Freedom from Urinary Incontinence

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Here we explain the rationale and techniques for using hi® massage to relax and improve the muscular tone of the pelvic floor muscles.  As a result of this, the goal is to potentially reduce certain kinds of stress-based urinary incontinence.  We suggest you talk with your healthcare provider about hi® and consider taking the hi® 30-day challenge.
*Please note that we are making no medical claims here.  This is an explanation of how the known benefits of certain types of massage can be applied to pelvic floor muscles.

Click on the topics below to go to that section of the page:

• Background for female urinary incontinence
• Reviewing female pelvic anatomy
• The rationale for helping urinary incontinence based on past research
• Overview of hi® techniques for pelvic massage
• How the three hi® massage positions work to strengthen your pelvic floor
• Position #1 –  hi®  is placed sideways on the lower abdomen, just above the pelvic bone.
• Position #2 – hi® is placed on the pelvis above and below the pelvic bone
• Position #3 – hi® is placed on the pelvis with the upper percussive head just below the pelvic bone (pubic symphysis) and the lower percussive head on the rectum.
• Product information
• Do not use hi® if…
• Contact Information

Please click here for protocols related to chronic urinary tract and bladder infection.

At some point in their lives, almost all women deal with urinary incontinence.  Many studies have indicated that 25% of younger women, 50% of older and middle-aged women, plus 75% of elderly women deal with this.

Unfortunately, many women are embarrassed to talk with their health care providers about it.

Stress-based urinary incontinence can have a devastating impact on women’s quality of life by limiting what they can do and requiring them to wear feminine pads.  The average woman in the USA with severe stress-based urinary incontinence spends up to $900 per year just on feminine pads alone.

Causes of female urinary incontinence

Female stress-based urinary incontinence is frequently caused by a weakening of the urethral sphincter muscles, atrophy of the pelvic floor muscles, and spasm or imbalanced muscle tension of the pelvic floor muscles.  It should be noted that there are other neurological and related causes for stress-based urinary incontinence.

That being said, our focus is on changes to the pelvic floor muscles, since this affects a significant number of women.

Spasm or weakening on one side of the Pelvic floor muscles can also cause the sides of the urethra to not align properly.  So even if the urethral sphincters are strong from practicing Kegel exercises, etc, they may not be able to close properly.  As a result, kegel exercises alone don’t always resolve urinary incontinence.

Childbirth increases the chances of urinary incontinence in women and increases with every natural childbirth.  Surgery or other traumas also affect the pelvic floor integrity resulting in urinary incontinence.

Hormonal changes, aging, and reduced physical activity can also cause atrophy of the pelvic floor muscles.

We also should note that we aren’t focusing on urge based urinary incontinence.  This is believed to be often due to chronic irritation of the bladder (possibly from urinary tract infections).  It can also stem from neurological challenges, diabetes, and other issues.

When our pelvic floor muscles become weak, or one side has a spasm, urinary incontinence, plus many other challenges can happen.

Our observation has been that these muscles respond well to the percussive stimulation from hi® massage – for both improving muscle tone, as well as helping reduce muscle spasm.

Our approach focuses on ways to help tone and restore the integrity of these critical, but overlooked muscles.

This specialized massage technique works through your clothing and pads and just takes a few minutes per day.

The hi® massage method for urinary incontinence

hi® massage applies the known benefits of percussive and vibratory massage specifically to the abdominal and pelvic floor muscles.

Before going into the details though we first want to share some information on the muscles we are targeting.

Reviewing female pelvic anatomy

Female stress-based urinary incontinence is frequently caused by a weakening of the urethral sphincter muscles, atrophy of the pelvic floor muscles, and spasm or imbalanced muscle tension of the pelvic floor muscles.

hi® directly stimulates the pelvic floor and abdominal muscles through clothing.  If needed a light feminine pad may also be worn.

The rationale for helping urinary incontinence based on past research

The Health benefits of percussive and vibratory massage have been well documented.  This includes relieving muscle spasm, increasing flexibility, improving blood and lymphatic flow, releasing tissue adhesions, and pain management.  As well as supporting muscular growth via inducing rapid myotatic reflex contractions that result from the percussive stimulation.

In situations caused by changes in pelvic floor muscles, stress-based urinary incontinence appears to benefit from percussive massage.

In 2007 one study found this approach helped stress-based urinary incontinence:

Transcutaneous mechanical nerve stimulation using perineal vibration: a novel method for the treatment of female stress urinary incontinence.   https://www.ncbi.nlm.nih.gov/pubmed/17869299

The results quoted from the above study were:  “At 6 weeks the cure rate (no incontinence episodes) was 73%, with durability through 3 months with 67% still reporting persistent resolution.”

