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

The foot is possibly the most important part of the lower extremities, and although its size might lead one to think otherwise, it is essential in the power and acceleration of the running start, being necessary in absolutely all sports and daily disciplines.

This means that they are constantly subjected to wear and tear, which makes them a common target for tendon, bone and muscle injuries of all kinds. Fortunately, electrotherapy allows the use of TENS and EMS, two forms of electrotherapy that will help both to relieve pain of all kinds and to strengthen muscles to avoid future injuries.

How to use a TENS machine to relieve plantar pain?

TENS unit therapy has been extensively studied over the last decade, reaching very favorable results for the treatment of pain that confirm its effectiveness. This is especially beneficial for the treatment of pain in the feet and ankles that often affect the quality of life of many people, but especially those with advanced age.

Among the most important benefits of transcutaneous nerve electrostimulation we can highlight:

• Release of endorphins: it has been proven that using TENS stimulates the production of endorphins, also known as the hormone of happiness as it has several effects on people's mood, which also works as a natural painkiller. This allows the feeling of relief in the foot to be maintained even after the end of the session.
• It influences the production of pain neurotransmitters: these are medullary cells that are automatically generated unconsciously when feeling an injury to the foot or ankle, and activate nociceptors to report the sensation of pain that will be transmitted by the tibial and peroneal nerves. TENS currents will limit and slow down their production to reduce the acute sensation of pain.
• Increases the pain threshold: the pain receptors of the tibial and peroneal nerves will be affected by the TENS currents, causing a higher neurotransmitter load to be needed to activate them, which will automatically raise the patient's pain threshold considerably.
• Prevents reciprocal innervation: which is an involuntary muscle contraction of the extensors and abductors of the toes close to the point of pain, which in turn is counterproductive and can increase the severity of the pain.
• Stimulates vasodilation: since TENS currents generate heat in the area of the foot where they are applied, dilating the blood vessels, which will help to relieve the pain, since both the heat and the oxygenation derived from the blood that will arrive have an analgesic effect.

These benefits make TENS therapy tremendously effective in treating foot injuries such as:

• Achilles tendinitis
• Ankle sprains
• Arthrosis of the foot
• Morton's neuroma
• Tarsal tunnel syndrome
• Plantar fasciitis

Best TENS machines for foot injury recovery

To save you time we have prepared a list of the best transcutaneous nerve stimulation units you can use to relieve foot pain.

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 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.

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.

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.

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 feet?

While EMS is usually used mainly to stimulate contractions that simulate those we get when training muscles in the gym, in the case of the feet we can give it a different function and use lower intensity currents to get a contraction that mainly simulates a massage.

In this way we can take advantage of benefits such as:

• Muscle relaxation: with less intense currents than usual, we can achieve a relaxation of the extensor and abductor muscles of the toes, as well as some ankle muscles such as the peroneus brevis or the lower part of the soleus, to eliminate accumulated tension and avoid tendon injuries or muscle overload.
• Muscle strengthening: by raising the intensity threshold of the current we can strengthen the muscles of the sole of the foot that make up the plantar fascia and other ankle muscles to provide greater stability such as the tibialis anterior, the peroneus brevis and peroneus longus, or the soleus.
• Injury prevention: the electrical currents used in EMS will strengthen muscles, increase their resistance to fatigue and improve their nutrient assimilation, creating healthier tissues and fibers that are less prone to injury.
• Improves fatigue resistance: using EMS has been proven to increase the fatigue resistance of the foot and calf muscles by significantly reducing their oxygen consumption. This will help if you spend a lot of time on your feet at work as it will reduce the wear and tear on the plantar fascia that can lead to plantar fasciitis or heel spurs.

Best EMS electrostimulators to strengthen plantar muscles

Below we share with you a list of the best EMS stimulators that you can buy in the market to strengthen the muscles of your feet and take advantage of all the benefits of this therapy.

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.

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.

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.

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.

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 the electrodes pads on the foot?

Electrodes for feet

• For tarsal tunnel syndrome: To relieve pain such as tarsal tunnel syndrome, an electrode is placed on the outer side of the ankle, and another slightly lower on the inner side, so that the current flows directly through the nerve.
• For Morton's neuroma: In case of other neuropathies such as Morton's neuroma, a pad is placed just above the point of pain, and another on the sole of the foot just below that point, so that the affected nerve is in the middle of the current.
• For plantar fasciitis: For plantar fasciitis, we proceed to place one pole at the base of the toes slightly angled towards the halux and the second toe which is where the arch of the foot is pronounced, and another pole on the heel or calcaneus.
• For calcaneal spur: In case you want to treat a spur, one pad is placed right on the heel and the other on the belly of the plantar fascia to shorten the radius of action. Another option is to use a mat-shaped foot massager with TENS functions.

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Most common types of foot injuries

The foot is full of ligaments, bones and small muscles that, not having too much tissue, make them unprotected against direct blows.

This makes it exposed to injuries such as those mentioned below:

• Tarsal tunnel syndrome: also known as tibial neuralgia, it consists of the pinching or compression of the section of the tibial nerve that passes through the inner side of the ankle, generating a sharp pain that manifests itself when standing for a long time or using the flexor muscles of the joint.
• Plantar fasciitis: this injury occurs due to the shortening of the fascial tissue of the sole of the foot, also known as plantar fascia. It usually manifests with a sharp pain when standing for a long time, but unlike tibial neuralgia, this is concentrated on the sole of the foot, from the heel to the base of the toes.
• Calcaneal spur: it is a calcification in the insertion of the plantar fascia with the calcaneal bone of the heel, generally caused by an excess of traction that causes irritation and wear in this union between tissue and bone. This spur is created in the form of a spear, which causes an uncomfortable pain to be felt when the heel is supported, which will eventually also generate damage to the fascia that will manifest itself as plantar fasciitis.
• Metatarsal fracture: the metatarsals are those bones that go from the ankle to the base of the toes that provide stability when walking. Unfortunately they are too exposed and with little muscle, which makes that any direct blow on them generates a fissure that can even be so pronounced that it generates a total separation of the bone in two or more parts. The most common metatarsal to fracture is the 5th metatarsal, which is located on the external side of the foot.
• Achilles tendonitis: consists of inflammation and irritation of the posterior tendon that joins the calf to the heel, the same one that allows you to stand on your toes. This manifests itself with instability when walking, sharp pain in the back of the foot and inability to separate the heel from the ground.

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

Electrotherapy has two methodologies. The first is transcutaneous electrical nerve stimulation or TENS, which uses electrical currents to act on the pain receptors of the tibial nerve, which when it reaches the heel branches into calcaneal branch, plantar branches and the baxter nerve, and the peroneal nerve, which when it reaches the ankle divides into several branches that pass through the metatarsals and reach the toes. The aim is to increase the patient's pain threshold by intervening in the neurotransmitter signals of an ailment.

The second is muscular electrostimulation or EMS. This uses currents that reach the flexor and extensor muscles of the fingers, and also on the calves and soleus to achieve a contraction of the same. In this way a strengthening of the muscle fibers is achieved that will reduce the likelihood of injury.

The differences between the two are evident; while EMS acts at a muscular level, TENS acts at a neurological level, which makes the latter the ideal therapy for pain relief in the case of tendon injuries or neuropathies such as tarsal tunnel syndrome or Morton's neuropathy. However, EMS is also useful to prevent future injuries, as well as to achieve a post-healing rehabilitation of any foot or ankle injury.

Contraindications in the use of electrodes and electrotherapy