I bet you have never wondered what your leg has to do with your bladder … ? It might surprise you to learn that these seemingly unrelated body parts are more connected than you think!
Overactive bladder (OAB) is a condition marked by symptoms like a sudden urge to urinate, frequent trips to the bathroom, waking up at night to pee (nocturia), and sometimes incontinence. The first step to manage these symptoms is through lifestyle changes and behavioural strategies, which can include pelvic floor exercises, delaying the urge to urinate, following a bathroom schedule, managing fluid intake, and tackling constipation.
But what if these strategies aren’t enough? That's where additional treatments come in, like Transcutaneous Tibial Nerve Stimulation (TTNS). TTNS is a non-invasive treatment that uses the tibial nerve in your leg to help manage bladder symptoms. This might sound strange at first, but there's a good reason for it!
The tibial nerve shares a similar spinal origin with the nerves that innervate the bladder and pelvic floor. During TTNS treatment, adhesive electrodes are placed on the lower leg for 20-30 minute sessions. The black/negative electrode is positioned 3 cm behind the inner ankle bone, and the red/positive electrode is placed 10 cm above it.
Before starting TTNS, your physiotherapist will ensure you don’t have any contraindications:
Pregnancy
A cardiac pacemaker
Epilepsy
Metal implants in the ankle
Open wounds in the ankle
Here’s a quick setup guide for your TTNS machine:
Before starting, ensure the machine's dial is turned off.
Set the mode to Normal (N) and the sub-mode to Modulated (M). The timer should be set to 30 minutes unless otherwise directed by your therapist.
Adjust the pulse width and pulse rate as instructed by your physiotherapist.
Attach the electrodes (black/negative and red/positive) to your leg as outlined above. Your therapist will advise whether to alternate legs or stick with the same one.
Position your leg comfortably.
When ready, turn the dial to the desired intensity. The sensation should be comfortable; if it’s too intense or causes your toes to curl, decrease the intensity slightly.
Once the session is complete, the machine will turn off automatically. Be sure to turn the intensity dial back to zero before removing the electrodes and placing them back onto their plastic sheets
Research supports the effectiveness of TTNS in reducing the severity of urgency incontinence, decreasing the frequency of voiding, reducing incontinence episodes, nocturia, the number of pads used, and improving overall symptom severity and quality of life.
At Female Focus Physiotherapy, we offer TTNS as a tailored treatment option based on individual symptoms and medical history. We also have TTNS machines available for purchase and hire.
By Liana McMorrow
Comments