How to use a TENS units & EMS machines for plantar fasciitis? Placement of electrode pads

The feet can be considered one of the most important extremities of the human body, and in terms of mobility and support of body weight it is possibly the most important, since, regardless of the level of physical activity, the feet support the entire body weight.

For this reason, the soles of the feet and heels are permanently subjected to a considerable amount of stress, which in the long term can lead to injuries such as plantar fasciitis, which can result in difficulty walking due to its symptoms. Below, we will show you how to use TENS and EMS electrotherapy devices to deal with the symptoms of this ailment.

How to use TENS machines to relieve foot fascia pain?

TENS therapy is specially designed to relieve pain by interacting with the pain receptors of the nerves located in the affected area. However, for the effectiveness of the treatment to be adequate, it is necessary to know the ideal position for the placement of the electrodes and the intensity with which to apply the therapy.

Where to place the electrodes?

Plantar fasciitis causes pain due to tension in the fascia, which runs along the entire sole of the foot from the heel to the toes. To treat the pain caused by this ailment, the most indicated position of the pads is as follows:

• External aspect of the gastrocnemius, at the level of the tibial nerve.
• Center of the soleus muscle, where the tibial nerve innervates.
• Sural nerve, on the external lateral aspect of the foot.
• Center of the plantar fascia, in the arch of the foot.

Although TENS therapy correctly applied can cause a considerable sensation of relief, it is necessary to emphasize that it is not a way to cure injuries, but a method to deal with the pain caused by these, in order to make the recovery process more bearable.

What intensity to use?

The ideal intensity of current to treat pain varies depending on the injury and the severity of the ailment. The appropriate intensity for acute pain ranges from 90 to 120 Hz, while chronic pain is treated at a lower intensity of 2 to 10 Hz.

With this in mind, in the particular case of plantar fasciitis, the ideal intensity will depend on how long the pain has been present. For recent conditions, up to three months, the ideal intensity is 115 Hz with a constant frequency that stimulates the application of endorphins.

In case of chronic pain caused by plantar fasciitis, the ideal intensity is 15 Hz in a burst that promotes the release of endorphins and the numbing of the nerve endings of the lateral plantar nerve.

Best TENS units to treat plantar fasciitis

Plantar fasciitis is a particularly annoying ailment that can become disruptive to our way of life by making it difficult to perform tasks as simple as walking. Fortunately, there are a variety of TENS devices designed to relieve the pain in the sole of the foot caused by this condition.

HiDOw presents its XP-Micro 8 electrostimulator, a versatile and compact electrotherapy unit that combines the best of TENS and EMS technologies with a dual channel function that allows you to apply treatment and stimulation to different parts of the body simultaneously. Its function is based on the emission of electrical impulses that block pain signals, and generate muscle stimulation to help develop strength and toning.

It has 8 preset programs and 20 intensity levels, along with a session timer function that you can set between 10 and 60 minutes. Its built-in rechargeable lithium battery provides excellent durability, and the package contains 1 XP Micro 8 electrostimulator, 1 set of large pads, 1 set of small pads, 2 cables, 1 power adapter, 1 user manual and 1 carrying case to take it wherever you need it.

Massage Therapy Concepts presents its TENS/EMS electrostimulation machine, which combines the best qualities of both technologies to generate a viable option with which to treat pain caused by various injuries and diseases, as well as stimulate muscle mass to increase strength and definition. All this integrated in 12 modes of use with different intensities and levels, designed for different types of ailments.

Its dual channel function allows you to treat multiple areas of the body simultaneously, and its easy to use mode allows you to set the massage modes without any problems. It has a timer that you can set up to 60 minutes, and an LCD display that allows you to visualize all the procedures very easily.

The Cure Choice brand of products has brought to its audience the best combo function electrostimulator you will find, with the powerful combination of TENS and EMS electrostimulation technologies, and an incredible 245 modes of use that are divided between electrical massage to relieve acute and chronic pain, and muscle stimulation to improve muscle strength and tone.

Its mode of use is incredibly easy, as the modes of use can be adjusted by pressing a few buttons, and the integrated timer will allow you to program the start and end of the session automatically. It is one of the safest forms of pain treatment, as it does not require medication or invasive processes to generate the sensation of relief, since it works by stimulating the body's natural painkillers.

This electric massage unit provided by iReliev is one of the most versatile and, at the same time, simplest electrostimulation machines you can find, with 8 predefined modes of use 25 adjustable intensity levels, you can program it to fit your body's needs. Additionally, its dual channel function allows you to program more than one massage mode simultaneously to treat multiple areas of the body.

