Notes from My Year of Electric Muscle Stimulation

“My own results have been so favorable that I am not interesting in debating whether or not EMS works but rather in optimizing the use of EMS in the training of elite athletes.” Charlie Francis

About August or September of 2013 I got really interested in the capabilities of electrical muscle stimulation (EMS) for strengthening. I had just read the Charlie Francis training system, found  charliefrancis.com where Giovanni Ciriani was posting a lot of advanced EMS information and then some. Also I had just read the 2-part review papers in the Journal of Strength and Conditioning Research on EMS parameters for strength, and EMS for athletes. The Truth about EMS article by Charlie Francis on T-nation was definitely worth a read as well. So yeah Charlie Francis was pretty influential.

I had used TENS for pain and EMS with patients with nerve damage before, having learned about both in physical therapy school, but never having been taught the real potential of either device. So learning what I had about parameters, not finding any of my current stimulators adequate, I ordered a couple machines, an EV-906 and some 2 channel Russian Stimulation unit. The Russian stimulator turned out to be weak sauce, so I sent it back, but the EV-906 turned out to be pretty good. I remember the first time I put it on my abdominal muscles and went up to about 60 mA I thought to myself, “if I turn this up anymore I’m going to have a hernia.” I had never felt an abdominal contraction that intense, and spent years working out as a competitive bodybuilder and weightlifter so hard abdominal work was something I was accustomed to.

When reading the research, there were no long term studies with EMS for strength and fitness in normal subjects, with the longest being in the ballpark of 8-12 weeks (generally successful). There were some studies longer than a year but they were done with spinal cord injury patients (again generally successful), so I figured why not quit lifting weights for a year and try electric stimulation instead. I knew it wouldn’t be a controlled study, lots of potential confounding variables, potential for bias, etc., but I had never heard of anyone doing the same and I figured it would at least give me a general idea of what the new machines were capable of. I figured it would also help me help others with its use as I worked through the practical problems of training all major muscle groups with EMS, and help me work out what I thought were the best electrode placements, best parameters, machines, accessories etc. After about 6 months I got a Globus Genesy 1100, wondering if it was worth the extra cost (for me it was). My year was up in October of 2013 and I learned a ton by doing so. I’m currently writing a book tentatively titled Electric Stimulation for Sport, Fitness, and Rehabilitation in which I hope to combine the practical knowledge I gained on myself and working with my patients (for whom I put EMS on better than 90% of them regardless of diagnosis) integrated with what I have learned reading a considerable number of research studies.

I’m still working on the book but I thought it would be a good idea to share the notes I took over the year regarding the things I tried and how I thought it worked.

After one year my comments are thus:

Overall, I thought the year was very worthwhile. Next to exercise, electric muscle stimulation is by far the most effective modality available to physical therapists. If you are a physical therapist and you don’t agree, it’s because you don’t know how to use it. Applied properly it’s immediately obvious. As Terence McKenna would say, it doesn’t require any faith.

Results: Better than expected, I quit weightlifting and did EMS instead for my leg muscles and it seems my muscle mass and strength largely held. I was a bit disappointed in how much I was able to clean (95 kg) after having not trained in a year, but when I looked back at my workout log book I hadn’t done cleans since 2012, so I probably wasn’t lifting 115 kg (what I did in 2012) when I started the EMS near the end of 2013. My body weight dropped from 192 to 183 pounds but my percent body fat dropped from 11% to 7.15%. I’m sure the fat loss was at least as much related to diet as the the EMS towards the latter half of my year as I made an effort to eat less. So my fat free mass went from 171 lb to 170 lb after a year of electric stimulation, which is well within the margin for error in skinfold caliper measurements. If measured well, I lost 8 lb of fat and 1 lb of muscle, which I think is pretty good for a year without lifting weights. Most of my muscle circumferences changed very little, largely I think because I stopped lifting weights and started doing EMS instead so one was offsetting the other. My neck circumference increased almost a full inch, from 15 ⅞” to 16 ¾ at my peak I think because I wasn’t doing any weight training for neck and I wanted to see what EMS would do. Yes, I know that every EMS unit has a warning saying not to stim the front of the neck, and yes I placed electrodes directly over my carotid sinus. I did it often and I did it intensely just to see what would happen. Nothing bad happened to me except my neck got bigger and stronger. I don’t suggest anyone do the same based on my results as I’m just one person. I do plan on talking more about EMS to the neck in my book and in upcoming blogs, but I just wanted to let everyone know I’m aware of the recommended precautions with EMS use and sometimes I broke them on myself. I didn’t think it would be appropriate to do so on anyone else first.

Conclusions:
Tier 1: EMS clearly better than exercise
Overall I thought EMS was pretty awesome (better than weights or any other exercise) for strengthening the core, in particular abdominals (for which I think any real exercise I have ever tried doesn’t even come close to EMS).

Nothing is as good as abs, but the neck is up there. Every precaution says not to do it, but I found EMS a very effective neck strengthener, and my neck was neutral throughout, putting my cervical discs in less risk than if I had done wrestling bridges. So I’m not telling anyone else to stim their neck, everyone else it seems disagrees with me, but I do it.

Also, I thought hand and foot intrinsic muscles were better trained with EMS than any exercise I can think of.

Tier 2: As good or almost as good as exercise
EMS was really good for hip muscles, quadriceps and hamstrings, probably not as good as squats, lunges and RDLs, but EMS is no slouch. Biceps, triceps, forearms, I could train real hard, but if not for my bad shoulder I would have thought it just as easy to lift weights as I thought it was a pain to one handedly strap electrodes onto my other arm. Tibialis anterior was trained really well with EMS.

Tier 3: OK, but clearly not as good as exercise
What makes quads and hamstrings, and most other muscles train well with EMS, is I can oppose them with some other muscle. I would generally train quads and hamstrings together, hip adductors and abductors together, abdominals and back extensors together, etc. That way, one muscle group would oppose the other and the joint would feel balanced. With calves however, the opposing muscle (tibialis anterior), no matter how hard it is stimmed can’t balance out a hard EMS-induced calf contraction, so my calf would flex hard, and even in standing would lift me off the ground. I once braced myself into my leg press and worked up to a full 120 mA on my globus, and it was intense, not pleasant, and I was there for 10 minutes, so I would have rather just done calf raises.

The other muscle I could never get to contract well enough was pecs. I’m not sure why, but I could get fair contractions at best.

So below you are reading my notes, written simultaneous with my stim sessions, not my recommendations. YOU HAVE BEEN WARNED! If you have any questions or wants some clarification, please feel free to ask.

What happened after my year: I took a break for a while, did some EMS as I felt like it, but now I’m back doing a number of new tests on myself, looking at other applications other than strength, like making EMS cardiovascular and burning fat, plus working to make it more efficient, maybe integrating it with weights. So I’ll probably have a new set of notes next year with ideas to maybe work into my book.

From the beginning:

10/10/2013
I’ve been playing with the EMS for a few weeks now, learning a lot with regards to applying it to myself for strength/fitness, and I think I better start writing down what I’m learning for posterity and to see how well it works.

I’m definitely developing my favorite stim placements that seem to work the best, but I think it is good to change things up periodically, put stim crosswise, linear, front to back, all with efforts to target different muscle fibers. I do notice a change in DOMS after changing the position of pads and also changing the position of limbs with joints flexed or extended. Working agonist and antagonists together I’m usually able to tolerate both extension and flexion during stim relatively equal. I think ideal might be to change days with flexion, extension, and halfway in between. Maybe, as you get more used to stim, you can change position between shocks, but it’s a little inconvenient to do so when I generally do my stim sitting and watching TV.

The idea gradually came after I read about sprint coach Charlie Francis using it with his athletes.

Why I think I’m a particularly good subject for this “study.”

Over the years I have accumulated a number of orthopaedic injuries that will not heal.
I’m a physical therapist that graduated Summa Cum Laude. I know muscle anatomy as well as anybody.

I’m a physical therapist that used to be a competitive bodybuilder and Olympic weightlifter combined for >15 years so I know strength training as well as anybody.
While I think the weightlifting exercises has more application to sports I think my bodybuilding experience gave me more to go on regarding the effective targeting of particular muscles, and a good feeling for what exercises work exactly what muscles, and what delayed onset muscle soreness feels like for each exercise. With that, I think I can feel better than most whether a given stim pattern or intensity works a muscle or group better than others. Placebo-controlled double-blind studies would be better, but I expect it will take better than 50 years for better science to catch up, and until then, my observations are better than nothing and it will be interesting to see at a later date how much I am right and wrong about.

Why I think my results might not be applicable to everyone.

I have a history of A LOT of weight training so I have what is in layman’s terms called ‘muscle memory’ such that I don’t have to lift weights that much to get a good result. I’m building back muscle that I had before, which empirical evidence suggests is a lot easier than building muscle that you have never had before. I certainly notice it is easier and faster to gain strength back that I have lost, then it was to build it in the first place as I started out very ectomorphic but to look at me now, I appear to be a mesomorph.
I had used electrical stimulation every once in a great while in PT school, and demoing stimulation on older stim units over the years and either due to a high pain tolerance, or just experience with stim, had little initial fear of turning the machine up, really high right from the start.

My body fat was 11% which is relatively low and I have a better amount of muscle mass than average to start with, and research and anecdotal reports indicate that both should make the stimulation more effective for me that for someone with lesser muscle and greater amounts of fat.

Since there are no long term studies on the effects of electric stimulation on regular people, I decided I would try it for strengthening instead of weight lifting for an entire year and see what I learn by doing so. I’ll just write down my observations as I go. I started stimming a few body parts in September and gradually developed a nearly whole body routine for it. I wasn’t doing much upper body weights anyway because of shoulder arthritis from an old motorcycle crash, and the shoulder limited my ability to do a lot of my favorite leg exercises like front and back squats, cleans, etc. 9/11/2013 was my last weight training workout with my legs, as it felt like the stim was working me hard enough and I wanted to see what happened. I kept doing cardio and short sprint/agility drills for the lower body for cardiovascular health and speed, and I wanted to see how the stim affected my various speed and agility drills, if it helped or hindered in comparison to when I was doing strength training.

11/25/2013
I noticed when I was demoing a calf stretch at the office that my calves feel tighter. I suspect it is due to doing stim with calves in neutral and contracted but never stretched. This makes me think that stim should be combined with occasional stretches, unlike weights which you can stretch during. You might also want to set up stim with muscles in a stretched position to prevent any shortening, but it could be advantageous to shorten an overstretched muscle, maybe, as I had theorized about before to foot intrinsics and posterior tib muscles in a contracted position.

