Electric Muscle Stimulation for Athletes

Electromyostimulation–a systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. J Strength Cond Res. 2012 Sep;26(9):2600-14. Filipovic A1, Kleinöder H, Dörmann U, Mester J.

Abstract
This is the first part of 2 studies that systematically review the current state of research and structure the results of selected electromyostimulation (EMS) studies in a way that makes accurate comparisons possible. This part will focus on the effects of EMS on strength enhancement. On the basis of these results, part 2 will deal with the influence of the training regimen and stimulation parameters on EMS training effectiveness to make recommendations for training control. Out of about 200 studies, 89 trials were selected according to predefined criteria: subject age (<35 years), subject health (unimpaired), EMS type (percutaneous stimulation), and study duration (>7 days). To evaluate these trials, we first defined appropriate categories according to the type of EMS (local or whole body) and type of muscle contraction (isometric, dynamic, isokinetic). Then, we established the most relevant strength parameters for high-performance sports: maximal strength, speed strength, power, jumping and sprinting ability. Unlike former reviews, this study differentiates between 3 categories of subjects based on their level of fitness (untrained subjects, trained subjects, and elite athletes) and on the types of EMS methods used (local, whole-body, combination). Special focus was on trained and elite athletes. Untrained athletes were investigated for comparison purposes. This scientific analysis revealed that EMS is effective for developing physical performance. After a stimulation period of 3-6 weeks, significant gains (p < 0.05) were shown in maximal strength (isometric Fmax +58.8%; dynamic Fmax +79.5%), speed strength (eccentric isokinetic Mmax +37.1%; concentric isokinetic Mmax + 41.3%; rate of force development + 74%; force impulse + 29%; vmax + 19%), and power (+67%). Developing these parameters increases vertical jump height by up to +25% (squat jump +21.4%, countermovement jump +19.2%, drop jump +12%) and improves sprint times by as much as -4.8% in trained and elite athletes. With regard to the level of fitness, the analysis shows that trained and elite athletes, despite their already high level of fitness, are able to significantly enhance their level of strength to same extent as is possible with untrained subjects. The EMS offers a promising alternative to traditional strength training for enhancing the strength parameters and motor abilities described above. Because of the clear-cut advantages in time management, especially when whole-body EMS is used, we can expect this method to see the increasing use in high-performance sports.

My comments:

The above emphasis was mine.  This is one of my favorite review papers on electric muscle stimulation (EMS), along with it’s brother paper that emphasized specific EMS parameters found to be most effective at increasing strength and sports performance. What’s interesting is that, like exercise, the principles between sports performance and physical therapy are almost identical. This paper should be a must-read for physical therapists, as electric stimulation seems clinically out of fashion (with dry needling for whatever reason being the latest fad). Ironically, the science, technology, effectiveness, and inexpensiveness of EMS have never been better. For athletes and patients, trying is usually immediately believing. Still, you need to be set up on a machine that can be programmed to proper parameters, using large comfortable electrodes, and you need to have a physical therapist who knows what parameters to use (here they are). Admittedly being hooked up to a circa 1990s TENS machine, or the typical physical therapy floor model combo machine with ultrasound, is a bit of a yawner. I’ll have to do an upcoming blog on what specific machines I like and don’t, because with electric stimulation technology you don’t always get what you pay for. The good news is that if you know what you are looking for, you can get a lot for a little.

I should point out that while the abstract in the above paper talks about whole-body EMS being time efficient, the paper itself describes whole-body EMS as less effective at increasing performance than localized EMS (and this agrees with the studies I have read as well).  Otherwise the abstract is a pretty good summary of the paper.

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Chad Reilly is a Physical Therapist, obtaining his Master’s in Physical Therapy from Northern Arizona University. He graduated Summa Cum Laude with a B.S. Exercise Science also from NAU. He is a Certified Strength and Conditioning Specialist, and holds a USA Weightlifting Club Coach Certification as well as a NASM Personal Training Certificate. Chad completed his Yoga Teacher Training at Sampoorna Yoga in Goa, India.

6 thoughts on “Electric Muscle Stimulation for Athletes”

    • Hi Daniel, I think the machine you list is very similar to the EV-906 I started out using in my year experiment. Mine was good enough to realize that there was really something of benefit to come from EMS and I used them in the my office for about a year. However if you read through my notes you’ll see I maxed out on it after a few months, then switched to my Globus units. The Globus costs more but I still have’t maxed them out, they store more programs, and they hold up better with regular use.

  1. Hi Chad! I just bought an EMS device (TensCare Sports Tens 2) and I see in the specs that the waveforms are asymmetrical. But I think that most EMS devices use symetrical waves. Are asymmetrical waveforms as good as symmetrical?

    • Hi Chrys,

      Asymmetrical isn’t quite as good as symmetrical but they usually aren’t that bad. If you look at my journal from when I did my year of EMS I started out with asymmetrical. What you’ll notice with asymmetrical is that the non-square wave electrode, the red one in all the machines I have used will feel weaker by about 30%. So long as that you still turn it up high enough to do what you want it’s cool, but the black side might then be higher than you can take. When I was using asymmetrical I would either put the red wire on the side I didn’t want to stim as hard (a smaller muscle for instance) or I would just randomly switch it up so that over time I kept things equal. Later when to my the symmetrical waveforms of my Globus I didn’t have to worry about it anymore, and both sides were, and still are, stronger than I can physically take if I turn it up high enough. FWIW, I tell people I know who want a Globus to order them direct from Italy off ebay as the USA models (unless they are Genesy medical models) have their software dumbed down so you can’t custom program them. Compex sucks.

  2. Hi Chad! I like the EMS Device I use mostly because it allows me to build my own programs. But I feel that soon or later I’ll need a stronger one that can reach150mA, 150Hz and at least 400 miliseconds in EMS mode (mine is 100mA, 120Hz and 350ms). It’s imperative that I want to be able to custom program it, but I dont want to order from Europe. Any advice?

    • Unfortunately I don’t know a better option right now that ordering a Globus Triathlon from Italy off ebay. The USA Genesy models are strong and programmable, but the USA distributer might only have the 1100 model, which costs $1200 last time I checked and you might still need a physicians prescription on top of that. The USA imported Triathlons are strong but not programmable, and still cost more than the Italian ones off Ebay. If you only need two channels the Twin Stim 4’s are almost as strong as a Globus, inexpensive, and symmetrical biphasic square wave.

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