It has an interesting session timer function that allows you to adjust the duration of each therapy up to a maximum of 60 minutes. Its compact size allows it to be carried in your pocket, so you can take it with you from home to work, or on the road, and use it whenever you need it.

This is a precise and compact wireless TENS electrostimulation device, brought to you by the iReliev brand, intended for the treatment of pain at precise points of the body. Thanks to its size and the fact that it does not require any wires to operate, it is completely discreet and can be used anywhere, while traveling and under clothing.

Its efficient use of TENS technology allows it to block pain signals before they reach the brain, making it a safe method of treating ailments. It also has a long-lasting lithium battery and an energy-efficient function, which turns the device off every 20 minutes. One of the best devices on the market in terms of portability, discretion and functionality.

How to use EMS electrostimulators to strengthen the muscles of the sole of the foot?

While muscle electrostimulation is not a therapy designed to treat plantar fasciitis, it is a widely used method to prevent this type of injury by strengthening the muscles of the foot.

Where to place the electrodes?

To maximize the effectiveness of muscle training, it is necessary to know the biomechanics of the foot, in order to position the electrodes on the correct muscles or muscle groups, which are:

• Extensor digitorum longus muscle, which originates in the lateral condyle of the tibia and fibula, and inserts on the top of the dorsum of the foot.
• Extensor hallucis longus muscle, which inserts at the metatarsophalangeal joint of the big toe.
• Triceps suralis muscle, the main plantar flexor, which is formed by the soleus and gastrocnemius muscle, whose tendons join to insert in the calcaneus.
• Medial flat muscle, which is intrinsic to the foot and is innervated by the lateral plantar nerve.

What intensity to use?

The appropriate intensity for training with EMS devices varies depending on the area being worked. Specifically in the foot, the goal of training is to improve stability and circulation.

For this, the ideal current varies between 50 and 60 Hz, the frequency at which the greatest muscle contraction is recorded, promoting fiber growth and increased resistance of the triceps suralis and medial plane muscle.

Best EMS machines to avoid nerve impingement

Although the use of muscle electrostimulation is not very common in the foot area, its use is really beneficial to improve balance, strengthen foot support and increase blood supply. For this purpose, the use of dedicated machines is recommended, among which we can mention:

The Compex Sport Elite 2.0 comes to the market as one of the most versatile and complete options to increase the results of physical conditioning and reduce the negative effects of the same through its TENS stimulation technology which allows an adequate management of the odor, reducing the intensity of the same and increasing the mobility and functionality of the muscles.

It includes 10 electrostimulation modes divided into 3 recovery modes, 2 warm-up modes, 1 TENS massage mode and 4 strength training modes. It also has 5 levels of progressive intensity that will help you improve your strength, endurance and combat various ailments caused by exhaustion.

The Omron Total Power is a very complete electrostimulation device by Omron, which has TENS electrostimulation technology for the treatment of any type of muscular ailments, as well as a heat therapy function that allows to reduce deep tissue ailments in a very easy way, providing a sensation of immediate relief to the patient.

This versatile device can treat both chronic and acute pain in a safe and natural way, thanks to its ability to increase the production of endorphins in the human body. It has 20 intensity levels that can be adapted to your needs and its heat therapy function allows it to reach a temperature of 43 °C (109 °F). Its long-lasting pads have a fairly long lifespan, allowing up to 30 uses.

PowerDot 2.0 wireless muscle stimulation electrodes are among the newest and most cutting-edge devices related to the field of physiotherapy, specifically designed to be portable, comfortable and provide an immediate sense of relief to its users. The package includes 2 pre-loaded pods, 2 sets of lead wires, 2 sets of electrode pads, 1 carrying case, 1 USB charging cable and 1 user guide.

To provide one of the fastest and most comprehensive improvements for pain of all types, the PowerDot 2.0 has over 400 different usage modes with different settings, aimed at muscle recovery, performance enhancement and pain relief, which can be adapted according to recent activity, fatigue level and the area to be treated. All these options can be managed through its mobile application, which is available for both Android and iPhone mobiles.

The TechCare massager is a dual-channel electrostimulation device with a rechargeable battery and a large number of functions dedicated to the application of TENS and EMS massages. It features an LCD display and various modes of use, along with a session timer, and an on-screen indicator of remaining battery time.

It has multiple modes of use and its A-B output channel allows you to apply two types of massage simultaneously, making it one of the most versatile devices available on the market. The package includes 1 control, 1 protective case for the TENS unit, 3 pairs of electrodes, 4 power output cables, 1 USB cable, 1 user manual, 1 plastic case and 1 belt clip.

The Conree electrostimulation machine was created for one specific use: symptomatic relief of chronic pain and temporary relief of aches and pains associated with exhaustion and muscle injuries in the arms, shoulders, neck, back, waist and legs due to strain caused by exercise or heavy work.