11/26/2013
Neck circumference has increased ⅜” larger from 15 ⅞” to 16 ¼”. I think my neck circumference is going to be a good baseline measurement since I don’t do any other exercises that work it, unlike my legs where I do sprints, bike, and stepmill.

11/28/2013
Stimmers are getting twitchy. I can’t tell if it is the wires or pads. I suspect the pads, as it seems to be happening on various machines, but sometimes the pads I think are bad still work when I try them later.

12/4/2013
A while into it I decided my rear delts were visually under developed and likely my external rotators of the shoulder so, I decided to make upper body just rear delts, later adding the external rotators as I could feel my shoulder was better stabilized when I did so. Just rear delts alone felt like my shoulder was subluxing, but adding the infraspinatus and teres minor at the same time made the contractions felt stronger and the shoulder joint more stable. I’ll definitely keep that in mind going forward when doing FES on shoulder patients. If and when my rear delts look symmetrical with the front I’ll do a more balanced upper body routine.

12/4/2013
Repeated and pretty strong DOMS makes me think that DOMS is not only caused by eccentric contractions. Also, pretty good soreness 48 hours after makes me think that 2 days rest between workouts might be as good or better. As I recall, there is research that says 3x per week treatment works better than 2 times per week, but perhaps as you take more intense stimulation, combined with more muscle/less body fat, would make 2.5 times per week as good or better, like how a powerlifter or bodybuilder often ends up training each bodypart less frequently as he advances in strength/muscle mass. Soreness is definitely not as bad as you go and you continue to train just as with weightlifting, but you definitely feel it if you miss a week and return, just like weightlifting. DOMS really feels like what you get after intense weightlifting. I will have to research.

I have noticed my patients who are not strong and max out the machine on the first day never complain of muscle soreness afterwards. I think either because the smaller/sicker muscles/nerves don’t react as well to the stim, or the lesser muscle muscle mass does not contract hard enough to get sore. I’ve observed this in older patients especially who were relatively lean, in the calf/TA region. While the younger girls can’t take the intensity.

12/23/2013
So I’ve been running 2 EMS units with a total of 8 channels and 16 pads for a couple weeks. I used to think I would want to run 3 machines with a total of 12 channels but I think managing the wires would be near impossible with 3 machines. With 2 machines it’s doable and cuts down your workout time considerably but managing the wires is tedious. Such that it makes you more likely to just skip a workout and put it off until tomorrow. Doing small muscle groups, like neck or rear delts, that only requires 2 or 1 channels seems really easy so I at least am a lot less likely to procrastinate.

1/29/2014
I think electric stimulation is a bit like exercise in general, as easy as you make it, it’s still something you need to make time for and if you start missing workouts you can get out of the habit. Training core, abs in particular is really easy but lets admit that it is a bit of a PITA and hurts more at high intensity if you don’t do it regularly.

Regarding neck training, I am still unable to find any studies or even case reports indicating any deleterious events putting over your SCM muscle/carotid sinus, but I did have some neck pain for a day after a hard session, likely from not keeping my neck “neutral” when the hard contraction went. In follow up sessions I have been careful to keep my neck strait during the contractions and to let my shoulders shrug up rather than resisting the motion as it seems to put more compression on the neck. Also, tonight I tried a diagonal electrode placement with channel 1 being on the right-front and left-back of my neck and channel 2 being on the left-front and right-back, which felt more even to me and better on the neck, than my prior method of channel 1 being right and left-front and channel 2 being right and left-back.

I still haven’t found a better machine than my EV906 for the price, or for more than the price, but one of my patients told me they noticed that the machine worked harder when plugged into an outlet rather than when using batteries. Testing it on myself, it feels like he is right. Next time I think about it I will try testing batteries vs outlet on my voltmeter and see if it measures different. [measured ~10% stronger when plugged in]

Also, a number of my patients have been bringing in their TENS machines and it seems they are all pretty powerful, and equal to the EV906, but what none of them have done so far is have 4 channels so you can work an adequate number of muscles at once, and more importantly, none of them let me vary the contraction time on and time off to prevent fatigue and get the contraction I want for strength, muscle hypertrophy, and pain relief. My patients are consistently reporting that the classic Russian stim pattern of 10 seconds on, 50 seconds off, for 10 (11 or 12) repetitions decreases pain better than traditional high or low frequency TENS patterns, such that I think it would make for a pretty interesting study.

Last, at this point I am three for three on eliminating or significantly reducing migraine headache pain with the Russian stim pattern at the highest intensity tolerated, with 2 pads on the suboccipital region. Patient one reported 10/10 pain reduced to 0/10, patient two said her pain went from 8 to 2/10, and patient 3 reported pain went from 4/10 to 0/10 and vision problems completely cleared. I’ll continue to record the results going forward with anyone I know with a headache.

3/14/2014
I got the flu, got a new office manager and had 2 large pistol matches to prepare for, so I have been slacking on the EMS this last month. So as I mentioned before it’s just like exercise, and in the last month I haven’t been doing my cardio either. I kept up pretty well on my neck and rear delt stim. Just like exercise the smaller body parts are more convenient to train.

Also, I tried 4 electrodes on hamstrings today and only 2 on quads. It felt like a significantly stronger contraction in the hamstrings so if hams are a relative weakness, they might be worth 4 pads. I recently tested my ham/quad ratio and had a .59 which is weaker than I would have expected, though I had been doing 4 pads on quads and 2 pads on hams since September ,so maybe that’s to be expected. I think going forward I will alternate 4 on quads and 2 on hams, and vice versa.

I’m also thinking, and today experimenting with an optimal lower leg pad placements. I put black pad over posterior tib and red under central dorsum of the foot. It feels good, but I also want calf and TA involved but I just trained calves and want to see if I have any differing DOMS so I am doing my right foot only for the foot and posterior tib muscle. I worked to 100 mA with foot flat on the floor in sitting which feels pretty strong. Also, I want to budget 4 pads per leg, I kind of want two pads on calves and one on TA, so I will have to give something up, probably a calf pad. For patients I will likely budget the calf vs TA strength with regards to the relative strength of their calf and TA. I don’t think the stim pattern is worth it for me, but I am just experimenting for use in patients with neuropathy, posterior tib tendinopathy, and acquired flat foot deformity.

Still, I don’t know if my “10-on, 50-off” is best, but I tried a “3-on, 10- or 15- (can’t remember) off” on core 3 weeks back and had increased soreness after, but I will try again after a few steady 10-50 treatments. It might be good to change it up to prevent adaptation and to perhaps train more muscular endurance instead of strength.

Still, I need to come up with faster and more convenient ways to apply pads, but my new 4” straps without buckles are pretty effective, the best I have used thus far.

3/15/2014
Follow up on yesterday’s stimulation of posterior tibial tendon and sole of foot on the right compared to the left. Both have mild DOMS, so I think the electrode placement was effective in comparison to just putting 2 pads on the gastrocnemius. Probably a good bit of the lower calf DOMS is the soleus muscle as the pad is right over it as well in attempt at targeting the posterior tibial muscle. Seems like it might be effective if I were looking to treat/prevent plantar fasciitis/posterior tibial tendinopathy/acquired flat foot deformity. I think the goal would be to start the stim at the first sign of PF or PTT, before the two degenerate into AFFD. I do want to investigate the role that the tibialis anterior plays in these conditions to see if it is worth placing an electrode over that muscle as well.

3/18/2014
I revisited large carbon electrodes (4” diameter circle) vs small sticky ones (1.5” square) that come with the machine). Left hip I put the carbon, right hip the sticky one’s. I was able to get to 100 mA intensity faster with the larger electrodes, but I still got there with the smaller one, but it had more of a stinging sensation and it felt like the muscle contractions were not as strong. The differences were smaller than I expected, however, it felt like the smaller pads just hit a smaller area of muscle. At this point I’m becoming fairly insensitive to stim, and can take more amperage than most of my coworkers or patients, so I’ll do a bit more experimenting on them, probably having them put 2 pads on each calf muscle with the large and small pads and record what intensity they reach on each, and have them rate the pain and contraction intensity on a 10-point scale.

3/21/2014
So I think I have figured out how you can tell when your rubber carbon electrodes are wearing out: the stim starts to sting. I think I noticed it over the last couple sessions, but today’s core workout definitely had stinging under the electrodes. I even re-wet them, and they still stung. I didn’t quite make it to 100 mA either in my workout due to the stinging, and afterwards I had some redness of my skin, which looks like irritation that I never used to get. So I’m going to continue using these electrodes for my next workout and if they sting at the start, I’m going to replace them and see if that fixes the problem. I’ve probably been using these electrodes for a couple months now, so if I replace them I will track how many uses I get out the the next ones. I’ve heard varying recommendations on the web about how often they should be replaced and have had some in my clinic I used for years, so it will be interesting to get some actual use data out of them, and maybe compare brands to see if there is a difference. I did notice that I was able to ruin some real fast by washing them with alcohol and various disinfectants.
… follow up, I just replaced the pads that stung, 2 of them, and it felt better. Cheaper than replacing them all.

3/24/2014
I got a Globus MyStim to play with. It’s not programmable but I learned a lot about it running through all 55 programs yesterday on my left calf while riding on a jeep trip with my girlfriend. Initial impressions are that it feels like a high quality unit, but the fact that it is not programmable is very annoying. Also, I think the number of programs is a marketing ploy as many of them feel the same and are just minor variations between various and common forms of TENS and EMS. Still, there are some things I like, such that if it were programmable it would be a favorite. Since it is not, I still prefer my EV-906.

What I thought I would test was the concept, I think called cronaxie (?) that says that legs require a greater pulse width and arms a lesser one, such that pulse widths should vary and this is why the Globus and Compex units have differing programs for upper and lower body and sometimes different individual muscles depending on which unit you buy and how many programs it has. I have not seen anything in the research about optimizing chronaxie, but rather the fact that a longer pulse width delivers more current to the muscle and should result in a better contraction per mA regardless of the muscle. So I’m hooking up the Globus to my biceps and triceps right now and will run the upper and lower body. Program 21 (increasing mass lower limbs) I was able to work up to 61 mA, and it felt really strong. Program 32 (increasing mass upper limbs and pecs) I got to 70 mA and it felt about as strong. Maximal power lower limbs (program 7) it got to 50 mA, and Maximal power torso and upper limbs (program 10) I got to 76 mA. Putting the machine on my calf muscle and repeating the above…

program 32 – 68 mA
program 21 – 54 mA
program 10 – 69 mA
program 7 – 61

EV-906 @ 300 uS on calf (without changing the pads) 100 mA (pretty strong but maybe 90% of what I felt with the Globus
EV-906 @ 50 uS on calf was anemic and just caused a mild muscle contraction, but that contraction increased rapidly as I ramped up to 300 uS, which is where the EV-906 maxes out.
EV-906 on biceps/triceps I got to 86 mA at 300 uS before I had to stop due to wrist pain from intense UE contraction
EV-906 to biceps/triceps at 50 uS I got to 39 mA before I could even feel a mild tingle and at 100 mA I felt a mild contraction of biceps/triceps but I’m typing this with both hands with it on, and I was able to ramp up to 270 uS before my tolerance was reached. Every 10 uS jump (the intervals on the EV-906 machine) lead to a pretty noticeable increase in muscle contraction, which felt at least equal to a 10 mA increase in intensity.

