treatment

Muscle stimulation is a method of treatment using a muscle stimulator device called electrical muscle stimulation (EMS). It is a method of treating voluntary muscles, known as striated muscles, but does not affect the viscera (intestines, internal organs). You can apply it to any muscle if it is close to the body surface and you can apply an electrical impulse directly to it. For this reason, it is less suitable for muscles in the deeper layers. In this article, I explain the general rules of application that will allow you to successfully use it on almost any muscle in your body.

The electrical impulses emitted by the device are transmitted through electrodes to the so-called motor point of the muscle. This is where the motor nerve reaches the muscle.

The electrical impulse triggers a series of muscle contractions in the muscle. You feel it as a twitch and this produces the effect of relaxing the muscle, improving its blood circulation, and increasing its strength – depending on the settings of the treatment programme.

The use of muscle stimulators is prohibited if you have a pacemaker or an implanted defibrillator. There is no other reason for exclusion. For relative (to be considered) contraindications to electrical treatments, read this article.

Preparations for muscle stimulation

You will need a muscle stimulation (EMS) device for the treatment (many people think that TENS is also good for muscle treatment – they are wrong)

At the end of this chapter, you will find some suggestions for muscle stimulator devices.

How many channels you need depends on how much muscle you want to treat. The larger the area to be treated, the more channels you need. If only one side of your neck is sore, a single-channel device is fine. If you need both thigh muscles treated, you’ll need 4 channels.

One stimulation cable and 2 self-adhesive electrodes are needed for each channel. Instead of the self-adhesive tens pegs on the limbs, you can also use a rubber electrode and a clamping strap. So if you want a 4-channel treatment, you need 4 cables and 8 electrodes. Get these out!

Connect the cable to the device, and connect the electrodes to the other end (which splits in two and ends in a needle-like metal or patent).

Stimulation cables can come in different colours. It makes no difference which colour cable you plug into which socket. The colours are only there to help you easily identify the two ends of the cable.

At the two ends of the same coloured cable, the current will flow between the two ends of the cable, this is what will create the muscle contraction. It follows that both electrodes must be on the same muscle (this also determines whether larger -longer- muscles can be treated with muscle stimulation)

Placement of electrodes

The basics to get started

Once you have the device, cables and electrodes prepared and connected, the next step is to attach the electrodes to the muscle to be treated. It is best to wash your skin with lukewarm, soapy water and towel dry beforehand. The oilier, dirtier, and sweatier your skin, the shorter the time you can use the same electrode.

The placement of the electrodes is essential for effective muscle stimulation. You may feel clueless when you first try a muscle stimulator. But don’t worry, even with the wrong electrodes in the wrong place, you won’t cause any trouble – at most, it won’t move your muscles.

The electrodes must be placed so that the electrical impulse reaches the neuromuscular plate, which then transmits the muscle contraction signal to the muscle. To do this, they need the following:

• Both electrodes must be located entirely on the same muscle or muscle group;
• Align with the direction of the muscle fibers (not crosswise to the direction of the muscle fibers);
• One electrode should be close to the muscle origin;
• The other electrode should be positioned in the middle of the muscle mass (because this is where the motor plates are most densely located)
• The electrode upstream should be preferably twice the size of the electrode further away.

Modern muscle stimulators use a rectangular, symmetrical waveform. Therefore, it makes no sense to “pay attention” to the positive and negative electrode placement. In the two phases of the wave, the direction of the current is reversed. Thus, one electrode is positive and the other negative.

Electrode placement diagrams in books indicate the positive and negative poles. Therefore, because there are medical therapy applications that use asymmetric waveforms and these are based on the polarity of the electrodes. For muscle stimulation, however, there is no difference.

Electrode types and placements

Another “convention” for polarity marking is to mark the active electrode as positive and the inactive as negative. These can be used to indicate the relative sizes of the electrodes. It is useful if the positive (active) electrode is smaller, so that the current can be concentrated to reach deeper into the muscle structure.

Some muscle groups (e.g. biceps, triceps and forearm muscles) are stimulated with electrodes of the same size for ease of use. However, if space is available, the passive electrode should be twice the size of the active electrode. For example, on the hamstring, the active electrode near the knee should be 5×5 cm, while the passive electrode on the mid-thigh should be 5×9 or 5×10 cm.

The most important principle regarding placement is that both electrodes connected to the same stimulation cable should be located on the muscle. If you want to treat your forearm flexor muscle, both electrodes must be on that muscle. (There is no such thing as putting one electrode on your ear and the other on your toe and having all your muscles “exercised”!)

There are no nerve endings where the muscle continues in the tendon. Tighten the muscle you want to treat and feel along! Determine how long it is “soft” and where it goes into a tendon. Place the electrodes only on the muscle.

Examples of electrode placements for certain muscle groups

High quality devices come with diagrams showing electrode placement. If you “copy” this, you shouldn’t have too much trouble. But feel free to experiment! Move one electrode left and right, up and down a few mm and observe the effect. You’ll soon find out which is the most effective point.

The imaginary line connecting the pair of electrodes should follow the direction of the muscle fibres. This is usually parallel to the direction of the pull of the muscle. If you place the electrodes crosswise instead of this way, the muscle will twitch and you may feel cramping pain. This is because the current exiting the electrodes forms a closed circuit on the muscle and hits several nerves at once.

Locate in the direction of the muscle fibres! If the circuit is properly closed, the electric current encounters less resistance. This is important to maintain a strong contraction and also improves your sense of comfort.

