Rehabilitation
EMS can play a role in the rehab of a variety of injuries and is used extensively in clinics to treat the VMO with knee cases. But its value in the rehab of hamstring injuries is poorly understood and under appreciated.
The selection of isokinetic machines over EMS contributes to a lengthening of injury downtime as the fluid resistance on which these machines rely hits the muscle all at once, causing muscle shortening and irritation. Often, effective treatment including EMS can have the athlete back in action within ten days.
Injury Assessment
Immediately after the injury, with the leg in its normal straight position, run your hand along the hamstring to feel for a depression in the muscle to determine if there’s been actual fiber separation (a third degree tear). In all but severe cases this won’t have happened, meaning it’s a first or second degree strain where a quick recovery can be expected.
This must be checked before swelling sets in and fills up any depression and afterwards the muscle should be wrapped, iced, and elevated in the usual fashion. Do not test or stretch the muscle, as further damage could occur and, regardless of the findings, the initial treatment remains the same. Surprisingly, it usually takes only 72 hours for the injury to heal, but extension injuries can occur above and below the original site and adhesions can form if the tissue isn’t mobilized sufficiently.
During the initial 72 hours, the athlete should stay off his feet as much as possible and an EMS pulsing mode can be applied above (not on) the injury site three to four times per day to reduce swelling and promote the transfer of nutrients to the site. After 72 hours, very gentle EMS pulsing can be applied to the injury site once per day while retaining the pulsing routine four times per day above the site.
From the third day on, high intensity EMS can be applied to all other muscles to maintain fitness during the recovery period. Additional therapy should include Active Release Technique (ART) if possible, to further reduce the prospect of adhesions.
Bodybuilding Applications
Most of what I’ve covered has dealt with non-strength athletes and rehab settings, but what about bodybuilding? Yes, EMS does have its cosmetic uses. Much like high intensity weight training, EMS increases muscular density or “hardness”. Think of Ben Johnson. If you slapped him on the back you’d think you were hitting a brick wall. Although he had a great physique, he wasn’t “puffy” like Arnold; he was as hard as a rock. So the thing to think about with EMS is density, not size. Think of it as maximal strength training and not hypertrophy training.
Also keep in mind that EMS is for large muscle groups only. Although an expert might be able to pull it off, the average user will not be able to use it on small muscle groups like the biceps, triceps and calves. These muscles will “roll up” on you, plus even if you could do it (like by placing your foot in a ski boot for calves) it would be excruciating.
Bodybuilders could also use EMS to help them break through a barrier. For example, if a guy’s upper body is weak as compared to his legs, he could use EMS to maintain his legs for a few weeks while focusing on upper body training. Basically, he’d be allowing all his body’s recovery mechanisms and central nervous system to focus on his upper body. He wouldn’t lose any size in his legs and may even see some improvement in density during this time of upper body specialization.
Here’s another trick that may help competitive bodybuilders. EMS can be used to temporarily “burn off” a layer of fat in small areas. What happens is that about two millimeters of subcutaneous fat is mobilized in the area directly under the pads. You can compare this to the effect seen when shooting growth hormone, i.e., there’s local mobilization of the fat at the point of injection.
Now, since that layer of fat is a protective mechanism, this isn’t permanent. In fact, the effect doesn’t last long at all. Once the area under the pad starts to cool, the fat starts storing again. So if you’re already very lean and are competing in a bodybuilding show, you’d have to use the machine (possibly even backstage) and then cover up and keep warm until you hit the stage.
Selecting a Machine
Are the machines in the muscle magazine ads powerful enough? Most are. This is because they’re designed for fat, non-athletes. It takes power to get through all that fat, after all. For an athlete who has a lot of white fiber (which conducts better) and very little fat, most machines are fine in terms of power. The machines we used with athletes were converted Slender Tone machines that were originally designed for fat women!
When looking for a machine there are a few things to keep in mind. First, I’ve seen good ones for as little as $280 as well as over a thousand. Some of them only allow you to use two seconds on/two seconds off pulses and rest periods. You don’t want that (although that’s fine for abs since abs should be trained as endurance fibers for ten to fifteen minutes at a time). Instead, look for a machine that allows you to control the rest periods. You’ll want to be able to get ten second contractions with fifty second rest periods.
The price may also affect the comfort level of the machine, though this isn’t always the case. More expensive machines may be more comfortable to use. A machine with higher hertz is usually more comfortable and better for sprinters, but the battery life will be very short. A low hertz machine has better battery life. Lastly, look for quality in the leads and pads.
Conclusion
No, EMS will not give you Arnold’s biceps while sitting on the couch, but as you can see, it does have many uses in athletics, rehabilitation, and even for bodybuilding. Just remember, crank it up!
Very interesting article, because it goes through so many concepts. Thank you for posting it. Can you reference the publishing date or when it was actually written by Charlie?
Exactly a few hours after I decide to start using it again =)) Thank youuu.
“The soles of the feet can even be treated in cases of insufficient foot strength.”