The Globus pulse width is supposed to max out at 450 uS, and I think that is where the extra power comes from, but with the machine being non-programmable, you don’t know what you are getting with each program. So I wish Globus, and probably Compex too (though I have yet to use one) would make their low price electric stimulators programmable, as obviously Everyway Medical can for a fraction of the cost. Or I would like Everyway Medical to increase the limits of its pulse width to 450 mA.

So I conclude that pulse width (uS) is just as important amplitude (mA) for eliciting muscle contractions, and I suspect for lessening pain for TENS treatments, and that this is the same regarding UE and LEs, with more being better than less if you hope to increase muscle, strength and lessen pain.

Someone has probably already done this work, but mA x uS probably yields some value with relation to effect and it would be interesting to know if there is any optimization to be had. If not done, this would make for a really good study. I’ll have to do a search to see if it has been done.

3/25/2014
Globus is “symmetric biphasic” alternate current ,which I gather means the alternating current is equal both positive and negative. When I step on my flip flop electrodes the amount of stim in each foot feels equal. The EV-906 and most other EMS/TENS units I have used is “asymmetric biphasic” alternate, which in practice means that the negative (black) electrode causes a stronger muscle contraction than the positive (red) electrode which feels weaker. So in practice I generally put the black electrode on the larger muscle or over the muscle I am trying harder to bring up. I know some research on wound healing and transcranial electric stimulation specifies placements of negative and positive electrodes, so that might be a plus for the asymmetric biphasic currents though I have not yet done much research into the latter. For general strengthening I don’t think that it makes a lot of difference one way or another. I’ve been using the asymmetric currents for 7 months now and they are plenty effective.

I tried Globus “max power lower extremity” on core today. It was pretty strong. I skipped the warm-up, skipped the cool-down and worked to 45 mA on abs and 58 on obliques and lumbar. At the last minute I upped it to 48 and 61 mA. I’m sure I could work to more, but I’m pretty sure I could not max it out. The recover pulses between intense stims are a bit annoying. I do like the ability to increase the intensity on all the channels together and I like how the stim stays on when doing so, so you don’t have to change from S to C or get the increases done during a burst like on the EV-906. The rest periods feel awfully short though so this feels like a lot more work than doing 10-10-50. 6 seconds on-15 seconds off, feels like it would build more endurance than power however. Hips I started off at 45 mA and worked up to 60 mA.

Rate feels considerably lower on their muscle/power building programs than the 120 Hz I program in per Charlie Francis’ recommendations on his sprinters.

I just did a right calf intensity test with EV-906 and got to 100 mA and it felt like a pretty strong contraction. Tried my new sample 4 channel EMS and it pushed my leg back at 100 mA and it felt real strong. Then I did the same with my Globus MyStim and full weight on my right leg and it lifted me up involuntarily on my toes that I could not come down on and cramped up the calves the 2nd interval such that I had to turn it off, so it’s a lot stronger at 100 mA. I think I will have to get a programmable Globus like the Genesy 500 Pro, which maxes out at 120 mA and I feel that will be strong enough that I might never max it out. All the machines at 100 mA were comfortable, maybe the Globus was the most by a little bit, with the muscle cramping being what caused the majority of the discomfort. I would like to try out the Globus on more of my patients with nerve damage.

3/26/2014
Globus MyStim workout on quads and hamstrings. Since my calves are both sore from all the testing I have done over the last couple days, today I’m training both quads and hams, 4 pads, each in a diagonal pattern for the first time with the Globus. With my EV-906 I get a great workout and can set the pattern I want, but I am able to max out the machine at 100 mA but just barely. With the Globus on program 7, (skipping the warmup and cool down) I was able to tolerate 46 mA on quads and 33 mA on hams and work to 63, 63 quads and 54, 61 mA hams.

4 pads on the quads and 4 on the hams with the knee extended feels pretty good. The contraction feels balanced with minimal knee stress. It makes me think this might be the way to go going forward, as the most pain during leg strengthening is the cramps you get in the calves. I’m too lazy to stand such that my bodyweight helps to prevent the calf strain for my right leg and left leg separate, but maybe combined will be worth it and I’ll have 2 more electrodes per leg to put on the tibialis anterior and soleus/posterior tibialis. So, I’ll try that out next time, as well as try 1 on the gastroc, one on the posterior tibialis, one on the anterior tibialis and one on the foot intrinsics. My plan is to try each one one leg and see which feels like the best workout.

One thing I am noticing about the Globus preset programs on the MyStim, is that the short rests and frequent contractions are mentally fatiguing compared to the 10-10-50 I prefer. I’m not sure at this point if there is any more gain to go with the increased frequency of pain.

3/29/2014
I’m nowhere close to maxing out the Globus MyStim on intensity on program 7 on core. I think I got up to the 60’s on low back and obliques. Glutes I started at 50 and hip in and out’s at 40, working up to 65-55.

I do notice with the power program on the globus with the short rests that my muscles fatigue faster, and it seems I can then turn the machine up more. So I’m not sure if that’s good or not. The Russian stim parameters 10-50-10 give you more rest so each contraction hits harder as the muscle fibers are better rested. The Globus Mystim power duty cycle has less rest such that the fibers fatigue faster, but maybe that is good because you can turn up the machine intensity more, perhaps hit deeper muscle fibers, more fatigue those fibers and get more results in strength, power, hypertrophy, etc. Unfortunately I am unaware of any research that compares the different duty cycles to see which results in better gains. Presumably the Russians (Kotz) did such research, but none of that is available in english that I have found. I’ve seen a couple summaries but even they were sketchy. Charlie Francis had a lot to say about the good results his athletes got with the Russian 10-50-10.

3/30/2014
I’m trying criss cross (front to back) on right thigh using program 7 with Globus MyStim, 35 mA to 50. Mid-thigh contractions maybe felt a bit soft compared to keeping channels on the front and back separate. My right thigh certainly felt fatigued afterwards. Criss cross (front back & top bottom) seems to get a lot of lateral contraction and contraction directly under the electrodes, but almost none in mid thigh. I don’t see any definition in the mid-quad and it is palpably soft. It didn’t feel as comfortable either as (criss cross front and back) or (criss cross high and low, still my favorite). It feels like it has hyperextended my knee and you can’t control quads vs ham contraction as precisely as when keeping the channels paired on each muscle. I started with 25 mA and worked up to 43 mA.

Calf, feet, TA and TP. TA on right: start 20 mA, heels started to lift at 35 mA, worked to 46 mA. Right foot toes curling more. Right foot had calf and posterior tib paired together and foot-TA paired. I think it would be good to try to pair calf-TA, and foot-PT and see how that feels next time. I do think having the TA stimmed separate will help with Acquired Flat Foot Deformity (AFFD), plantar fasciitis, and PT tendinopathy, not to mention balance and neuropathy. 2 pads on the foot as I had done before seems like it might be overkill given the small amount of muscle there. I still hate to lose 2 pads on the gastroc, but maybe a larger electrode there might get more muscle fibers as it does not seem like I am lacking for mA with the Globus. 14” strap works well on the foot, and 3” strap when doubled around barely makes it on me so probably a 4 foot strap could be kept looser making application of the pads easier.

I will see if there is any diff in DOMS tomorrow for both thighs and lower legs.

4/1/2013
Hamstrings are a little sore from 2 days ago, calves real sore, but can’t feel any difference between right and left. The pad on my gastroc was put central on muscle and that’s where the muscle soreness is with palpation, not on medial and lateral gastroc where there previously would be a pad each.

4/3/2014
My-Stim program 7 on neck, worked up to 45 mA. Warmup and cooldown on neck are annoying.
Post delt 59 mA, wrist extensors and hand 30 mA on left. Left wrist was sore afterwards even with electrode on extensors. On my right forearm I placed an electrode on the extensors and flexors, skipped the hand, and got to 58 mA on the forearm. I had only slight wrist pain afterwards (I think from prior workouts where I isolated one side). My hand intrinsics felt like they were contracting but not as much as with the grip electrode, grip pressure was immense and a hand grip to prevent finger cramping was absolutely mandatory. The metacarpal region was a little sore afterwards so I think the increase on time of program 7 might be overkill, and I think it might be better to try a split electrode on the forearm (front and back) shared with a grip electrode on the hand (or vice versa) for the best of both worlds, and lower the frequency of contractions 10-50-10 to prevent overstressing the joints of the hands. Good thing my Globus Genesy 1100 is supposed to arrive today, which like my EV-906 and unlike my My-Stim, is programmable.

4/4/2014
I did calves program 7, 51 mA at start, with 2 pads lateral on calves. It lifts me up on toes partially while standing, and I worked to 75 mA. Next time I will try this same pattern on calves with other channel on foot intrinsics and TA. It might be best to skip stim on PT unless there is indication of flat foot, PTT, or PF. Quads sore from yesterday, perhaps from switching back to x pattern stim on them, and perhaps from stimming them with knees flexed ~90 degrees. Hamstrings are not that sore though, when stimmed with same pattern, whatever that means.

I stimmed core start at 40 mA and worked to 50 on front and 55 on back and sides. Hips 50 mA to 57.

4/5/2014
I just got a Globus Genesy 1100 in the mail today. I programmed 10-50-12 into it with a 1 second ramp, 120 Hz and 450 uS. Rest has a 1 Hz mild pulse that I can’t figure how to get rid of, but I guess I can live with that. For some reason it lists 51 seconds rest, but maybe it counts the 1 second rest on to that. I guess I’ll see by doing. I got rid of the warm up and got my workout time down to 12 minutes so that’s cool.

