EMS/TENS vs Ultrasound

I have a horrendous knot in my back. I went to physical therapy where I had ART and massage done with no improvement. Then the therapist started using TENS and Ultrasound on the spot and it seemed to really help to break up the knot. I can’t afford the $600 it would cost to go back to therapy (my insurance sucks), but I have a cool doctor who would write me a script for a EMS/TENS or Ultrasound so I could buy one and fix the issue myself ($100 vs $600 and time out of work). So my question is this, would it be better to get a portable ultrasound unit or a portable combo EMS/TENS unit?

It’s my understanding that TENS only shut down pain by inhibiting neural pain transmission and in no way release muscle knot or trigger points…

I just found that online somewhere else. Thanks for the post. It must have been the ultrasound that was loosening it up then. I just don’t understand why self massage isnt working at all. I have been working with a foam roller and a baseball and it just will not loosen up. Is there anything else I can do?

Can you tell me which muscle in the back?

Also I have found that foam roller may help for “flushing” massage but not that much for trigger points since the pressure is not enough hard to cause a release. (just my experience, some say mid pressure can cause a release, but it take a longer hold. I have not much time to loose so, you already know my opinion).

The pressure must be kept until the pain decrease or even stop. If you don’t go until that point, you won’t have any release. With a good pressure, It usually take less than 20-30s.

Be carefull no to further injure yourself in the process. If there is any inflammation avoid trigger point therapy.

Im not sure what TENS unit you guys use - Mine works a treat in reducing mucsle tension. On Monday i used it on One client who had a bad back that foam rolling, massage etc just wasnt working with, so on Monday i used my Tens Over his Rhomboids and Spinal erectors- Worked a treat, not only pain gone, but also the tension, the muscle softened right up. He came for some training on Wed and Thursday, No issues with back whatsoever.

Another guy came in Last fri - showed him how to Foam roll his back, It worked somewhat, but he was just THAT tight that it hurt too much and took too long. So Thursday, i used the TENS on his back, before i started his spinal erectors were like Steel rods in his back, his rhomboids were like golf balls. After the TENS, they were like Jelly, massaged well and you could then pick up the Adhesions easy.

TENS works - perhaps just don’t use them cheap versions?

This may be too obvious a point, but where you apply pressure is of utmost importance. I have had good results with applying light pressure to the non-hurting area and slowly easing along the muscle to the area of tightness/pain. And the right amount must be applied – too little and not much will happen, too much and you bruise more tissue. This can largely be determined by how the muscle feels.

Yes, use Charlie’s advice of working everything else first and then working around the area and then on it. Many times the area loosens up before you need to dig in. Also, if you went too deep too soon and/or too long, it may become irritated and inflammed. Would also try the heat rub and plastic bag wraps found in the injury clinic threads I believe.

Yes, I think It may happend…just not sure If It is really a structural release (soft tissues scars & triggers) or just cause a neural release.

Which RATE and WIDTH signal do you use in such cases? I used 100-70 at an intensity of 10-30 without any visible contraction for 10min. Yes the pain was reduced, but why exactly? They say shut down of the neural pain. I would be more that pleased myself to learn that It can do more.

I would also be interested in what Rate and Width to use. I read the EMS theory thread, but the recommendations there seem to be more for strength. I have two issues going on with me. In my upper back (rhomboid/mid-trap area) I have a large band of scar tissue or a large knot in the area. How can I use my EMS/TENS unit to help me break this up or loosen it up? Also, I recently strained my lower back so I imagine the recommendation in this case would be different than my upper back. Any help or a point in the right direction would be greatly appreciated.

By the way, I have this unit:

Often, a knot is in response to pain and in that case TENS can help. This might explain why massage and roller etc are not helping- the pain involved keeps triggering it.


In my case, would TENS or EMS be more beneficial to help with the knot?

What about for the low back strain, TENS or EMS better suited to help recover the injury?

Is the knot a recurring issue? TENS(subtetanic stim) works ok for reducing pain and tension for short term issues, but it tends to decrease in effectiveness over time and it won’t actually fix what is causing the knot if the problem is chronic. Not sure about EMS and Ultrasound, someone else will have to help you out with that.

Now that I really think about, I would venture to guess it is more “scar tissue” than a “knot”. I just call it a knot because that is what it feels like. I remember injuring the spot playing softball. I play the outfield and a ball was hit to my left. I dove with my left arm extended and thats when I noticed the pain in the back (upper left area, rhomboid/mid trap) and I believe referred pain in my left shoulder.

When the pain wouldn’t go away I went to a physical therapist who could feel said knot/scar tissue and treated me with some exercises and Stim/Ultrasound. The scar tissue/knot never went away completely, but the pain did. Now, 6 months later, the scar tissue/knot feels like it has come back and their is tightness in the back and some referred pain in the shoulder, particularly during pressing movements.