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How to use a TENS units & EMS machines for ankle pain relief? Placement of electrode pads (UK)

The ankles are the most important joints for any athlete, but also one of the joints that usually receives the most wear and tear due to high impact activities, since they are the ones that support the greatest load of body weight.

That is why it is very common to suffer injuries and various ailments in this part of the body. Luckily, TENS and EMS electrostimulation can be of great help, which is why today we will show you how to use electrostimulation to relieve any pain or discomfort in the ankles.

How to use a TENS machine to relieve ankle pain?

TENS units are specifically manufactured to generate pain relief for athletes and people with muscle and joint ailments.

Among its uses and benefits we can highlight the following:

  • Raises the pain threshold: the frequencies used work directly on the pain receptors in the ankle located in the superficial peroneal nerve and the sural nerve to increase pain resistance during and minutes after the session.
  • Limits pain-producing cells: in this way, the cell groups around the ankle responsible for causing the sensation of pain are suppressed, resulting in a feeling of instant relief for the user.
  • Alterations in the reciprocal innervation: in this way a relaxation of the deltoid ligaments, the calcaneofibular ligament and the posterior and anterior astragaline peroneal ligaments is achieved, causing an analgesic effect.
  • Vasodilation: the currents applied on the ankle generate heat, which causes dilation of the blood vessels surrounding the joint, which in turn generates a local analgesic sensation, helping to maintain a feeling of relief even after the TENS session.

All these benefits mentioned above, make transcutaneous electrical nerve stimulation useful to relieve pain caused by injuries such as:

  • Tendonitis
  • Bursitis
  • Sprains
  • Arthrosis
  • Arthritis
  • Tarsal tunnel syndrome

It should be noted that transcutaneous electrical nerve stimulation is not a method of healing, but of pain relief, which means that by using it you are not going to heal the injury but reduce the symptoms. The latter can only be achieved by following the indications of a specialist, while TENS will simply make the recovery process more pleasant by minimizing acute pain and reducing recovery times.

Best TENS machines for ankle injury recovery

Here's a list of some of the best transcutaneous electrical nerve stimulation (TENS) machines and devices you can use to relieve ankle injury pain.

Omron - Intense Wireless TENS Muscle Stimulator with remote control
  • Type: TENS
  • Channels: 2
  • Modes/Programs: 9 Programs
  • Intensity: 15 Levels
  • Wireless: Yes
  • Heat therapy: No
  • Battery: Rechargeable
  • Electrodes: Not specified
  • Display: Digital
  • Size: Not specified
  • Improves blood circulation
  • Includes user manual
  • Accelerates recovery from sports injuries
  • Portable and small size
  • Includes carrying bag
  • No heat therapy
  • No battery life specified
  • Size and weight not specified
The E3 model from OMRON is a TENS electrostimulator of compact size and great power, designed to be portable and used to relieve pain caused by exhaustion, injuries or diseases such as sciatica or neuropathy. This device uses TENS stimulation technology, proven and widely used by physiotherapists for its ability to relieve any type of pain.

It has a wide variety of pre-programmed modes of use designed to treat a wide range of ailments. Its compact size makes it incredibly convenient to carry wherever you want, and its specialized long-lasting electrodes can be washed and reused up to 150 times. The purchased package contains 1 OMRON E3 electrostimulator, 1 electrode cable and 1 long-lasting pad.

Dioche - Digital TENS device for muscle relaxation and effective pain management
  • Type: TENS
  • Channels: Not specified
  • Modes/Programs: Not specified
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (300mAh)
  • Electrodes: 4 Pads
  • Display: Digital
  • Size: Not specified
  • Reduces pain symptoms
  • Includes user manual
  • Improves joint mobility
  • Portable device
  • Improves blood circulation
  • Does not include carrying bag
  • Does not specify channels and modes/programmes
  • Does not specify intensity levels
Dioche has available to the public one of the best TENS machines on the market, which stands out for its ease of use, versatility and portability. You can use it to relieve pain caused by various causes, from neuropathies and arthritis to injuries and muscle contractures.