Thigh workout today, did calves yesterday, which is out of sequence so I will have to get the back with thighs, but I guess it doesn’t matter if I do them with abs and hips. The right started at 30 mA and worked to 46, the left from 30 to 50 mA. Immediately afterwards my thighs felt deeply fatigued, maybe more than with the longer program 7 on the My-Stim. I only got to 50 mA, which is far short of the 120 mA the machine goes to, so I don’t see myself maxing it out any time soon, if ever.

On my first time doing stim on abdominals I was able to reach _____. It felt like the hardest abdominal contractions I have ever felt and like I was going to get a hernia if I turned the machine up any further.

4/6/2014
I did my neck with Genesy 1100, put channel 1 on front and channel 2 on back, as opposed to my normal criss cross pattern on neck. I don’t feel a lot of difference either way, maybe because it’s a lot of electrodes in a small area. I started with 30 mA, with my favorite program 10-50-12, and I like that the machine tells you where you are with seconds countdown. I have mixed feelings about the 10 seconds on getting extended because I add intensity during the burst. I got to 36 on the front, and had to back down to 33 because I felt like it was going to dislocate my hyoid. My back got to 40 mA without much problem. I felt like if I went to 120 mA I would likely injure something, so people should keep safety in mind, and with the neck, if the stim wants to shrug your shoulder, let them shrug.

Going back to 10-50-12, the muscle hit harder each time, but you don’t end up turning the machine as high (because those muscles are hitting harder) so it might be good to do some workouts with shorter rest periods, so you can tolerate more current and thus reach deeper untapped muscle fibers, perhaps.

4/7/2014
Core- 30 mA front, 40 mA sides and back to 43-53 mA. Hips started at 40 mA, worked to 45 mA..

4/8/2014
Calves worked to 53 mA, TA and foot to 35 mA. Quads and hams in the 40’s.

I think with the Genesy 1100 every time you up the contraction intensity it adds 2 seconds to your contraction time.

4/9/2014
Neck, criss cross to 35 mA. Post delt 48, forearm front and back 39 mA. No wrist pain.

4/10/2014
Core 34, hips 40 mA

4/14/2014
I did quads 10-50-12 and worked from 45 to 50 mA. I noted that quads do seem to fatigue during the last 4 seconds of the 10 second contraction. Maybe 6 seconds on would be better. For calves (lateral), TA and foot, I got to 59 and 38 mA, respectively. mA limitation on feet is not pain but the ability to keep the stable even when leaning against the wall. Contractions on calves and feet don’t seem to fatigue like the thighs do, but that may be because I’m not able to get a maximum contraction. (I will try braced on leg press at work and see how much I lift, but I don’t think that will be practical.

I think the best pattern for feet and calves, with 4 electrodes, is to do a pad each on foot (I will try flip flops next) and TA each time, and alternate between lateral and vertical alignment on calves.

I’ve been working on a forearm pattern and 2 pads on extensors and 1 gripper and one pad on flexors works really well without being overpowering. Next time I will try 2 pads on the flexors and one each on extensors and hand, but I’m not sure if the flexors will overpower the hands that way.

My body weight is 190 today and I’m starting creatine today to see what happens when combined with ES.

4/16/2014
Today I did posterior shoulders, forearms and hands. My fingers feel uncoordinated several minutes after stim and it is mildly difficult to type. My shoulders got to 60 mA and felt really strong with the Genesy 1100. Hands and forearms I paired hand grip with extensor pad, and 2 pads on forearms and it worked really well. I got to 32 mA (flexors) and 34 mA on grip and extensors on left and 38-38 mA for both on right. The stim felt reasonably balanced and flexors did not overpower extensors even with the 2 pads on the flexors, if anything my wrist felt biased into extension. Even with fairly neutral force felt across the wrist, the intensity I was at put me on the edge with regards to mild wrist strain/pain.

My entire upper back felt fatigued after just doing my basic posterior delt program at 60 mA with 1100 with 450 uS width contractions.

I missed a day training so today I’m doing 2 workouts.

For core I got to 50 mA in the front, 55 on the sides and back, and it felt really strong but I could have suffered through more. Hips started at 40 mA and stayed there because I was reading, but I could have and should have moved up.

Thinking about an optimal pattern for dysphagia, I think you would maybe want a 1-2 seconds ramp up, 2-3 seconds on, half second ramp down and 5-10 seconds rest for 12-15 minutes.

The first try was at a 2 second ramp, 3 second contraction, 1 second down ramp and 10 second rest for 12 minutes (with 300 uS and 120 Hz so I could compare apples to apples between Globus and EV) felt on the money. I started at 25 mA and worked up pretty steady to 50 mA as muscles fatigued and I could take more stim without cranking my neck (at 50 mA I started feeling sensations traveling up to my ears that remained for the last few minutes). If treatment was longer I probably could have gone higher, but I can’t imagine I would need to for effective swallowing treatment, perhaps done daily. I would expect this to be considerably more effective than the Vitalstim machine/program used for dysphagia. This pattern felt like it might be good for headaches as well.

The above pattern worked on my first 2 headaches and decreased pain, but when I tried it with EV, the on time felt a lot less than stated on the machine so it didn’t feel like what I programmed into Genesy. When I set the ramp of EV to 2s and on time to 6s, off 10s it felt about right and was on for what I timed as 6 seconds total, including ramp. It felt comfortable though up to 60 or so mA ,and I tried over my Adam’s apple to simulate dysphagia placement. It felt like it was doing something different and I worked up to 81 mA. My throat was kind of sore and tender after, so maybe it did something. 2 pads on front didn’t feel that strong. I think criss-cross front and back of neck like my normal thing feels like the best combination of comfort and intensity, but if patients have their own home machine they could try all the placements on different days if they wanted.

4/17/2014
My theoretical dysphagia program yesterday worked pretty well as I have pretty good DOMS throughout my neck and upper traps. Today I’m training legs with my current preferred criss cross pattern of 4 electrodes on both quadriceps and hamstrings. I’m doing it with the knee flexed better than 90 degrees sitting at a couch as I type this. I do think changing the joint angle changes the effects of the stim and better strengthens the muscle through a full range of motion, quads contracted and hamstrings stretched one day and the opposite the next. I was able to start at 30 mA for 10-50-12 and worked to 45 quads and 40 hams in that position by the finish on my right. My left started at 33 mA and worked to 51 and 43.

4 electrodes on the quads and 4 on the hamstrings at the same time does feel “right”, it feels balanced and more comfortable than when I was alternating which muscle got 4 and 2 before, and I think this will correct the muscle imbalance I was getting by always doing 4 on quads and 2 on hamstrings. The downside is I don’t have 2 free pads to put on calves. Speaking of calves, I did the vertical arrangement on gastroc and soleus/post-tib combined with TA and flip flop pads for feet. The flip flop pads felt pretty good, but the setup was a PITA because I had to change out the 2 electrodes, keep my wires straight and use another strap to hold the PT electrode in place. I think that’s the major challenge going forward with electric stim for fitness, making all the hook-ups fast, easy, and still effective. Standing against the wall while hooking up pads on feet will be challenging for those with LBP so its probably best done in sitting on your couch or heavy chair that you can stand and lean against once it’s all set up.

I learned that the Globus does not currently let you alternate between channels like my EV does, which is too bad because on calves, even when standing, the Globus picks me up on my toes limiting how intense of stim I can take, so I figured if I alternated between channels I could put all my weight on one foot as the stim activates to better hold me down, then shift that weight over the other foot when it goes. My EV-906 let me alternate, but I never needed to do so as the intensity wasn’t enough to pick me up when standing. The EV-906 felt plenty intense however when sitting or having my foot braced against my coffee table, so I think the discomfort felt when doing so was the muscle cramping rather than contracting or the amount of stim.

My forearm flexors have moderate DOMS from yesterday’s EMS session, unlike a lot of my other muscles my forearms almost never get sore, so I think the pad placement I did will be my new standard unless I come up with something better.

4/18/2014
My quads are super sore today upon awakening from yesterday’s EMS session. The only thing different from usual was having the knees flexed during treatment thus stimming the muscle fibers from a more stretched position, and maybe changes which muscle fibers/motor nerves are within the electrical field. This further confirms my thoughts that stim should be done periodically from different joint angles and perhaps different pad placements. The pad placements I’m a bit conflicted on, however, as I do develop my favorites and I don’t like to spend as much time trying things that don’t feel like they work as well.

I’m raining core today and trying a vertical rather than criss cross pattern on rectus abdominus and will see if that feels different tomorrow. It feels like a good workout today, but no better than usual.

I started at 35 mA and worked up to 50 mA on Globus Genesy 1100.

The battery charge indicator is at ~⅓, which seems more graduated than the Globus My-Stim which shut off soon after it indicated a half charge. I haven’t had to recharge it since I purchased it on 4/4/2014. Not too graduated though because it went from ⅓ to none during my following 10 minute treatment, still stimming strong though with 3 minutes to go so we’ll see if it lets me finish, then I’ll charge it full. Made it. CHARGE AT ~⅓!

4/20/2014
Using the Genesy 1100 on my neck I started at 30 mA, and progressed to 35 (I felt the stim go into my teeth). Perhaps this was a bit much as I felt a lot of compression. The left delt I started at 55 mA and on my forearm and grip started at 35 mA working up to 58/38 mA.

4/21/2014
My quads are still a little sore from the last time. I trained with knees extended this time and got to 50 mA, calves,TA/feet to 45 mA.

4/26/2014
For lower legs, I think my favorite is 2 pads lateral on each calf, 1 on TA and 1 on the sole of the foot. I worked to 56 mA on calves and 42 mA on feet. It uses 2 straps: one for feet and one for calves and TA. If I go with a vertical placement on calves, I would need a third strap which is a PITA to put on. Doing the stim against a couch seems most practical, better than a wall because it’s easier to put the pads on and you can sit down between bursts if you want. With the calves up against the couch it helps to stabilize you during the burst. Still, I lift up on toes uncontrollably around 50 mA, so a better way of bracing would let you work the muscle harder without cramping. I would maybe have to do that on a leg press or calf machine, but that’s not practical for home use. I do think I could take a lot more stim if I could better stabilize my ankles during the stimulation.

For my neck I did 5-20-12. I changed to try some other parameters, still 450 uS, 5 on 20 off. 150 Hz didn’t feel much different than 120 but more comfortable than 75 for which you can feel the separate impulses. They don’t hurt, but a higher rate feels more smooth. A 2 second ramp feels less sudden and more comfortable than 1 second. I started at 35 mA, moved to 41 mA.