Ange,
Do you recall any situations where athlete’s had pronated foot/feet? Maybe others can comment as well, I have heard the foot could re-align with strength work (whatever that may be, EMS???).
Just tonight, I had a conversation with T-Slow about EMS for strength. Being in groups and only one unit with often limited time, it’s been difficult to apply. In one athlete I found a 2 week block of 6 sessions lead to a nice improvement in speed. I have an athlete I’ll be training one-on-one for a while and will be using the strength protocol on him with my Compex.
Re-reading this article gave me a bunch of new “nuggets”. Since T-Slow reported back on his Waldemar sessions, where stim is used pre-massage to help loosen things up, I have began using it pre-massage as well. Charlie’s point about the legs being elevated is something I will try.
It’s amazing to me that athletes who go through rehab and have stim are given it at levels that are comfortable. I had one girl who needed extra work for her quads. After one stim session, she said she wouldn’t train again if she had to the that “stem thingy” again. Yet she had done it many times in therapy, of course, not to the same intensity.
Thanks for re-posting this gem! I know how you feel, but I miss having Charlie around…
Recent studies* have shown that to be effective the intensity level in an EMS protocol has to evoke a force at least 50% that caused by voluntary contraction. So I believe this is one of reasons (if not the “main” one) why many practitioners and scientific studies failed to get results.
With regard to the pain thing, I believe that pain is a thing of the past for EMS, i.e. old EMS technology: Russian wave forms, machines with inadequate chronaxie (i.e. wave form duration), machines with sluggish inadequate electronic components that do not give a clear-cut square wave form. I believe Charlie wrote the article a dozen years ago. I know that after trying the units I import, he didn’t mention biting a piece of leather anymore (I think Ange can testify to it since she still uses that machine).
Also increasing pad surface can make pain go away (I personally tried doubling the number of pads with wire splitters and I can assure you it works). This become obvious if one tries to picture how electric current flows from the skin through the muscle. If one widens enough the pad area, current intensity per unit of surface (milli-Amperes per square centimeters), will be low, and will not be able to trigger the pain, pressure and heat receptors that are present at the surface of the skin. However, no matter how wide the pad area will be, as the current’s path bends to go through the muscle it will concentrate again, and will be able again to trigger motor neurons.
One thing the article by Charlie does not mention (unless I missed it), but which is fairly important, is the time saving consideration. Quoting from the same journal article*:
this training modality is less time consuming than voluntary resistance training protocols (i.e., 15–20 vs. 30–60 min) so that NMES appears as a method of choice when the time available for strengthening program is limited.
Note*:
Gondin J, Cozzone PJ, Bendahan D. Is high-frequency neuromuscular electrical stimulation a suitable tool for muscle performance improvement in both healthy humans and athletes? European Journal of Applied Physiology. 2011. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21909714.
Charlie wrote this for a magazine ( I think it was T Mag) in the early 1990.
Mike ( foot dr. Mike) told me most people, including athletes pronate. It’s very common according to him.
Strengthening is always a good idea but again always be careful on how you " fix" something that is " wrong". ( says who?).
I had a lot of issues with my feet after I had my son. The chemicals released when a woman gets pregnant effect the muscle tone in the feet and loosen the tendons in the feet as well as every where else. This is why many woman go up in shoe size post child.
Stim can be used on the feet but likely it makes a lot more sense to deal with the calves and or the other areas that can get stronger to allow the foot time to build up over time.
Derek and Giovanni have come up with a protocol for speed work using a stim. ( SpeedCoach is the name of this custom unit they came up with).
Perhaps one or both of them might talk about how a stim specializing in a speed protocol might work.
Can I have much infos about this kind of stim (speedcoach)???
Thank you Ange…
I have found this site about SpeedCoach if you interested http://speedendurance.com/store/speedcoach-electrical-muscle-stimulation/
Number Two (aka Derek) and I developed the new programs. The impetus came from Number Two who believes that there are many things lacking in the stim units currently available, particularly for application to high performance sports. He and I reviewed the literature of the last couple of years on EMS research. We poured through many articles, several coming from the ISEK 2010, The XVIII Congress of the International Society of Electrophysiology and Kinesiology, which had a section dedicated to: Electrical stimulation for testing and training in exercise and sports. This knowledge was bootstrapped to the library of close to 1000 programs that Globus has built in its machines in the course of several years.
Number Two has an interesting review of a very recent article:
Girold S, Jalab C, Bernard O, et al. Dry-land strength training vs. electrical stimulation in sprint swimming performance. J Strength Cond Res. 2012;26(2):497–505.
This article seems to confirm the direction we have undertaken. In his words:
Based on my experience, EMS works effectively at improving strength and enhancing recovery.
It just occurred to me that Charlie’s article is mostly about force building, but this thread is in the Recovery and regeneration section. This is probably the most common misconception about EMS: it is commonly thought of a rehab tool, that few people use for strength. It should instead be the other way around: it is a strength tool that some can also use for rehab.
A very vital Fact that every Coach and P.T. that trains females should know - but few do.