Select a treatment programme for muscle stimulation

Some people believe that all muscle stimulators have the same effect. They are wrong!

The effect of muscle stimulation is mainly due to the

• quality of the device (the more precise the pulses produced by the device, the less pain and the better the effect on the muscles)
• is determined by the settings of the handler (mainly the frequency, pulse duration and current intensity values)

You should therefore choose the treatment program according to your goals!

If your muscles are stiff, you should run “relaxation, stiffness relief” or “blood circulation improvement” programmes. Avoid any “strengthening” programs as they will increase stiffness.

If your muscle strength has weakened, for example, due to long-term illness or injury or surgery, the first thing you need to do is to regain “endurance strength”. For this, neither “stiffness release”, “muscle mass increase” nor “maximum strength” programmes are suitable. These can be done once you have regained your “core strength”.

If you’ve never used a muscle stimulator before, try a stiffness reliever or blood circulation booster as a first trial. These will elicit subtle twitches and help you understand how to use the stimulation. If you start with a maximum-strength programme straight away, it can be painful and scary, and you can get serious muscle fever after just a few minutes of treatment.

12-week exercise plan using a muscle stimulator

This is a general-purpose, step-by-step program for regaining lost muscle strength. It can be applied to any muscle group. Pay attention to proper electrode placement.

Week 1	M	T	W	T	F	S	S
Stiffness relief	X	X	X	X	X	X	X
Endurance training	X		X		X		X

 

Week 2 – 3	M	T	W	T	F	S	S
Stiffness relief	X		X		X		X
Endurance training	X	X	X	X	X	X	X
Strength training			X				X

 

Weeks 4 – 12	M	T	W	T	F	S	S
Endurance training	X	X	X	X	X	X	X
Strength training		X		X		X

Intensity setting

When you start the tutorial, you don’t feel anything. To make something happen, you need to increase the current intensity. Look for the + and – buttons on your device.

For muscle relaxing, stiffening and blood circulation treatments, the intensity should be moderate. You should feel firm contractions, but they should be neither uncomfortable nor painful!

For muscle-strengthening treatments, stimulate at the top of your comfort zone. At this point, try to see what the current is that you can no longer tolerate and then reduce it by a few milliamps (with the – button)

It is a mistake to use too low a current when stimulating! If you don’t feel definite muscle contractions, the treatment has no effect.

Every person feels the current differently and reacts differently. You will feel differently even on different days. That’s why your appliance always starts from zero. You have to find the right value for you. If you increase the intensity in steps, you will gradually feel subtle twitches in your muscles. These subtle contractions have no effect yet, so you need to keep increasing the intensity. The higher the intensity, the stronger the contractions you experience and the stronger the effect.

However, above a certain level (specific to you), the treatment becomes painful. At this point, take back some mA values! The higher the current, the more uncomfortable the treatment can be. The pain is caused by the voltage across the skin.

After treatment

Once the treatment time has elapsed, the program will end and the pulses will stop.

Turn off the device and take the electrodes one by one, carefully detach them from your skin, not by the cord, and immediately stick them back on the plastic sheet.

Tip: keeping the electrodes in the fridge (not the freezer!) will increase the life of the adhesive.

How much time do you need?

Muscle strengthening occurs as a result of stimulation, but electrical treatment does not cause it.

Your body -like gym exercise- senses that you are regularly “working” the muscles. Your body responds to the load. If it senses that more muscle power is needed, it “tells” the hormonal system to increase the amount of hormones that stimulate muscle building. These trigger the “building” of muscle cells, slowly producing more and stronger muscle fibres.

Just like weight training, the results do not happen overnight. Keep a good routine and you should see results from 8-12 weeks of daily treatments.

While gradualness is important, i.e. you should get your muscles used to the stimulation in the first week, then from the second week you will get more frequent and more intense sessions, and then after the basics have been “laid down” you will enter the real strengthening phase.

By the end of the third to fourth week, you’ll feel your treated muscles tightening up, but they’re not “ready.” Don’t stop after three months of stimulation, because without regular contractions, muscle strength will start to decrease again.

At this point, however, you can move on to regular gym/exercise/exercise. This way you can keep your muscles in good condition and use the stimulation as a supplement to improve recovery and increase circulation.

Recommended muscle stimulators with built-in programs

[message title=”MyoBravo Multifunctional Muscle Stimulator” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

• Mid-level, 4-channel electrotherapy device
• Multifunctional, i.e. in addition to muscle stimulation, it also provides other forms of current (TENS, FES), i.e. versatile
• Precise programmes for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle recovery
• Sport applications
• Custom program creation
• You can use it to treat only 1 channel (i.e., small muscles) or simultaneously treat the largest muscles (thighs, back, abdomen)
• For home use, but also recommended for beginner physiotherapists and trainers

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[message title=”Premium 400 Multifunctional  Muscle Stimulator” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

• High-end, 4-channel electrotherapy device
• Multifunctional, i.e. in addition to muscle stimulation, it also provides other forms of current (TENS, MENS, FES)
• Precise programmes for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle recovery
• Sport applications
• Arthritis and tendonitis treatment
• Possibility to create your own program (requires expertise)
• You can use it to treat only 1 channel (i.e., small muscles) or simultaneously treat the largest muscles (thighs, back, abdomen)
• For home use, but also recommended for beginner physiotherapists and trainers

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