I tried another forearm pad placement and it felt both balanced and effective. I paired 2 pads on on prox fl and ex and another pair on grip and distal flexor. I worked to 41 mA on the forearms and I got to 62 mA on rear delt/infraspinatus placement. It is normal for me to get higher with the shoulder than the forearms, which is the opposite of what I feel when I do proximal leg vs calves. Though forearms may be limited more by too much stim causing wrist joint strain, rather than stim tolerance of muscles. Still, I’m nowhere close to maxing out my Genesy 1100.

With 5 on 20 off you certainly feel like you are working harder, and the time passes slower than with 10 on 50 off. I’m not sure if it works better, or if it is good to alternate between different programs.

4/28/2014
My wrist extensors are moderately sore from last time’s session. It may be something to new stim pad placements; it may be new favorite.

5/1/2014
Doing core with Genesy 1100, what can I get to? Start at 50 mA, 55, 60, 65, 70, 75, 75, 75, 75, 80, 80, 80 mA. With more time, I think I could have worked to 85 mA, but I think you can only do that as muscle fibers fatigue and thus give more force. At 85 mA I felt some stinging under the electrodes, but not bad at all, the thing that kept me from going higher was just the overall force of the contractions, which felt like an extreme valsalva maneuver. Contraction intensity felt extreme the whole way from 50 mA, up. I imagine blood pressure increases considerably during. Inhalation is out of the question during contractions. I didn’t feel like I was going to tear muscles and get a hernia like it did when I first started. It will be interesting to see if and how sore my abs get after, as the highest I have been with the Genesy 1100 prior on core was 50 mA on front and 55 mA on back. Thinking about gate control theory of pain, I should say that when the 80 mA was going, it constituted 100% of my attention span for those 10 seconds. I would have to think that nociceptive fibers would have no chance of being noticed under such a barrage. I’m becoming of the opinion based on experience and research, that if you are going to exploit gate control theory to reduce pain, EXPLOIT THE THEORY.

Hips got to 45 mA.

5/2/2014
I woke up today and my abs are pretty sore (DOMS). Not extreme, but I can definitely tell yesterday’s core workout did more than usual. I will see if it gets worse tomorrow. As the day went on they got a bit more sore, but not really suffering.

I did my right thigh with my knee flexed to 90 degrees, what can it get to? Start at 30 mA, 33, 35, 42 quads/40 hams. (When my hamstrings felt cramped I was able to increase quads a lot, then it felt more comfortable to increase hams), 45/40, 50/45, 53/48, 55/50, 60/55, repeat (that’s it). Left 36/31 (I noticed having x-electrode placement across quads, my intermedius does not appear to be contracting as hard as the quadrants, maybe I need to find a more medial dead center placement at least once in a while, maybe arrange electrodes in a + pattern rather than x.) 44/37, 50/37, 53/38, 60/42, 65/47, 70/52. All contractions were real strong, but I didn’t go to where I was climbing the walls.

Bilateral calves, TA and foot intrinsics, unsupported, what can I get to? 21 mA, 22, calves/TA feet 30/22 (sucks!), (sucks!), (sucks!). I’m not moving up because it feels like it’s going to break my left big toe. Unsupported might help to build arch. I tried again after and got to 35 mA pretty easy with calves turned off, and toes went more into extension than hyperflexion. Maybe for fallen arches it would be good to stim unsupported. I’m not sure about adding a pad to TP muscle unsupported though. I will have to try that later. The foot sure curls up though with one pad on the instep and another on TA.

Cosmetically I notice my rear delts have come up a long way. Not quite as full as I want, but I would say about 80%. I might start increasing the reach of my upper body workouts now that weakness is nearly brought up.

5/3/2014
My abs are still sore today, but no worse. My legs are sore but not extreme. I trained neck and was getting a pretty good jolt. I increased preset ramp time from 1.0 to 1.5 sec on my 10-50-12 program. I started at 35 mA and worked up to 50 mA, which was made a lot easier with the extra half second ramp. At 45 mA my ears were ringing. At 50 it tickled my throat and caused me to cough once per contraction. With the slight increase in ramp time, the higher intensity felt a lot more gentle with regards to my cervical vertebrae. My work stimulators don’t have as fine an adjustment of ramp time, but I might increase them all from 1 second to 2 seconds. My neck circumference is now 16.5” (started at 15 ⅞”) and I want to see if EMS can get it to >17”, so the increased comfort with ramp time may allow me to get there, as previously I have been holding back on intensity to prevent strain on the vertebrae which did feel like it was occurring at as little as 35 mA with my new machine. My prior amplitude record was 41 mA, so today got a lot higher. I know I once got to 100 mA with EV machine at 300 uS.

Also, now that my rear delts are catching up, I’m starting to think about what else I want to add into my workout program. I have an extra channel on each posterior delt/forearm/hand workout so that seems like a no brainer to add the extra channel to biceps and triceps. I’ll just have to test to make sure it does not hurt my right shoulder to do so.

5/4/2014
For my L UE I started at 60 mA on the rear delt, 31 the rest, and worked to 65/36, then 70/40. For my RUE I went straight to 70/40 which felt severely strong but not particularly painful. Higher than 40 mA on forearms I think would overstrain my wrists. I added a pad to biceps and triceps, which is the first time I trained biceps and triceps in months. It didn’t seem to overstrain my arthritic right shoulder. Funny as biceps felt like they were winning the cocontraction war but triceps felt especially worked afterwards. Also, I kept biceps and triceps at 40 mA, equal to my forearms which are limited by wrist pain/strain. Next time I’ll try to work them up to intensities more equal to my posterior delt (closer to 70 mA than 40 mA.)

Applying pads to the arms is harder than everything else because you only have one hand to do it. Straps work but are a PITA. I need something better but have no known better options. I’m still thinking of a way to best strap and hold pads in place for pecs. Maybe I’ll add a chest and back workout or maybe I’ll add pecs with neck without adding a workout. I want to add only 1 workout to core day so it’s 3 workouts daily. So I could have an entire back workout. I could also add rear delts to my back program, and pecs to arms, but I’m not sure I want my pecs working unopposed as it might be too much strain on my shoulder capsules.

5/7/2014
For my neck I got to 45 mA before I was stopped by what felt like cramping around the hyoid region. I relaxed and later got to 50mA at my usual 450 uS. I have to think this intensity would really have me training my swallowing ability if I had dysphagia. I haven’t tried the Genesy 1100 directly over the throat like they do with the VitalStim.

My triceps are sore from 2 days ago.

5/8/2014
I did stim on one arm last night (triceps still sore bilateral) and this morning did the other arm and DOMS felt the same as far as I could tell. So another stim session does not seem to have much effect on DOMS, about the same as lifting weights again.

5/31/2014
It has been awhile since I have blogged. Not a lot of changes, but went on a road trip to Zion National Park so I missed some EMS workouts. I brought my Globus 1100 with me and still did some neck workouts and read some studies on EMS and lymphedema, edema and cerebral palsy that I will have to blog about later. One change I am playing with is trying a 5 on 15 off for 12 minutes (5-15-12) program rather than my prior favorite of 10-50-12. My patients with back pain, neuropathy, and headaches (who all liked the 10-50-12) say they like the new program better and maybe for pain it is, because the stim is on more often. But maybe it just feels like it is, because 10-50-12 was very effective. For strength I don’t know if one is better or not, but I’m going to try it for a while. I expect I still won’t be able to tell, but I’m curious to see if it lets me work to higher intensity of stimulation due to what I expect will be greater fatigue. So I’ll compare mA levels to what I achieved below. For my neck I just got 53 mA at 450 uS pulse with, my prior best was 50 mA on 10-50-12 so it was a little more. My hypothesis is that the 5-15-12 would be better for increasing muscle endurance, if not strength, due to the shorter rest times and the stim being on 25% of the time instead of 16.7% with the 10-50-12 program. It might be I’ll adopt a few favorite programs and alternate through them similar to what some non-linear periodization programs do with strength. Part of what got me thinking about this is I just purchased the SpeedCoach programs for my Globus 1100, which comes with a linear periodized plan to vary electric stimulation programs in conjunction with speed and strength training for sports. Since I’m not trying to peak for any particular event, I think, for me at least, it’s best just to alternate though my favorite duty cycles, trying different things out, and trying to see if I can tell any difference. I have to admit that at this point I think EMS (much like weightlifting) is a blunt instrument and I don’t expect small variations to have much effect on performance or sport outcomes, so I’m suspicious that attempts to periodize training with EMS by fine tuning the parameters will lead to much if any change in performance. However, the variation does keep it interesting, but I expect I’m not going to discern much difference so I will have to hope that randomized controlled trials start testing various EMS protocols against each other with regards to strength, endurance, and hypertrophy, of which there has been very little of so far.

For my right UE I worked to 75 mA on post shoulder, biceps and triceps and 55 on forearm and hand (forearm and hand intensity by perceived wrist strain and my wrist was sore afterwards. Prior record with 10-50-12 protocol was 70 mA on my shoulder and 40 on my forearm and hand. 75 mA on my shoulder and upper arm definitely stung, and the stinging/pain feeling under the electrodes is something I only notice when using >60 mA at 450 uS. I have a feeling this might be when the intensity gets high enough to depolarize nociceptors, which in theory do take higher levels of stimulation than do motion and pressure receptors and more than it takes to depolarize muscle. I brought some of my (much) larger electrodes home because I want to see if larger than my current favorite 4” round rubber carbon electrodes, will let me take the Globus comfortably higher. This was never a problem with my EV-906, I think, because the machine just wasn’t strong enough. The difference might be academic, however, as the problem I noticed before when I was using the super large pads (4” x 6” and 5.5 x 7.5”) was that while they were more comfortable, they were just too large to put many of them on a muscle. So in quads where I prefer 4 of the 4” pads, there just isn’t enough room to fit 4 of the larger pads on my quads, so overall current is less. The left upper extremity got to 90 mA on my posterior shoulder, biceps and triceps and 55 mA on my forearm and hand (and my left wrist was sore afterwards as well). 90 mA is the highest I have taken the Globus Genesy 1100 on any body part so maybe there is something to the 5-15-12 protocol. However, I should be cautious about any conclusion because I have a feeling if I put the machine on continuous I could bring it it up to the max 120 mA over time as my muscles fatigue, and I expect that would not do much to build muscle (which would be as dumb as the VitalStim protocol used for dysphagia).