It offers a professional solution through its 12 massage modalities with 30 intensity levels, which you can easily adjust to adapt the therapy to your needs. Additionally, its dual channel function allows you to apply different modalities on the A and B channels of the stimulator, allowing you to treat two different areas of the body, or even two different people, simultaneously.

Video: How to place electrodes pads on the foot?

Electrodes for feet

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What is plantar fasciitis and what are the causes?

Plantar fasciitis is an ailment of the sole of the foot and heel caused by inflammation of the plantar fascia, a band of tissue that connects the heel bone to the toes across the sole. The cause of this is not a particular condition, but a set of factors that increase the risk of suffering it, among which we can highlight the following:

• Age: the wear and tear of the tissue increases the possibility of suffering plantar fasciitis, especially between 40 and 60 years of age.
• Exercise: Certain physical activities that put pressure on the heel and attached tissues can lead to plantar fasciitis. For example, long distance running, dancing or ballet.
• Foot mechanics: certain conditions such as flat feet, a too high arch or even the way you walk can put excessive stress on the plantar fascia.
• Obesity: excess weight puts excessive pressure on the ankles, feet and sole, facilitating the onset of plantar fasciitis.
• Too much time on your feet: professions that require spending most of the time on your feet tend to have a high rate of employees with plantar fasciitis, thanks to the stress exerted during working hours.

What are the most common types of foot pain?

The main function of the feet is to balance the body and support its weight during movement, so they are usually subjected to a considerable amount of pressure that can vary depending on some factors. This stress is usually a fairly common cause of wear and tear on tendons, ligaments and other tissues, which can lead to a wide range of ailments.

Among the main causes of foot pain, we can highlight the following:

• Achilles tendonitis: this is an injury to the Achilles tendon caused by overuse, so it commonly occurs in runners and middle-aged people who play sports.
• Bunions: is a bony protrusion formed in the metatarsophalangeal joint, which occurs when one of the bones becomes misaligned causing the tip of the big toe to point toward the other toes and the base of the big toe to become inflamed and red.
• Bursitis: is a disorder that causes inflammation in the joints. Although it occurs most often in the elbows and shoulders, it can also occur in the heel and the base of the big toe.
• Gout: is a form of arthritis caused by uric acid buildup that usually causes swelling, tenderness and pain in the big toe.
• Flat feet: is a condition that causes flattening of the arch of the foot, and although the sensation of pain is not usually present, there are cases in which flat feet can cause pain in the arch or heel area, which can intensify with physical activity.
• Foot fracture: is an injury to the foot bones of varying severity that can occur from a blunt impact on the foot. It can be caused by accidents or falls.
• Ingrown toenail: is a very painful condition that occurs when nail growth causes the nail to bury into soft flesh. It usually occurs on the big toe, and can cause inflammation, pain, redness and, in some cases, infection.

Differences between TENS and EMS: Which is better for treating plantar fasciitis?

TENS and EMS electrostimulation devices work in a very similar way, since they both work through electrical impulses. However, they are not intended for the same function, as their effect is focused on completely different areas.

Transcutaneous Electrical Nerve Stimulation, or TENS for short, has the following characteristics:

• It focuses on treating symptoms of injuries that cause pain.
• It uses low intensity electrical impulses (1 Hz to 250 Hz).
• They interact with nerve endings in the sole of the foot, located in the medial plantar branch and lateral plantar branch of the posterior tibial nerve.
• Its objective is to mitigate the sensation of pain and generate a feeling of relief in the patient.

In contrast, electrical muscle stimulation, or EMS (Electrical Muscle Stimulation), while having similar characteristics, has important differences. These are the following:

• It uses medium to high intensity electrical impulses, ranging from 70 to 150 Hz.
• Itcauses muscle contractions that lead to an increase in muscle mass, strength and elasticity.
• It is widely used in the rehabilitation of muscle injuries and physical training.
• It is a method of physical training and rehabilitation, not a treatment for pain.

With this information, it is clear that the ideal therapy for pain caused by plantar fasciitis is TENS transcutaneous electrical nerve stimulation, thanks to its interaction with the nerve endings in the sole of the foot to mitigate the sensation of pain caused by the injury to the plantar fascia. And although there is a certain amount of muscle tissue in the plantar fascia area, the effect of TENS is the most recommended for pain in this area.

EMS is not an effective method for dealing with pain caused by plantar fasciitis, because its effect is more focused on the contraction of muscles and muscle groups, not on the interaction with nerves, so using EMS therapy with injuries such as plantar fasciitis may increase the sensation of pain.

Contraindications to the use of electrodes and electrotherapy