This study used a device that transferred a small amplitude percussive stimulation to the perineal region.  A graphic of an equivalent product is below.

Above is a representation of the alignment of the device used in the study shown by a cross-section of a woman’s pelvis (the original product was the Ferticare, but an analogous product Valdivia is shown here).

This study took the “Ferticare” percussive stimulation tool and had women apply it to their perineum once a day for a few minutes.  After 6 weeks, 73% of the women reported no incontinence episodes.  They followed up 3 months later after the volunteers had stopped the daily therapy and 67% still reported no incontinence.

You can learn more about the Ferticare 2, and Valdivia here from Orion Medical / Family Fertility Healthcare, Inc.  They also distribute hi®

Overview of hi® techniques for pelvic massage

Our approach builds on the success of a percussive technique reported in 2007 technique in the above-mentioned paper.  Like the original technique, we stimulate the perineum. However, we also stimulate the lower abdominal muscles and a much wider aspect of the pelvic floor muscles.  The percussive stimulation is significantly higher amplitude and more powerful.  We also apply vibratory stimulation to different areas as well as combining percussive and vibratory massage at different frequencies.

The intention is to improve pelvic muscle tone, reduce spasm, increase flexibility, improve blood and lymphatic flow, while potentially releasing tissue adhesions.  The goal is that these combined benefits will help reduce or eliminate urinary incontinence in women.*

This approach may also be helpful for a variety of situations where challenges are caused by pelvic floor muscle spasm or atrophy.*

hi® pelvic massage includes the following 3 techniques:

• Lower abdominal massage
• Upper pelvic massage
• Middle pelvic massage

Each technique is performed approximately 3-5 minutes.  We recommend not holding the hi® unit for more than 3 minutes on a specific location, so if the technique is held longer than 3 minutes the unit should be moved slightly. The techniques should be done daily if possible.  Fortunately, most women find the procedure pleasant and look forward to doing it.  This makes doing the techniques long term more likely.

Our observations have been that women typically begin feeling positive changes in their pelvic floor within a week.  By 4 weeks many have reported significant positive changes.*

These protocols are for improving general pelvic floor wellness with percussive massage.  The hope is that as overall wellness improves urinary incontinence might be reduced.  Please note, we are not making any medical claims about urinary incontinence treatment or cure.

How the three hi® massage positions work to strengthen your pelvic floor

Position #1 –  hi®  is placed sideways on the lower abdomen, just above the pelvic bone.

Applies percussive stimulation into the lower abdomen compressing the bladder several thousand times per minute.  This rapid compression generates rapid pressure waves of urine in the bladder.  This action appears to cause the urethral sphincters to adapt and strengthen by spontaneously contracting in response to intermittent pressure.

It also can help relax potential spasms of the abdominal muscles.  Spasm in the abdominal or internal muscles in this area can potentially cause challenges in the pelvic floor muscles, so it’s a good way to relax the whole region.

After multiple uses, this appears to simultaneously relax and tone the tissue.   Over time this appears to strengthen the sphincter and reduce urine leakage.

A video demonstrating the lower abdominal massage method is here

Position #2 – hi® is placed on the pelvis above and below the pelvic bone (pubic symphysis) without the lower blue vibrational guide turned on.

The upper percussive head applies percussive stimulation above the pubic symphysis (pelvic bone), resulting in a compression wave traveling into the lower abdomen.

Simultaneously the lower percussive head applies percussive stimulation below the pubic symphysis, sending a compression wave into the mons pubis.  This compression wave travels directly through the area of the urethra and urethral sphincter.  This appears to both induce rapid myotatic reflex contractions in the pelvic muscles as well as stimulate general circulation.

This stimulation appears to travel more than 6 cm, further on certain tendons/fascia.

A video demonstrating the upper pelvic massage is here

Optionally the lower blue vibrational guide can be turned on.  This appears to strongly stimulate the puborectalis and iliococcygeus muscles, while simultaneously triggering the bulbocavernosus reflex.

Position #3 – hi® is placed on the pelvis with the upper percussive head just below the pelvic bone (pubic symphysis) and the lower percussive head on the rectum.

The upper percussive head applies percussive stimulation just below the pubic symphysis (pelvic bone), resulting in a compression wave traveling into mons pubis region.

This appears to strongly stimulate puborectalis, pubococcygeus, and iliococcygeus muscles, while also triggering the bulbocavernosus reflex.

A video demonstrating the middle pelvic massage is here

This transfers percussive stimulation into the vulva.  The urethra and vaginal canal are directly stimulated by this rapid compression, but at a more direct angle than the upper pelvic massage technique.  This also appears to improve circulation, and over time tissue integrity in the entire region.