Another thing I’m working on is optimizing the strap situation. With my 4” straps, with 4” wide velcro I found out they attach end to end very well and have no trouble holding firm. In fact, the velcro is, at times, annoyingly strong. When I last ordered straps I ordered many different sizes from 16” to 48”, and they all pile together in a big mess. Plus, the variety of sizes does not let me lessen costs much with a bulk purchase. So I’m thinking about getting rid of the larger straps and just linking together several of the shorter ones to make a “do everything” set up for a single lesser price. So 5 of the 24” just worked pretty well for arms and neck and I expect will work well for everything else, but I’ll test that out in the coming weeks as I’ll be having to make a new order soon since I am running low in the 36” straps that a lot of my patients are buying to work “core” at home. The 24-inchers linked together I think will work just as good, be more universal, work better on arms and legs, and with a bulk purchase will likely be a less expensive option. So far, the best thing I have noticed is I can link them all together and fold them up real nice, being both neater and taking up less space than my pile of assorted sizes. That lessens the PITA factor, which I think is the primary deterrent to EMS use at home.

6/1/2014
On my core I got to 75 mA on 5-15-12 which is not as high as my best of 80 mA that I got to on 10-50-12.

6/2/2014
On my right thigh I got to 50 mA, which is about the same as what I get to with 10-50-12.

6/5/2014
After a few days training with 5-15-12 I can’t tell that it’s better or worse than 10-50-12, but it does feel different. I have started alternating them, which feels like a good compromise. I switched over to 5-15-12 on my patients as well, some liked it more, some less, some said it felt about the same. So if 5-15-12 is at the high end of duty cycle (25%) and 10-50-12 the low end (16.7%) in the research for strength gains, I might play around with some programs in the middle. Also, I am not sure if duty cycle is everything or if there is much difference between a 5 and 10 second on time. 10 seconds on really does feel like it wrings the muscle out, more so than 5 seconds, so maybe a 10 on and 20-30 second off would be good to try, maybe particularly so with my headache patients as it might better stimulate/fatigue the occipital nerve.

Also, I want to try some of the endurance protocols again with my Globus. I was not that impressed when I tried them before with my EV-906 but as I recall, my pulse width was weaker than what the researchers used (400 uS), but my Globus goes up to 450 uS. I don’t expect it to be a great workout cardiovascularly, but it might be better than nothing. My last attempt at an electric stimulation cardiovascular workout felt only marginally better than nothing.

Also, I’m reading papers on electric stimulation and diabetic neuropathy and just tried out my flipflop electrodes again with the Globus. With one channel and one wire per foot at 450 uS, I was only able to tolerate 30 mA on the first couple pulses. I’m sure I could work up to more over 12 minutes, but the machine was pretty strong. I felt very strong foot contractions, as well as paresthesias up to my knees, and contractions up to my of both calves and TA (that were weaker). So I think there might be some benefit from splitting a channel between legs, particularly for those with nerve problems. With two electrodes under the ball and heel of the foot, Charlie Francis style, the contraction felt entirely localized to the intrinsic muscles of the foot, the stim felt sharper, but the muscle contractions surprisingly did not feel stronger even though I was able to go straight to 35 mA. Trying the flip flops again (again to 30 mA), it still felt like foot intrinsics were going stronger, but it’s likely my toes were just curling more because the flip flops got more of the extrinsic foot muscles. Flip flops still felt like the best workout.

Also, I tried 2 pads on one foot (top and bottom) and was able to get to 50 mA immediately, with what felt like weak localized contractions. So either the foot intrinsics, if targeted alone, aren’t that strong, or the top-bottom electrode placement had a lot of the current just go from electrode to electrode through the skin but not the muscle. Last, I tried closing the tops of the flip flops but there was no way, so I just cut the straps off with a scissors to get them out of the way. They’re still a bit small for me, but usable. I have another style at the clinic and will probably cut those straps off too as they just get more in the way than anything else.

6/8/2014
I wanted to try out electrode placement above my eyes as done in the percutaneous stimulation studies for migraine headaches with my 5-15-12 and headache/dysphagia (ha/dys) protocols and at 450 uS, just 10 mA feels pretty strong and 15 mA was all I could take at first and each additional mA felt like a substantial increase. I worked up to 20 mA and anything above 15 mA was painful, 18mA and above and it started making my teeth clench. After 20 mA, going back down to 15 was a pleasant buzz. I will have to create a program that mimics that headband thing to see how that feels but this felt pretty stout and will have to try it out on my headache patients. Stimulation felt strong but superficial with no noticeable brain effects, though I can’t say I know what that would feel like anyway.

6/10/2014
Set up Cefaly parameters in Globus, (Constant TENS, 60 Hz, 250 uS (16 mA max) for 20 minutes)over the supraorbital nerves and it felt pretty strong at 15 mA. 16 mA was unpleasant, at least at first, using a pair of my larger 10 cm round electrodes (total area 157 square cm). They used a single 3 x 9.4 cm electrode = 28.2 square cm. What was interesting was that with the constant current at 15 to 16 mA, if you decreased 1 mA you could not feel a thing, so I think you accommodate to the constant TENS pretty quick. If you go down to 1-2 mA and work back up you feel it again, but top down feels like nothing. I suspect, however, that at 16 mA a lot of people will find it painful. I got used to 16 mA after a few minutes to where it didn’t hurt. I tried again with a pair of 4 cm x 4 cm (total 32 cm) to better mimic the Cefaly headband and it hurt a little more at first but I got used to it the same as with the larger ones, being less of a difference than I expected. I’m pretty stim tolerant so I expect a lot of headache sufferers won’t like 16 mA, and in the study that was a big complaint. One potential problem with the Cefaly device was that it was described as going up to 16 mA automatically unless you stopped it, and apparently none of the people who didn’t like it knew to do so, so rather than limit the mA they turned it off. I think it might be better if they could manually control the increase (like on a normal TENS machine), rather than have to stop an automatic increase.

6/12/2014
EMS neck 10-50-12 got to 55 mA (new record), holy shit! It sure feels like it will put my bloodpressure up and not down. Swallowing was impossible during the “on” phase.

6/13/2014
I maxed out Globus Genesy 1100 today with 120 mA (had to work up to it) with 450 uS on 5-15-12 on my calves with 2 pads placed lateral on each gastrocnemius. I did it on leg press with my calves braced with 450 lb to prevent cramping. It worked and probably is the way to do it going forward. That amount of EMS was very extreme but tolerable with feet braced to prevent cramping. I would not have been able to tolerate it at home with just bodyweight bracing the calf.

My neck has only slight DOMS from 2 days ago.

I’m working on pecs and a lateral placement of 10 cm round electrodes on my right pec does not feel like it gets the full pec. I got to 50 mA for 10-50-12 without much difficulty. It feels like it misses the muscle fibers above and below the line of fire (so to speak). I can’t figure out how to strap a more high-low electrode placement so I will try larger electrodes. For my left pec I used super large electrodes, one on pec and one posterior on lat. It felt better and I got to maybe 65 mA ,but flatter coverage felt like a more complete contraction. I might want a wider strap to go with wider electrode, maybe 6-8”. I will see what left vs right DOMS feels like in the next 2 days.

6/14/2014
My calves are getting sore but not extreme. I did core 5-15-12 and got to 70 mA at the end without a lot of difficulty. It was pretty strong, but if I were trying harder on the way up I think I would have gotten higher. Actually, 2 days and 3 days later, DOMS got bad enough that I was limping slightly, so it was pretty intense. Not the worst it has been, but the worst it has been in a long while. Sitting on the leg press for 12 minutes taking 120 mA, however did not seem to be any easier or faster than just doing calf raises there.

6/23/2014
I got to 85 mA on core with 10-50-12. I started at 35 and kept working myself up. I didn’t really feel any stinging sensation this time until 75 mA. My hips got to 72, starting to sting around maybe 65.

6/27/2014
I’m reading a paper about EMS and intermittent claudication in which they used a Compex stimulator set up at 250 uS for 20 minutes. So on my Globus I wrote a similar protocol, but set the pulse duration at 450 uS, figuring that would be stronger and better, with 2 horizontally placed electrodes on my gastrocs. I went up to 54 mA and let the machine run and definitely felt some muscle burn at 3-4 minutes in. I thought about turning the machine down but will try to keep it up to see how I feel after.

I worked up to 93 mA for a brief period, came back down, and then went up to 120 mA for a few seconds. It was definitely painful, with pain getting bad as I crossed 90 mA, but I was able to get there and there was no foot cramping or noticeable joint stress because the twitches were so brief.

The legs do just twitch so I don’t get the cramping I do with the high frequency EMS settings. After 11 minutes, the burning feeling in my calves went away, perhaps due to fatiguing muscles producing less lactic acid as they began to give up the ghost, so I increased the mA to 70 and felt the burn again, which lasted the rest of the 20 minutes. Active twitching lasted the entire 20 minutes.

I may not be cramped up, but my feet are definitely plantarflexed during and it’s difficult to actively dorsiflex during, which felt like it would be a pretty fair dorsiflexion exercise to actively try to dorsiflex during.

I wrote a new program immediately after, but with 250 uS pulse duration as used in the Compex, and it felt like it would work just as well. I had to go up to 100 mA to make it feel like the 70 mA at 450 uS. As a treatment, I think I would rather have the 450 uS so I have the increased power available if needed, as I think at 250 I might eventually max it out as tolerance increases. For my patients with nerve or muscle damage, I suspect 250 mA would not get a powerful enough contraction. It might be worth a test though because all I would have to do is program in 2 separate treatments and try one or the other on them.

Also, I tested out my trigger finger treatment EMS brace and it felt like it would work, but I think it can be improved with padding to better support the fingers, prevent slipping, and maybe hold the pads in place without need of straps. I still need to figure out how to hold the boards shut. For my test I just pinched them between my knees, which was a PITA, but definitely felt like I was getting a lot of tendon pull without putting any stress on the finger pulleys.

Incidentally, I hooked up the EV-906 to my core yesterday at work, showing patients and staff how I could go immediately to 100 mA, and let the treatment run since I was hooked up. It did not feel as hard as my Globus, but it certainly wasn’t meaningless, and today I have DOMS in my anterior abdominal muscles. I have to say the smaller machines are still pretty good, and there is something to 5-15-12

6/28/2014
I wrote an hour long program on Globus at 6 Hz@450 uS. The maximum length of a program is 30 minutes so I added a second phase and put 30 minutes on that. I’m doing only my left calf as I want to know DOMS differences, if any, compared to treatment of both of my legs from last night. I started at 60 mA and that got me about a ¼” heel bounce off of the floor while sitting. After 9 minutes I moved to 70 mA. At 15 minutes in I moved to 80 mA (ouch). I went down after 15 or so minutes to 70 mA which was mildly uncomfortable. 60 mA was completely comfortable with no pain at all. It didn’t feel like the contractions weakened over time, more like a constant bounce the whole hour. It felt reasonably aerobic to the calf muscle, though my breathing and heart rate did not increase noticeably. My “C” pads are just over 6” in diameter, and I think another 1-2” would maybe be better so I’ll try to get some samples of a larger size if available.

