Education: Contraindication & Precautions for Commonly Prescribed Medications & Therapies. Retrieved from https://www.healthcare.uiowa.edu/marcom/uihc/pain_medicine/contraindication_precautions_best062018.pdf