One of its best features is the presence of a laser line for the nose that will allow you to treat rhinitis symptoms effectively, improving your health conditions considerably. The dual channel function of this rechargeable mini TENS machine allows you to treat multiple parts of the body simultaneously, bringing benefits such as improved circulation, reduced pain and accelerated metabolism.

Med-Fit - Dual Channel TENS Machine for Pain Relief and Pain Management Therapy
  • Type: TENS
  • Channels: Dual
  • Modes/Programs: 3 Modes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: 2 AA Batteries
  • Electrodes: 16 Pads
  • Display: No display
  • Size: Not specified
  • Includes user manual
  • Reduces pain symptoms
  • Improves joint mobility
  • Improves blood circulation
  • Accelerates recovery from sports injuries
  • No intensity levels specified
  • Does not specify measurements and weight
  • Display not included
The Med-Fit TENS unit is presented as the most viable and sophisticated option for the treatment of ailments of any kind, thanks to its innovative dual-channel function that allows you to treat the symptoms of diseases such as sciatica, arthritis, and muscle injuries in different areas of the body simultaneously.

Its electrostimulation method allows you to relieve chronic ailments through the application of mild electrical stimuli that inhibit pain signals and stimulate the production of endorphins. The best results are obtained when using this unit for 60 to 90 minutes. The use of this device is widely recommended because it does not interfere with any medical treatment and is completely safe.

Beurer - Digital dual channel TENS and EMS Combo machine with 70 programmes
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 70 Programs
  • Intensity: 50 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: 3 AAA Batteries
  • Electrodes: 4 Pads
  • Display: Digital
  • Size: Not specified
  • TENS+EMS combo
  • Improves blood circulation
  • Improves joint mobility
  • Includes user manual
  • Portable and small size
  • Does not specify dimensions and weight
  • Battery operated
  • Touch screen not included
The physiotherapy brand Beurer offers its users one of the most versatile electrostimulation devices that can be found on the market. This is the Beurer EM49, which contains an incredible 3-in-1 function that allows you to apply therapeutic massage, muscle stimulation and nerve stimulation, providing a completely different level of relief to its users with its more than 70 programs and 50 levels of intensity.

This powerful electro-stimulator offers immediate relief for almost any type of ailment using stimulation methods that stimulate the production of natural analgesic agents within the body. It also works as an effective methods to accelerate muscle growth and regeneration, making it one of the most complete and versatile electrostimulation units on the market.

Easy@Home - Dual channel TENS & EMS machine with 16 modes and 4 electrode pads
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 16 Modes
  • Intensity: 20 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 10 hours)
  • Electrodes: 4 Pads
  • Display: Digital
  • Size: Not specified
  • Rechargeable battery
  • Accelerates recovery from sports injuries
  • Includes user manual
  • Reduces pain symptoms
  • Improves blood circulation
  • Transport bag not included
  • Does not specify measurements and weight
  • No heat therapy
Twenty intensity levels can be selected independently for each output to meet different massage needs, whether for leisure or sport. Two independent channels control the electrode pairs, so that two channels of the electric massager can be used simultaneously on different parts of the body. Includes high quality adhesive electrodes (replacement electrodes sold separately)

This combination device is ideal for pain relief and can also be used as a massager to relieve persistent tension. It is a non-pharmacological alternative to relieve pain and tension for people suffering from muscular, chronic, nerve and even some acute pain. For those who wish to tone and firm their muscles, the EMS mode of the device stimulates the muscles and improves their performance. For sedentary people, the device promotes local blood circulation.

How to use an EMS muscle stimulator for the ankle?

As mentioned in previous sections, EMS is a training therapy in which a current of between 70 Hz and 150 Hz is used to achieve muscle contraction and stimulate muscle strength and elasticity. Therefore, it should only be used on specific muscle groups.

In the case of the ankle, EMS is not used because we are talking about a joint that is not composed of virtually any muscle, so a stimulation of this type would be sterile and even counterproductive if it is in a recovery process.

In the best case scenario, it would be used to strengthen and stimulate muscles responsible for mobilizing the ankle joint such as the tibialis anterior, extensor digitorum longus, extensor hallucis longus muscle and the peroneus anterior muscle.