7/3/2014
I tried out the “chest” or “C” electrodes on pecs and they seemed to work pretty well. I got up to 65 mA, which was comfortable, but 68-70 mA started to sting pretty good. I think a wider than 4” strap would make them work even better. They felt like reasonably strong contractions with no noticeable shoulder stress with my arms at my sides. I wonder if with the close proximity of the electrodes more of the stim just goes through skin and does not get as deep in the muscles. It was a lot easier to setup the dual pads than using singles front and back. I think I’ll stick with them for a while and see what happens. Probably I will pair this pec protocol (bilateral using 4 electrodes) with my neck that also uses 4 electrodes to increase workout efficiency. I think I will have to try a front and back compared with C pads on right vs left side to see what difference I feel.

7/8/2014
I’m going to try daily neck stim starting today and see if that increases hypertrophy. I’m at 16.5” right now and have been static at that point for a few months. Interestingly, 5-15-12 pumped up neck ¼” to 16.75” immediately after. I’ll have to compare that to some other parameters. I tried a 3-12-12 to see how that feels with a shorter contraction, shorter rest, but a 20% duty cycle which would be intermediate between the 16% of 10-50-12 and the 25% of 5-15-12. It seemed cool. Also, I tried a 2-2-12 on hip musculature and it made me sweat with house at 72 degrees. I tried 2-2-12 on my calves and worked to 42 mA (unsupported). It felt like it would really increase circulation. Maybe I can test different protocols on calves and see how much pump I get on different days or different protocols on right vs left. My calves felt tight/pumped/fatigued for a while afterwards, more than I would expect for such a light intensity without foot support.

7/9/2014
I tried 2-2-12 on my neck. It felt pretty strong the entire time. I worked up to 50 mA at 7 minutes and got to 52 mA at 10 min. My neck felt fatigued after and post stim to 16 & 11/16”, but didn’t do a pre-measurement.

7/10/2014
My neck circumference was 16 ¾ ” in the morning, and in evening I did 5-15-12 parameters. I worked to 60 mA. I only gained 1/16” of pump after though.

7/12/2014
I tried a moderately light intensity (up to 40 mA) 2-2-12, on thighs, knees bent and laying sideways. I would not say it was comfortable, but not painful; I don’t think I could fall asleep to it. My calves are still sore from the last time on 7/8/2014. My neck circumference is a solid 16 ¾ cold. Neck stim at 25 mA I did fall asleep with.

7/19/2014
I think I figured out how I like stimming my pecs. Just use one channel, criss-cross the straps, and use two extra large electrodes (~4”x6.5” rectangular), one on each pec. Interestingly, I was able to work up to 120 mA (10-50-12) surprisingly comfortably, I think due to the extra large electrodes. With smaller ones I don’t get anywhere near that high, which confirms my earlier suspicions that even with my 4” circular electrodes (that are pretty big) at some point (around 70 mA) I think you start stimulating nociceptors. With larger still electrodes you can get higher. The only problem with larger electrodes is it gets hard to fit them on a muscle. Still, I might have to try and get some 5” circles and maybe more of these 4×6.5”s.

7/23/2014
I did 2-2-12 at 450 us on my neck today up to 70 mA, and it was pretty intense, felt tingling bilaterally in my hands over 60 mA. Also, I’ve been losing weight due to eating less: my bodyweight is down to 182 lb (from 186-192 in weeks prior) and tested my bodyfat at 7.6% which is a new low for me in recent years. Due to the fat loss, much of my double chin is gone, which looks better, but my recent increase in neck circumference is gone too, now back to 16.5”, which is good given the less fat but not good in that I wanted to increase neck circumference to 17” with the use of EMS. The last few weeks I have been doing daily or nearly so neck EMS, but I don’t think it makes much difference and probably every other day is just as well, as is shown in the research, so I think for the neck I will go back to every other or every 3rd day as I was doing before, with the extra EMS time I was putting on the neck probably better spent on pecs or UEs.

8/6/2014
In hindsight, playing with a number of different duty cycles, if I were to only allowed one, my favorite I think is 10-50-12. It works real hard, even if I take a few days off, I subjectively notice it tones me up at least as well if not better than the others, and I just worked up to 90 mA on core with it, which is a new record. The muscle contractions felt, in a word, immense at 90 mA. I still get a stinging sensation under the pads over ~75 mA, and at 90 mA on the core it’s one hell of a valsalva maneuver. I would imagine my blood pressure is going through the roof due to such a strong isometric contraction. I think my earlier idea that I could work higher with a 2-2-12 or 5-15-12 (with the idea that lesser rest would increase fatigue and let me work higher) seem unsubstantiated. So maybe Yakov Kots and later Charlie Francis were on to something.

Also, in the hours after my 90 mA core workout I felt considerably more muscle fatigue and soreness than I get with a typical workout of 50-60 mA, so for me at least, I feel like the stim is continuing to work me harder, and not at all like the 50-60 mA gets all there is to get with the core musculature.

8/7/2014
My abs are pretty sore from 90 mA yesterday, with DOMS and/or some other pain a solid 2” up into ribs. Lateral calf placement got to 70 mA in standing which put me up on toes. I could flatten on one leg with the cramping not too bad on unloaded leg, maybe you just need to get used to it. I did a top and bottom foot intrinsic placement unloaded and got to 42 mA on 5-15-12 and it felt pretty intense. The stim is still more comfortable, as I recall, when I stand on them. I again think unloaded might be better if you are trying to restore the arch of the foot as you are not already flattened out to the max if you overpronate. The thing I don’t like with the top-bottom placement is that even with 4” electrodes, it feels more focused (like 1”) in the foot and does not feel like it’s maximally working the entirety of the foot intrinsics the same way it does when you stand on the electrodes. It is nice to not have to stand during the treatment though, so maybe a mixture is ideal.

I tried my largest electrodes (5.5×8”) with one channel shared on my pecs with lateral 8” strap, placed lateral over shoulder, and I still get poor contact but was able to get to an early 65 mA but does not seem immediately much better than with my blue (4.5×7”) electrodes. I still need to press them down with my hands to get the best contact and contractions, but even at 80 mA it does not feel that strong. I will try a criss-cross with 8” straps next time to see if it’s better but this way it is hard to turn up the machine intensity while you are using both hands to keep good electrode/skin contact. I think I could get to 120 mA with relative ease but perhaps not better than with the blue electrodes. Maybe a front-back electrode placement with the pink electrodes on pecs and blue electrodes on rear delt/post RTC would work better also. Afterwards (of 5-15-12) my pecs did not feel that fatigued so I think they really need 120 mA, but I’m starting to think the pecs are not an ideal muscle to try and work with EMS. It may be better to just do regular exercise if that is an option, but I’ll keep working on it.

8/9/2014
My abs were only a little sore but lower ribs are still tender to the touch and were worse yesterday than abdominal musculature. I’m not sure if the high tension at 90 mA stressed the ribs themselves, the attaching abdominal tendons, or if it recruited my lower intercostals and they got DOMS. It does not feel at all serious but certainly feels worked like never before.

I’m still working on an idea for a plantar fasciitis stim pattern, and again tried the Charlie Francis method of standing on 2 pads and worked up to 40 mA (5-15-12) which is a little less than the 42 mA I got with the unloaded top/bottom foot placement. Then I tried standing with a single huge electrode under each foot (8×5.5”) like the flip flops and it felt considerably stronger at only 32 mA (with a lot more toe curling) than either electrodes under the feet or top/bottom placement. Maybe that’s the ticket for plantar fasciitis, as I felt like I was getting a pretty strong calf and TA contraction and was having difficulty standing up straight, with my shins wanting to push backwards. It felt stronger with just the single large electrode under the feet than when I added an extra channel one leg with electrodes over TA and TP muscles. The 8” long electrodes were a little short so I had my feet diagonally on them which worked but might not work so well for people with larger feet. I’m a size 10. A padded surface under the soft but flat electrodes might give even better contact.

8/16/2014
The other day’s work testing on electrode placement for a plantar fasciitis condition has my lower calves real sore, not so much my gastrocs but lower in the soleus, toe flexor, posterior tibialis region so I might be on to something with the flip flop to TA channel combined with the 2 lateral placements on the gastrocnemius. Unfortunately or fortunately I also retested (but only for a couple minutes not an entire workout like the prior) the split flip flops one per leg and it felt every bit as strong by itself, but I don’t think I had it on long enough to be responsible for today’s DOMS.

8/17/2014
I did arms today for the first time in a few weeks with 10-50-12 settings. I tried to do some different electrode placements, actually the same placements as my favorites but changed up wires to keep the channels as far apart as possible to hopefully get some deeper contractions. I just finished and it’s hard to say how well it worked, felt at least of regular strength, but fingers sure feel fatigued and it is hard to type afterwards.

8/26/2014
I tried just 2 channels/4 pads, but big pads (8”x5.5”) placed on quads and hams with blue on distal quad and proximal ham, and orange on distal ham and proximal quad to criss cross through the leg. It felt strong, worked to 85 mA (with stim feeling comfortable with big pads), felt like good central contractions on the right, and felt really fatigued afterwards. On the left I put channel 1 on quads and channel 2 on hams to compare after (should have done concurrently). On the left I worked to 75 mA and it felt less comfortable, maybe with contractions feeling less deep, and I felt less fatigued after. I will see if there is a difference in DOMS in the next few days.

8/27/2014
I tried calf (lateral), TA, and foot flat placement of electrodes and split all pairs between right and left leg on 5-15-12 to see if it felt stronger like just the foot ones alone do. It was pretty strong and at 29 mA my heels first started to lift up. I did a big calf raise up at 30 mA, at 31 mA, I got another big up, slipped, and fell on my a-s- s. I still worked up to 33 mA after, but I had to hold onto the table to maintain balance. My impression is that splitting up the foot electrodes does a lot, but I’m not sure that splitting up the other ones made as much of a difference, so I think I would have to try each individual muscle independently. Also of interest is that while I feel paresthesias up to my knees by just standing on the electrodes, having them higher on calves did not make the paresthesias go higher, with them still feeling like they stopped at the knees. Still felt like a pretty good workout but for me, I think I would still have to brace my calves in a leg press to prevent cramping. I think I want to try the split feet electrodes reclined with my feet up to see if cramping is intolerable or if it’s something I could work up to.

