Pelvic floor dysfunction is so common, affecting millions of people worldwide and about 2 in 3 women throughout their life. And, it’s a condition that can often lead to problems like urinary incontinence (those leaks when you jump or sneeze) and reduced core stability.
One of the most effective non-invasive treatments available today is the BTL Emsella chair, which uses high-intensity focused electromagnetic (HIFEM) technology to stimulate and strengthen pelvic floor muscles.
When it comes to Emsella treatments there are two protocols—Protocol 1 and Protocol 2. So, let’s answer the big question – what’s the difference between Protocol 1 and Protocol 2 when it comes to Emsella?
Emsella Protocol 1: The Standard Approach
Emsella Protocol 1 is the initial and most commonly used protocol designed for general pelvic floor strengthening and the treatment of stress urinary incontinence (SUI) and mild-to-moderate urge incontinence. This is the protocol you’ll start your Core Restore Co journey with and I like to refer to it as the ‘barre class’ of pelvic floor strengthening. Why? Well, picture a barre class. You might have really light weights (think: 2 kilo dumbells or ankle weights) and at the start of a movement, you can catch yourself thinking ‘this is sssooo easy’. But, you’ll be completing many, many reps – so by the end of the movement, your arms are exhausted and fatigued. The light weights end up being super decieiving!
Key Features of Protocol 1:
Patient Suitability: Recommended for first-time patients seeking pelvic floor rehabilitation and initial incontinence management.
Session Structure: Typically involves six treatment sessions, conducted twice per week for three weeks.
Mechanism: Utilises a specific frequency and intensity to stimulate supramaximal contractions in the pelvic floor muscles, equivalent to approximately 11,000 Kegel contractions per session (BTL Aesthetics, 2021).
Outcomes: Enhances neuromuscular control, improves pelvic muscle tone, and reduces symptoms of incontinence within a short treatment duration.
Research shows that the 6 sessions of Emsella have a 95% patients success rate under Protocol 1 (Samoudi et al., 2022). This protocol is particularly beneficial for women postpartum and individuals experiencing pelvic floor weakness due to ageing or hormonal changes.
Emsella Protocol 2: A Targeted Approach for Advanced Cases
Protocol 2 is an alternative or follow-up protocol designed for more complex cases and in the Core clinics, it’s an option for patients who’ve completed 6 sessions of Protocol 1. Why? Well, Protocol 2 is like the weight-lifting equivalent – really heavy weights on the pelvic floor. And, you’d never give someone who hasn’t done a workout before a 100 kilo barbell, right? THe risk of injury is too high. So we need to strerngthen the particularly those involving urge incontinence, mixed incontinence, or cases where Protocol 1 has not provided sufficient improvement. Additionally, Protocol 2 offers notable benefits for sexual wellness, as pelvic floor strength plays a crucial role in sexual function for both men and women.
Key Features of Protocol 2:
Patient Suitability: Used for patients with moderate-to-severe urge incontinence or those who have plateaued after completing Protocol 1.
Session Structure: May involve a more customised frequency and intensity adjustment based on individual patient response.
Mechanism: Adjusts HIFEM settings to target deeper neuromuscular stimulation and bladder neuromodulation, which helps regulate bladder contractions and improve continence control.
Sexual Wellness Benefits: By strengthening the pelvic floor, Protocol 2 enhances blood flow, improves muscle responsiveness, and increases sensitivity. For women, this can lead to improved vaginal tightness and enhanced orgasmic function. For men, it can contribute to stronger erections and better ejaculatory control.
Outcomes: Further strengthens the pelvic floor, enhances bladder function, and provides relief for those who may not have achieved optimal results with Protocol 1.
A study published in the International Urogynecology Journal found that patients with urge incontinence and overactive bladder symptoms showed significant improvement with tailored Emsella protocols, including Protocol 2 (Alinsod, 2023). Additionally, research highlights the positive effects of pelvic floor strengthening on sexual satisfaction, increased arousal, and improved sexual confidence.
The Emsella chair has revolutionised pelvic floor rehabilitation by offering a non-invasive and highly effective treatment for urinary incontinence and core weakness. Protocol 1 serves as the foundational treatment, while Protocol 2 provides a more advanced and customised approach for individuals requiring deeper neuromuscular stimulation and enhanced sexual wellness. Understanding these protocols allows both patients and clinicians to maximise treatment benefits and improve pelvic health, sexual function, and overall quality of life.
References:
BTL Aesthetics. (2021). Emsella: A Breakthrough Treatment for Incontinence and Confidence. Retrieved from www.btlaesthetics.com
Samoudi, A., et al. (2022). Efficacy of High-Intensity Focused Electromagnetic Stimulation in Pelvic Floor Rehabilitation: A Clinical Study. Journal of Women’s Health & Physical Therapy.
Alinsod, R. (2023). The Role of Electromagnetic Stimulation in Managing Urge Incontinence: A Review of Clinical Outcomes. International Urogynecology Journal.