It’s at it’s highest levels for 2 or so months, and trace amounts for up to 2yrs later!
Naturally it’s at its peak level during actual Birth
The back of the " Charlie Francis Training System" is an entire chapter Charlie wrote via the interview he had with Paul Patterson for the Coaching Association of Canada Project pre 1988. Charlie never was interested in this manual which was something he never had time to do but decided differently post 1988 of September.
In the manual Charlie discusses the use of EMS in sport, Immediate Post Injury Applications of EMS, Why EMS - Training of Speed is interesting ( ie = ems preferentially contracts white fibre before red …, which is opposite the natural recruitment order of the body…, Charlie goes on to talk about EMS in training Hamstrings/ Ankle and Abdominal Strength and discusses Planning and Periodization of EMS into a Modern Training Program.
Anyone wanting to use EMS for feet might also be interested in this section as he talks about stepping on the pads while in use as to prevent cramping.
This actually has been disproved by recent research, which suggests that EMS recruitment is not selective. However, the fact remains that EMS recruitment of muscle fibers is different than voluntary-training, muscle-fiber recruitment. Therefore this difference can be harnessed for particular training goals.
Is it possible for you to let us know which study / studies suggested that EMS fibre recruitment is not selective?
I gave a few quotations 3 years ago in this forum at the thread [b][u]EMS Theory[/u][/b].
Since then, the following paper summarizes the situation, and I will quote from it a passage that is relevant for this forum:
Maffiuletti* NA. [b][u]Physiological and methodological considerations for the use of neuromuscular electrical stimulation.[/u][/b] Eur. J. Appl. Physiol. 2010;110(2):223–234.
In an excellent review paper, Gregory and Bickel (2005) suggested that motor unit recruitment during NMES is nonselective or random (see also Jubeau et al. 2007); that is motor units are activated without obvious sequencing related to unit types (i.e., ‘‘disorderly’’ recruitment). This implies that NMES can activate some fast motor units, in addition to slow units, even at relatively low force levels. Indirect evidence suggests that the relative proportion of fast and slow motor units in a muscle activated by NMES at different force levels would be quite constant, as twitch contractile speeds were not found to differ between NMES training intensities of 20, 40 and 80% of MVC (Binder-Macleod et al. 1995). Such peculiarity of NMES recruitment inevitably entails some disadvantages (e.g., onset and extent of muscle fatigue, see below) but also several advantages, particularly for impaired muscles. For example, elderly individuals and patients presenting a selective atrophy of type II muscle fibers (e.g., chronic obstructive pulmonary disease, chronic steroid myopathy) (Gosker et al. 2002; Kanda et al. 2001), or orthopedic patients who cannot perform high-intensity voluntary contractions because of injury, recent surgery or impaired activation (Petterson and Snyder-Mackler 2006; Stevens et al. 2004), and also athletes requiring high levels of muscle strength and power (Babault et al. 2007; Delitto et al. 1989; Malatesta et al. 2003), would benefit from the use of NMES exercise—even at low intensity—to (re)train at least some of the fast fibers that otherwise can only be activated using high-force voluntary efforts. The main consequence of such a unique motor unit recruitment pattern for NMES is the exaggerated metabolic cost of an electrically evoked contraction (Vanderthommen et al. 2003), which, compared to a voluntary action of the same intensity, provokes greater and earlier muscle fatigue (Deley et al. 2006; Jubeau et al. 2008; Theurel et al. 2007). According to Vanderthommen and Duchateau (2007), these differences, in motor unit recruitment and thus in metabolic demand between NMES and voluntary contractions, constitute an argument in favor of the non-concomitant combination of these two techniques in the context of muscle (re)training. Differences in spatial recruitment between these two activation modalities, would also contribute, at least in part, to the significant muscle damage produced by NMES but not by voluntary isometric contractions of the same intensity (Jubeau et al. 2008).
Note*:
I consider Maffiuletti the author of the article one of the most knowledgeable scientists in the field of EMS for sport. You can see for yourself how often his name appears in the [b][u]bibliography I keep in my web site[/u][/b].
Thank you for the article reference. Perhaps you can confirm that my understanding is correct, hopefully I am not way off here.
Even if fast and slow twitch fibres are recruited equally when using EMS, it’s still useful because voluntary contraction of muscle preferentially recruits slow twitch fibre, while EMS recruits equally and thus probably more fast twitch fibre than can be done voluntarily. (If you can contract more fibre with EMS overall, then you are very likely contracting more white fibre overall) Thus in the end, even if you are not preferentially contracting white fibre, you are still contracting more white fibre simply because you are able to contract more fibre overall.
Is that correct or am I not understanding?
T-Slow, I think you are basically correct. But remember that happens only in the fibers that fire (i.e. that are triggered by the EMS). So you have go high enough with current intensity.
In addition you cause more muscle fatigue in those fibers, than you would with voluntary efforts. Finally, EMS done for a sufficient number of weeks would convert some fibers I and IIx fibers into IIa fibers (also shown by research published by Maffiuletti).
Thank You…