EmSella Chair
Hi, Bestie and welcome home! I’m so excited that Autumn is upon us, as it is the perfect time of year to cozy up on the couch with a piping cup of coffee/tea/other bladder irritants and have a chat! I’ve got my latte in hand and am ready to go! Today, we’re talking about the Emsella Chair–what it is, what it (claims it) does, and what it means for pelvic health. Let’s jump in.
What is the Emsella Chair?
According to their own website, the Emsella chair is a “pelvic floor physiotherapy treatment that greatly improves the quality of life for those with serious urinary incontinence” (1). It claims to help improve urinary incontinence and sexual satisfaction (1). The Emsella chair is meant for both men and women with urinary incontinence and symptoms should improve over the course of six 30-minute sessions. During each session, the client sits in the chair while it vibrates and generates thousands of supramaximal pelvic floor muscle contractions–in fact, Emsella claims that each session is equivalent to performing 11,000 pelvic floor exercises (1). Sessions can occur up to twice a week, so all six sessions will be complete within a three week span.
Benefits include repairing, “tightening,” and strengthening the pelvic floor with no recovery time and no pain (1). It sounds almost too good to be true.
One of the downsides of the Emsella chair is the cost. It can cost upwards of $3,000 USD for a course of six sessions and improvements may only last for a year. This could mean having to complete extra sessions yearly and doling out extra money to maintain the effects.
What does the research say?
There are quite a few research articles that have been published looking at the effects of Emsella chair pelvic floor treatment. The two articles I’m talking about today looked specifically at postpartum/parous women. This means the women studied have a history of giving birth.
Both of the articles studied the effects of the Emsella chair versus electrical stimulation (e-stim). I thought this was a bit of a strange comparison given that e-stim has not been shown to be super effective for improving pelvic floor strength. In fact, e-stim is really only effective in folks with incredibly weak pelvic floor muscles (PFMs), such as those with only ⅕ strength. Most people are stronger than this and therefore will not see a benefit from e-stim. The Emsella studies showed the Emsella chair to be more effective at improving pelvic floor muscle activity than e-stim (2, 3). Again, given that e-stim isn’t super effective, this isn’t saying much. One of the studies even said that the Emsella chair was “better than e-stim in the short term”, which is essentially saying very little about how well it actually works (2).
Further, the studies demonstrated that Emsella was able to improve pelvic floor muscle activity (2, 3). My issue with this is that pelvic floor muscle activity is not an indicator of strength and has very little to do with whether a pelvic floor is functional.
In all, the research I came across left me unimpressed. While I can see the draw of a tool that helps improve continence in the short term, I think there are better options available.
What are my thoughts?
I have a lot to say on this topic (what’s new?). First, for those who’ve experienced success with the Emsella chair, that’s awesome! I’m all about doing what works for you. Also, I love to see more and more companies getting involved in the women’s health space! However, I am a little bit wary when it starts to feel like companies are only joining the women’s health space to turn a profit. I’m definitely not saying that’s what’s happening here, but I make sure to keep that in the back of my mind.
In terms of the actual treatment, here are my thoughts: I can understand the draw of this treatment in the short-term, but worry that there is limited data to back up its potential to help in the long-term.
The claim that a single session in the chair is the equivalent of doing more than 10,000 kegels is a little absurd. I certainly don’t doubt that number, but I do doubt the actual, clinical need for that number of pelvic floor muscle contractions. I’m not sure I believe it to be necessary to complete tens of thousands of kegels in order to improve pelvic floor strength and function.
Even more notable, pelvic floor activity and strength are not the only things that matter. While the Emsella chair might help improve strength and activity of the pelvic floor, neither of those components of pelvic floor health actually matter if your pelvic floor doesn’t know when to contract/relax. Continence is not just a matter of pelvic floor strength, but the ability of the pelvic floor to contract at the right time and in the correct way. What’s so special about pelvic floor physical therapy is that your therapist works with you on training FUNCTIONAL pelvic floor strength, not just strength on its own.
Finally, research consistently shows that active involvement in your plan of care is what leads to best outcomes. Treatment where you just sit in one place for 30 minutes on six different occasions can never match being actively involved in the way your muscles work. It’s similar to learning any kind of new material. For most folks, just listening to a lecture won’t allow them to learn or retain enough information to do well on an exam. Actively writing notes by hand has been shown to help with retention and learning.
Final takeaways:
As I’ve mentioned, I can see the draw of the Emsella chair. It offers a quick solution to a problem that affects so many and can be incredibly embarrassing and limiting. However, I think there are better and cheaper alternatives. Use of a pessary or a poise impressa tampon can result in an immediate improvement to urinary incontinence, while working with a pelvic floor physical therapist can help you to develop the tools to improve your symptoms now and for the long-run.
If you’ve tried the Emsella chair and it worked for you–good for you! I would love to hear about your experience. If you want to know more about the alternatives to the Emsella chair, stick around.
Let’s talk soon.
XOXO,
Your Pelvic Bestie
References:
https://btlaesthetics.com/en/for-providers/emsella-providers
Silantyeva E, Zarkovic D, Astafeva E, Soldatskaia R, Orazov M, Belkovskaya M, Kurtser M; Academician of the Russian Academy of Sciences. A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data. Female Pelvic Med Reconstr Surg. 2021 Apr 1;27(4):269-273. doi: 10.1097/SPV.0000000000000807. PMID: 31860567; PMCID: PMC8016513.
Elena S, Dragana Z, Ramina S, Evgeniia A, Orazov M. Electromyographic Evaluation of the Pelvic Muscles Activity After High-Intensity Focused Electromagnetic Procedure and Electrical Stimulation in Women With Pelvic Floor Dysfunction. Sex Med. 2020 Jun;8(2):282-289. doi: 10.1016/j.esxm.2020.01.004. Epub 2020 Mar 4. PMID: 32146133; PMCID: PMC7261686.
*The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a qualified health provider regarding any questions you may have about a medical condition or health objectives
