Emsella for Stress Incontinence in Cambridge, MA

Stress incontinence is a failure of the urethral closure mechanism, specifically, a failure of the pelvic floor muscles to generate rapid, reflexive contractions strong enough to clamp the urethra shut when intra-abdominal pressure spikes (during a cough, sneeze, jump, or heavy lift). Effective urethral closure requires both types of skeletal muscle fibers: fast-twitch (Type II) fibers that generate the rapid, powerful contractions needed for immediate closure, and slow-twitch (Type I) fibers that maintain sustained baseline tone to keep the urethra sealed at rest. In stress incontinence, both fiber types have typically degraded, fast-twitch fibers have atrophied from disuse, and slow-twitch fibers have lost their tonic contractile capacity. Emsella's HIFEM protocol addresses both fiber populations through varied contraction patterns. The treatment cycle alternates between high-frequency bursts (which preferentially recruit and strengthen fast-twitch fibers) and sustained contractions (which target slow-twitch endurance fibers). This dual-pattern stimulation mirrors the physiological demands of actual urethral closure: you need fast-twitch fibers to slam the urethra shut in the milliseconds before a cough generates peak abdominal pressure, and you need slow-twitch fibers to maintain resting closure between events. Over six sessions, the supramaximal contractions force both fiber populations through progressive overload, the same stimulus that drives muscle adaptation in strength training, but at an intensity and comprehensiveness impossible to achieve through voluntary kegel exercises. The result is a pelvic floor that can generate faster, stronger reflex closure responses while maintaining higher baseline tone, addressing the two biomechanical failures that define stress incontinence.

Real Strength. Real Performance.

The muscle HIFEM builds is functional. Patients report stronger lifts, better endurance, and improved athletic performance.