In this way, benefits such as:

  • Muscle strengthening and toning thanks to the internal contraction of the muscles when using EMS currents.
  • Reduction of fatigue by reducing the oxygen consumption of the muscles by up to 16%, increasing their resistance to fatigue by up to 20%.
  • Improves muscle power when used long term by reducing the response time to accelerate the recruitment of fibers in the tibialis anterior and peroneus anterior when performing explosive movements involving the ankle as when performing a sprint in sports such as basketball, tennis, soccer or soccer.
  • Stops the loss of muscle tissue either by age, chronic injuries or sedentary lifestyle, offering a method of activation and muscle exercise for the elderly or people with disabilities.
  • Improves blood flow by up to 20%, as a result of vasodilation that will increase the capacity of the muscles to receive blood, which in turn will allow better oxygenation of tissues and maximizes the assimilation of nutrients, strengthening the muscles responsible for the mobility of the ankle to make them more resistant to injury.

Best EMS electrostimulators to strengthen the muscles around the ankles

We have already told you that EMS muscle electrostimulation will not help you to directly strengthen the ankles or any other joint, but it can help you to take advantage of the benefits mentioned above in those muscles responsible for mobilizing them, such as the tibialis anterior and peroneus anterior. To do this you can use some of the following devices:

Compex FIT 1.0 - TENS & EMS Muscle Stimulation Device with 10 programmes and 4 channel
  • Type: Combo
  • Channels: 4
  • Modes/Programs: 10 Programs
  • Intensity: Not specified
  • Wireless: No
  • Heat Therapy: No
  • Battery: Rechargeable
  • Electrodes: -
  • Display: Digital
  • Size: Not specified
  • Accelerates recovery from sports injuries
  • TENS+EMS Combo
  • Portable and small size
  • Rechargeable battery
  • Includes user manual
  • Size and weight not specified
  • No intensity levels specified
  • Separate electrodes
The Compex Fit 1.0 electrostimulation device is a massage unit designed to apply electrical impulses on different muscle groups, promoting the regeneration of muscle fibers, toning and strength. It allows you to define muscles of the abdomen, arms, shoulders, back and legs, thanks to its application of EMS technology through its 4 channels.

In addition, it has a TENS massage mode with which you can treat acute and chronic ailments caused by various conditions. It has 10 modes of use: 1 for pain treatment, 1 for physical rehabilitation, and 8 physical training programs. All these features make it the number one choice for increasing physical performance in a completely natural way.

TechCare Massager - Portable TENS+PMS unit with 10 rechargeable massage modes and LCD display
  • Type: Combo
  • Channels: 2
  • Modes/Programs: 10 Programs
  • Intensity: 20 Levels
  • Wireless: No
  • Heat Therapy: No
  • Battery: Rechargeable Lithium
  • Electrodes: 8 Pads
  • Display: LCD
  • Size: 8,3cm x 6,3cm x 0,5cm
  • Reduces pain symptoms
  • With adjustable timer
  • Accelerates recovery from sports injuries
  • Includes carrying bag
  • Improves blood circulation
  • No battery life specified
  • No weight specified
  • No heat therapy
The TechCare mini massager is one of the best and most practical tools to deal with acute and chronic ailments safely and without the use of medication. It is a device that combines TENS and EMS massage functions, applying low voltage electrical impulses to effectively block pain signals, as well as increase the natural production of endorphins, a natural painkiller.

It features 10 pre-programmed massage modes and 20 intensity levels that target different types of ailments and injuries. It has a session timer function that allows you to adjust the duration of the sessions and has a lithium battery that allows you to apply therapy for more than 20 consecutive hours.

Beurer - Digital dual channel TENS/EMS device with heat therapy, 70 programs and 50 intensity levels
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 70 Programs
  • Intensity: 50 Levels
  • Wireless: Yes
  • Heat Therapy: Yes
  • Battery: Rechargeable Lithium
  • Electrodes: 4 Pads
  • Display: Digital
  • Size: Not specified
  • With heat therapy
  • Incl. user manual
  • TENS+EMS combo
  • Accelerates recovery from sports injuries
  • Reduces pain symptoms
  • No battery life specified
  • Transport bag not included
  • Does not specify dimensions and weight
The physiotherapy brand Beurer offers its users one of the most versatile electrostimulation devices that can be found on the market. It is the Beurer EM59, which contains an incredible 4-in-1 function that allows you to apply therapeutic massage, muscle stimulation, nerve stimulation and heat therapy, providing a completely different level of relief to its users with its more than 70 programs and 50 intensity levels.

