Dr. Zatrok's blog
Dr. Zatrok's blog

Dr. Zatrok's blog

Electrical Muscle Stimulation aka EMS

by Dr. Zsolt Zatrok

EMS, or electrical muscle stimulation, has been used for decades to train athletes. In this article, we will take a look at what the muscle stimulator is for, how it works, and how to use it.

What is electrical muscle stimulation (EMS)?

EMS or Electrical Muscle Stimulation, is used to treat the so-called striated muscles that provide voluntary movement. It does not (substantially) affect the smooth muscles of the muscles of the spine.

Muscle stimulation involves the delivery of a milliampere (mA) electrical pulse through an electrode attached to the skin to the muscle, which contracts. You can determine the type of contraction, the fibres to be contracted, and the number of fibres involved by adjusting the pulse’s frequency, intensity, and duration. The pulse’s adjustment influences the resulting effect.

You can focus the stimulation on a specific muscle or muscle group, focusing its effect on those muscles. This is why it serves as a supplement, not a substitute for exercise.

Typically, an electrical signal from your brain initiates muscle contraction. With muscle stimulation, the muscle receives similar artificial impulses. There is no difference between the tension and the impulse from the brain. In both cases, it contracts by exactly the same mechanism, the same metabolic processes take place in it, and it fatigues, acidifies, and ruptures filaments in exactly the same way.

Muscle capabilities improve through repetitive muscle work implying that muscle stimulation will achieve similar outcomes.

What does electrical stimulation do better?

When you voluntarily move, the brain’s regulatory systems deliver the contraction, a principle described by Hennemann’s rule.

This means that during a contraction, small muscles contract first, followed by larger muscles. Type I fibres are initially stimulated within the muscle bundle, followed by type IIa and finally type IIb fibres.

It is also true that the brain “spares” each voluntary contraction, i.e. it does not allow all the fibres to contract at the same time. That’s why stress or danger amplifies the force; an adrenaline rush is released into your bloodstream, deactivating the reserve.

Electric muscle stimulation bypasses this “economy of effort” system. There is almost no limit to the number of fibres that can be activated. Therefore, EMS can activate muscle fibres in much larger quantities. Even with stimulation, achieving a complete 100% contraction is not possible, as some muscle fibres are always in a “refractory” phase, unable to contract due to previous contractions.

Another important capability of electrical muscle stimulation is the “teaching” of the neuromuscular (nerve-muscle) connection. According to some studies, the brain and the motor neurons that run from the brain to the muscles need at least 10,000 (ten thousand) repetitions to learn how to perform a movement most quickly and efficiently. This is why athletes repeat and refine a movement endlessly. Stimulation can significantly speed up the optimisation of muscle function.

You may have experienced that after an injury, the right movements have to be relearned and “memorised”. Muscle stimulation is also an excellent way to “relearn” optimal movement coordination.

Certain conditions forbid the use of muscle stimulation

Do not use electric muscle stimulation if you have an implanted pacemaker or defibrillator, acute thrombosis, tumours, epilepsy, or infectious diseases. Exercise caution during pregnancy and menstruation. Read more about contraindications here.

Applications of muscle stimulators

For Athletes at home

Professional and amateur athletes, as well as individuals with musculo-articular disorders, can utilize muscle stimulation, but their needs differ.

Amateur athletes train relatively less, so the main uses of muscle stimulation are injury prevention, gaining passive training time and accelerating muscle recovery.

For professional athletes, the main application is to accelerate muscle recovery, prevent overuse injuries, stimulate the fastest possible recovery from injury and gain better results through training.

Muscle stimulators for athletes

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  • 2-channel electrotherapy deviceThe Globus Elite SII Electrotherapy device with muscle stimulation programs
  • multifunctional, versatile
  • Built-in programs around pain relief, muscle strength development
  • sport applications


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  • Dedicated sports programs for runners
  • TENS | EMS, NMES, FES | MENS, MCR | Iontophoresis
  • max. 4 channels (8 electrodes)


For recovery at home

You can apply muscle stimulation to numerous muscle or joint conditions. Thus, muscle atrophy, various forms of paralysis (Bell’s palsy, ALS, multiple sclerosis, stroke, spinal cord injury), post-operative strength recovery and recovery acceleration are the main areas. These are separate topics, I will deal with them in another paper.

Explore articles on muscle stimulation for various medical conditions like Bell’s palsy, Lumbago, Sciatica, Rheumatoid Arthritis, Trigeminal Neuralgia and Piriformis treatment.

Muscle stimulators for treatments

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  • Denervated treatment – triangle, trapezoidal, square wavePerobravo Electrotherapy Device for Peripheral Paralysis Treatment, Bell's palsy
  • Healthy muscle treatment – biphasic square wave
  • ETS (EMG based) – biofeedback triggered stimulation
  • Time/intensity (i/t) testing support
  • Gait relearning function with foot sensor (peroneal palsy)


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  • Recovery after ACL surgerygenesy 300 pro multifunction electrotherapy device, facial neuritis
  • Swollen ankles
  • Functional recovery
  • Severe incontinence
  • Quadriceps atrophy


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