This transfers percussive stimulation into the vulva.  The urethra and vaginal canal are directly stimulated by this rapid compression, but at a more direct angle than the upper pelvic massage technique.  This also appears to improve circulation, and over time tissue integrity in the entire region.

The lower vibrating guide is bent outward and behind the coccyx and is optional.

The combination of the 2 percussive and vibrational sources stimulates the majority of the pelvic floor.

Please note that the legs don’t have to be lifted, this was to help demonstrate the position

This transfers percussive stimulation into the vulva.  The urethra and vaginal canal are directly stimulated by this rapid compression, but at a more direct angle than the upper pelvic massage technique.  This also appears to improve circulation, and over time tissue integrity in the entire region.

This position strongly stimulates all the pelvic floor muscles – through clothing.  An alternative placement on each side appears to directly stimulate the sacral plexus (on each side).  Regular stimulation here (based on observations) appears to improve the overall pelvic health and response.

Please reference the pelvic floor muscles diagram below for reference to the muscles stimulated.

Product information:

The hi® massage system is sold as a retail, consumer product.  It can be used for female pelvic and abdominal massage fully clothed, as well as full body massage.

It utilizes a unique design optimized for pelvic applications and combines both high amplitude percussion frequencies ranging from 4hz to 35hz – which vibration ranging from 40hz to 140hz.  These aspects can be independently controlled to create unique therapeutic waveform patterns.  The device and methods are patented in the United States,Canada and Australia.  We have also received notice of acceptance of patents in the European Union.  Additional patents are being filed.

The device is powered by low voltage 24V DC (<1.5A) via a power supply.  It will run on both US 110V and EU/Asian 220V power sources.

Since it is technically low voltage DC power, and UL/CE/FCC approved, our current experience has been it much easier for approval by human use committees.

The motor in the unit is unique that it has more power than most AC powered professional massage systems, and it provides higher amplitude waveform generation.

The additional percussive head covers can change the nature and intensity of the percussive stimulation by spreading it over a wider area, or changing the angle of contact.

Below are photos of the hi® massage system, carrying case, power supply and US/EU power cables, plus additional percussive headcovers.

(I) Vibrating guide, (J) Lower percussive head, (K) Upper percussive head, (L) Handle, (M) DC power locking connector

(F) Power button (you must hold 4 seconds to start/stop, (G) Percussive head speed control, (H) Vibrating guide speed control

Carrying Bag

Compartment for additional percussive headcovers.  These can be used to modify the intensity and way the percussion is transferred to the tissue.  The oval version also can be used for the penis.

Interior of bag, plus inner compartment holding power supply and US (110V) and EU / Asian (220V) power cables.

Please note that the bag is padded on the sides as well in a manner similar to a laptop bag.

(A) Power supply unit, (B) DC power line with locking connector, (C) USA (110V) style power cable, (D) EU / Asian (220V) style power cable

Please note that we have SGS, UL, CE and FCC certification.  We are not yet registered with the Australian certificates.  However, the Australian requirements are very similar to the CE and related certifications that have already been approved.

(N) Cylindrical percussive head covers – transfer kinetic energy over a wider area  (O) Oval sloped head covers – used for lower vibe guide to change the angle of kinetic energy transfer for the woman on the mons pubis, or for male use on the lower percussive head for stimulating the penis.

Do not use hi® if…

• You are pregnant or think you might be pregnant
• Have endometriosis, mesh implants, or other conditions were vigorous pelvic massage might not be helpful
• Have high blood pressure
• Are wearing any genital piercings (remove them first)
• Have any tumors, open wounds or bruised areas
• Are not in good enough physical health for vigorous massage
• Have had surgery in the past 6 months, or longer depending on your condition – check with your healthcare provider
• You have any type of deep vein thrombosis, artificial joints, or related situations where you should avoid vigorous stimulation
• Have any type of pelvic mesh or implant surgery that should not have vigorous stimulation
• Have any condition or concern you think you should discuss with your health care provider first – particularly for receiving a very intense massage.
• Please refer to our user manual for additional areas to consider.

Contact information

If you would like to discuss applications for hi® in research or related studies, please contact:

Steve McGough at 910-707-3774   or paul.stephen.mcgough@gmail.com

*Please note that hi® has not been evaluated by the Food and Drug Administration. No medical claims are being made. The hi® product, and or any statements made by this site as well as any associated video, audio, or written content therein, are not intended to diagnose, prevent, treat, or cure any disease.  hi® and its related training programs are not intended as medical advice, or to replace the guidance from a qualified health care professional. This site and all associated content, and products are intended to help share knowledge about wellness and relaxation approaches. Visitors and customers with any medical or health-related concerns are encouraged to contact a qualified health care professional.