This powerful electrostimulation equipment offers immediate relief for almost any type of ailment using stimulation methods that stimulate the production of natural pain relieving agents within the body. It also works as an effective methods to accelerate muscle growth and regeneration, while combining with heat therapy to provide one of the most complete treatments you will find.

PowerDot 2.0 - Wireless TENS & EMS smart device controlled by mobile application (red)
  • Type: Combo
  • Channels: -
  • Modes/Programs: 15 Programs
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium
  • Electrodes: 4 Pads
  • Display: No display
  • Size: Not specified
  • TENS+EMS combo
  • Control from mobile app
  • Rechargeable battery
  • Includes user manual
  • Reduces pain symptoms
  • No battery life specified
  • No intensity levels specified
  • Does not specify dimensions and weight
The PowerDot 2.0 is an intelligent electrical stimulation electrode that will allow you to apply TENS and EMS current shocks for both pain treatment and conditioning of different muscle groups. It includes more than 400 customised programmes that can be easily managed with the mobile app available for both Android and iOS.

The simple interface of the PowerDot app will guide you through everything you need to know to operate the electrodes efficiently. The purchase package includes 2 pre-loaded pods, 2 sets of electrodes with corresponding pads, 2 sets of cables and 2 micro USB charging cables, along with a carrying case so you can take your electrodes with you wherever you go.

HealthmateForever - Handheld TENS electrotherapy device with 4 channels
  • Type: Combo (TENS+EMS)
  • Channels: 4
  • Modes: 15 Programmes
  • Intensity: Not specified
  • Wireless: No
  • Heat therapy: No
  • Battery: 4 AAA
  • Electrodes: 8 Pads
  • Display: LCD
  • Size: Not specified
  • Improves blood circulation
  • Includes 15 modes
  • Independent control mode
  • Reduces pain symptoms
  • No rechargeable battery
  • Does not specify intensity and size
The Health Mate Forever brand has one of the most advanced electro stimulator models available on the market, with 4-channel function and 15 modes of use that you can apply to various parts of the body simultaneously. Maximizing the efficiency of your workouts. Its simple and easy to understand design allows anyone to use it, and makes it much easier for you to program your sessions.

It also has a session timer that allows you to control the duration of the therapies. You will be able to set the time of each session in an interval between 10 and 80 minutes. The package includes 1 electro stimulator, 4 sets of guide wires, 4 pairs of electrodes, 1 electrode case, 3 AAA batteries, 1 pad positioning guide and 1 user manual.

Video: How to place electrodes pads on the ankle?

Electrodes for ankle

Electrodes for ankle

  • For ankle sprain: If you have pain in the inner side of the ankle, you should place an electrode on the head of the first metatarsal closest to the joint, and the other just on top of the astragalinus.
  • For Achilles tendinitis: If the pain is in the Achilles tendon, you should place one electrode at the point where the tendon joins the calcaneus, while the other electrode should be placed at the top of the tendon, where it joins the calf.
  • For the tibialis and peroneus: The first is the tibialis anterior muscle. The electrode is positioned in the middle area of this muscle. The second muscle is the peroneals, both the short and long peroneals, where the pads are positioned in the middle area of both muscles, to achieve a more uniform overall contraction.
  • For soleus and calf muscles: Lastly, we have the soleus and calf muscles. In this case, two electrodes are placed on the back of the calf over each calf, and another two on the sides on both sides of the soleus shown on both the inner and outer sides of the calf.

More types of EMS electrostimulators and TENS machines you should know about

Most common types of ankle injuries

The ankles are an essential joint in the motor skills of the lower body, basically in all high impact sports and daily activities we use them.

Therefore it is normal to suffer injuries such as the following:

  • Ankle sprain: is an injury caused by an incident that forces the ankle into an unnatural motion, which pushes the ligaments and tendons to the limit of their capabilities and tears them. This injury is classified in three degrees, being first degree when the soft tissues are stretched and swollen without further damage, second degree when the soft tissues are slightly or partially torn, and third degree when the ligament is completely torn.
  • Ankle fracture: it is an injury generated by an unnatural movement of the ankle, which in this case is so strong that it fractures or breaks one of the bones that make up the joint such as the base of the tibia, the talus (talar dome) or the fibula.
  • Tendonitis: injury generated by the wear in the ligaments or the Achilles tendon that are located around the ankle. Those that most often suffer such degradation are the deltoid ligament, the fibular calcaneus and the posterior and anterior astragaline peroneals.
  • Bursitis: it is the inflammation of the bursa of the ankle joint. This is in charge of storing synovial fluid to cushion the impacts and to avoid the friction between the bones that conform a joint, and when they become inflamed it is due to an excess of this fluid, generating an acute pain when supporting the foot or trying to mobilize the ankle.

Differences between TENS and EMS: Which one to use for ankle pain?

Transcutaneous Electrical Nerve Stimulation (TENS) is a technique used to control the nerve impulses responsible for generating pain. Different types of low or high intensity currents ranging from 1 to 250 Hz are usually used to increase the pain threshold, cut the pain transmitters and generate a sensation of relief in a localized area.

Muscle electrostimulation or EMS is a stimulation technique used to generate a contraction at a muscular level, for which a high intensity current is used to mimic the nerve impulses generated in the brain to contract or relax a muscle. This therapy is used for aesthetic purposes to increase muscle mass or tone it or to improve performance by offering a way to strengthen muscles outside the training schedule.

Knowing this, we can say that the correct therapy to relieve the pain of an ankle injury is undoubtedly transcutaneous electrical nerve stimulation or TENS, since it allows intercepting the pain transmitters in that joint. In addition, since the ankle is an area with a lot of hard tissue (bones, joint and ligaments), as it is not covered by muscle, it is more efficient to use this type of current.

EMS is contraindicated for the treatment of pain, and focuses more specifically on muscle training, a quality that is not very useful in the ankle, since this therapy only works in areas where there is abundant muscle tissue, such as the calves, pectorals, back and other similar groups. In addition, in the case of an injury that causes pain, it is best to maintain a certain period of rest, and the contractions generated by EMS disturb this recommendation.

Contraindications in the use of electrodes and electrotherapy

Contraindications for electrode placement

The placement of the electrodes is of utmost importance in electrotherapy, whether TENS or EMS, so here are some things to keep in mind before starting a session:

  • Symmetrical placement: the negative and positive poles of each electrode should be connected symmetrically. That is to say, if we use two pads, we should use one positive and one negative pole on each one, while if we use four, the equivalence should be two positive and two negative.
  • Do not cross the electrodes: one electrode cannot be used on the lower train and another on the upper train and more importantly, never cross the electrodes from the left side to the right side of the body and vice versa, since the current path can negatively affect the patient's health. For this reason it is always recommended to use the electrodes in a localized way.
  • Motor point: at least one of the electrodes, whether positive or negative, must be positioned over the motor point, which is the point where the greatest force is achieved in the muscle in question.
  • Control the intensity: the size of the muscle must be taken into account when choosing the intensity of the current, since the less volume and size the muscle has, the lower the tolerated intensity will be.
  • Be careful with the skin: EMS or TENS should not be used on recently depilated areas since the pores will be open and this could generate skin sensitivity. Do not use on irritated or reddened areas, open wounds or recent scars.

Contraindications for the use of electrostimulation

Being a therapy that applies currents to the body, it cannot be used for all conditions, therefore its use should be avoided in cases where the user suffers from the following conditions:

  • Epilepsy.
  • Cardiac pacemakers.
  • Circulation disorders and problems.
  • Abdominal or inguinal hernias.
  • Neurological disturbances.
  • Tendency to bleed.
  • Skin irritation, burns or wounds.
  • Diseases that affect muscle metabolism, such as diabetes.
  • Metabolic syndrome (diabetes, hypertension and obesity).
  • High uric acid levels.
  • Metabolic disorders and metabolic pathologies.
  • Inflammatory pathologies.

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