9/3/2014
I’m experimenting with more criss-crossing of pads from right side to left on hips creating an “X” pattern on gluteus maximus and combining right hip abductors and left hip adductors and vice versa. Using 10-50-12 the stim feels comfortable but strong at 40 mA and real strong at 50 mA. It felt different, like it might be stimming deeper and hitting more or different muscle fibers than my prior way, which I generally used ~50 mA, but once worked up to 72 mA. Ideal might be to move it around a bit. I think next time I want to try right hip extensors crossed with left hip ad and abductors.

On my thighs I tried a criss-cross right-left, quad to ham pattern, with 4” pads working both thighs at once and got to 55 mA, which felt like it was working both legs pretty hard. With my central placement with 2 pads vs quadrilateral it felt like I was getting central muscles better, but I felt like it would have been better still with the super large pink electrodes. The only problem is that I need to get 4 more of them to test it out. Still, as I worked up the stim it felt like the contractions were pretty complete for the mA level and only 2 pads per quad and 2 per ham, so I think I’m really starting to like crossing sides of the body to keep each channel as far apart from each other as possible. I’m still not ready to say that’s the way it should be done all the time, but going forward for the time being I’ll continue with it some, if not most of the time. I do like getting both thighs done at once as it saves workout time and hassle, making me more likely to do it.

This got me thinking, what would happen if I did the exact same as the above but instead of placing the pads anterior and posterior (4 per leg), what if I did medial and lateral? It might get some real good contractions right under/nearer the IT band, and maybe hit adductors a little different as well. I expect it might be dumb because I’m already hitting quads and hams hard and they are what’s right near the IT band, but it will be interesting to try it and see what I feel, so next time.

9/5/2014
I took 1.5 weeks off from stim, wasn’t eating as much and lost 5 lb, and when I got back on my stepmill was unable to do my normal level 12 intervals for 20 minutes on 2 consecutive workouts. I did near total body stim over the weekend and gained 6.5 lb the following day and got all 20 on stepmill with relative ease. I maybe ate a bit more but not 6.5 lb in the time off, so I wonder if the EMS caused an increase in glycogen synthesis and thus increased water weight and perhaps that helped with the stepmill performance. I know there is a couple of studies related to EMS (but more of a TENS pattern) and recovery in sports performance with the increased recovery being unexplained could be related to glycogen and perhaps some muscle “potentiation” whatever that is. All I know is if I don’t do the stim for longer than a week my muscles appear to deflate and I have less energy and just one EMS session and I look and feel pumped back up, in bodybuilder terms.

9/5/2014
I did calves with 2 pads lateral to each other, non-weight bearing, and split channels per leg. I got to 40 mA on 10-50-12 and it felt pretty intense, it was all I could tolerate. It would be a good comparison to do the exact same protocol but with one channel per leg instead of split. I felt real sore/tight immediately afterwards.

9/8/2014
I did calves just as last time but with one channel per leg, non-split. It felt as strong as splitting and only got to 37 mA, not 40 mA like the last time, but afterwards did not feel as fatigued so I’m not exactly sure what to make of that.

9/14/2014
Continuing with my theme of doing EMS with electrodes on a single channel as far apart as possible I did core, but paired low back left with abs right, and vice versa, and oblique left with abs right and vice versa. It feels fairly strong at the start with only 34, at 40 mA feels real strong and ‘different’ and I was able to work up to 65 mA without trying my hardest. Afterwards I would say it felt different, it felt like it was working well, but I can’t say that it felt like it was working better or worse than what has been my go to pattern. Still, I think it might be worth switching it up with an effort to reach different muscle fibers for an overall greater treatment effect.

9/16/2014
I did regular calves, lateral pad placement with one channel per leg, but unsupported. I only got to 37 mA and thought the cramping feeling was most unpleasant. Not a lot of difference in mA reached vs splitting the pads, but I didn’t feel like my muscles were working that hard.

I immediately redid the treatment but split the channels between right and left and the stim immediately felt stronger throughout the lower leg with paresthesias well into the feet at a lower mA (BIG difference). I think you get a better overall contraction, recruitment of more muscle fibers with a lesser feeling of cramping. Maybe with the closer electrodes you get more cramping of fewer muscle fibers. Splitting the electrodes the second time I got to 39 mA. Maybe the increased paresthesias from splitting the electrodes masks the uncomfortable cramping feeling you get when they are not split. I felt like I was getting muscle contractions throughout the lower leg besides the calves with the split electrodes. The intensity was still limited by the cramping feeling with the split electrodes, it just felt like I was getting a lot more out of the workout for the same level of pain.

I stood up and walked a few seconds after the non-split electrode treatment and my calves felt almost normal. I stood up after the split treatment and felt a feeling of immense muscular fatigue in the calves, very similar to what I reported when I did the same on 9/5/2014 when I split the channels, but not on 9/8/2014 when they were non-split. I’m talking about a BIG, UNMISTAKABLE difference! So it’s resolved, splitting the channels between legs leads to a much stronger feeling workout, with no increase in discomfort during that workout. Very interesting! I’m going to have to try that now with my arms. Maybe my shoulders first as it’s hard/impossible to control the machine when both arms/hands are cramping.

9/17/2014
For foot intrinsics with the EV-906, the EMS felt slightly stronger with the black electrode on the ball of the foot and the red on the heel, Charlie Francis style. Splitting the channels between right and left legs the stim felt much stronger up to about the knees but a localized foot intrinsic muscle contraction may be felt stronger with the Charlie Francis placement of one channel per foot. I think with the Globus being so much stronger of a machine it might not matter but I will have to try it again.

I did rear delts today splitting channels between right and left and it did feel stronger than my normal way. I was only able to work up to 38 mA, compared to 60-70 as before. It might be that there are times you want to split the channels and times you don’t.

9/22/2014
I did calves unsupported 5-15-12, with split right and left (SRL) and only worked up to 23 mA today. I’m curious as to how I feel after since I haven’t done 5-15-12 in a while. I felt moderately fatigued immediately after, either because I didn’t get as high as the last time or 5-15-12 isn’t as good as 10-50-12.

I did 10-50-12 SRL on quads and hams getting both legs worked together. I got to 41 mA and it felt pretty damn strong. I think this would be the bomb with the super large electrodes but I’m having trouble ordering more from China. Even with the 4” circles it feels pretty strong and comfortable. It definitely feels like a lot more muscle contraction per mA delivered compared to one leg at a time, even with half the number of electrodes (4 vs 8) per leg. I will have to try this with the EV-906 to see how strong it feels with this workout but if I’m only getting to 41 mA with the Genesy the EV-906 might still be pretty good. I definitely like getting both thighs done at once instead of one at a time.

With hips I did 10-50-12 with a new SRL pattern and got to 46 mA. It felt pretty strong; it felt like it was causing more involuntary hip extension than my prior pattern, even at 37 mA. It made me work up a sweat just sitting on the couch typing, so I imagine I’m probably burning some number of calories.

I got to 70 mA on 10-50-12, for the 2nd time ever and it was pretty hard and I had to be careful not to bite my tongue because I could not open my mouth when the stim was going. I didn’t feel the paresthesias go into my hands this time though.

9/23/2014
I did SRL posterior delts and shoulder external rotator pattern I only got to 40 mA compared to 60-70 mA with my prior pad placement. The contractions felt plenty strong but were limited by right shoulder pain, (arthritis related rather than stim related) but felt fine immediately after.

I did the Charlie Francis pad placement on my feet with 5-15-12 and worked up to 47 mA and got a very localized-feeling contraction of the foot intrinsics. I could see my foot arch rise and fall with every contraction. I followed it up with SRL immediately after and I did not notice my foot arch rise so much but it certainly felt more globalized (everything below the knee), but perhaps less focused and intense on the foot intrinsics themselves, though their contraction/foot motions might be masked by the overall intensity of stimulation feeling and co-contractions of other muscles. It’s hard for me to say which is best, with both feeling of value, so it might be best to trade off. I’m sure the foot intrinsics are contracting with the SRL because everything else is, they just may not be going as hard. Got to 38 mA on SRL with 2 4”pads under each foot just like placement but with wires switched to SRL. Now that I am finished, both seem good, so I would probably switch off the different pad placements when treating plantar fasciitis, posterior tib issues, shin splints, or trying to build up the arch for patellofemoral pain, but would go with the SRL when treating neuropathy or intermittent claudication. The contractions felt as good to me with the 4” electrodes as with the flip flop pads, but you use an extra channel on the machine to do so. I think a single channel on the Globus works just fine to power the flip flops, but the EV-906 (not being as strong) is much better with the pair of 4” electrodes per foot.

9/26/2014
Core yesterday with a SLR pad placement. I got to 100 mA for the first time, which is my new record and it felt pretty intense, and I did it in standing and had to hold onto a table for support when the stim went. I did the 10-50-12 program with the Globus Genesy 1100. Waking up this morning my abs are sore already but not terrible. My low back muscles have a little DOMS too, which is something I don’t recall feeling before. My abs have been sore a lot, but not my erector spinae to my recollection.

9/27/2014
My core still fairly sore from 2 days ago, and the lower 3” of my ribs are sore too.

I did thighs with the new SLR electrode placement as I did last time, but with the EV-906 instead of the Globus Genesy and it felt reasonably strong. Probably more than most people can take, but I was able to get to 100 mA right from the start, with it not feeling as strong as when I put 8 electrodes on each leg with the same machine. Towards the end of the workout I found that with effort I could both bend and flex my knees with the stim on and I couldn’t do that with the Globus at 41 mA. I put 8 electrodes on my one leg immediately after and it was considerably stronger stim so the increase in electrode distance doesn’t feel like it compensates for less channels and total current in this case with the less powerful machine. I was still able to get to 100 mA right from the start though.

After the left thigh workout, it didn’t feel that hard and my muscles didn’t feel that fatigued, in contrast to the 100 mA I did on my core with the Globus yesterday. I suspect for strengthening that you eventually get used to a given current level, like you would get used to a given resistance level when weight training, and if you stay at that level you would just maintain, with either the weights or the EMS, but if you want to continue to gain, you have to continue to increase the EMS intensity just as you would want to continue to increase your weights when weightlifting.

9/28/2014
I’m going for a new record on neck at 10-50-12 with Globus Genesy. My old record was at 70 mA, at 60 mA my biceps start contracting, not hard but they started flexing against gravity. Ok, I’m stopping at 75 mA with 6 minutes to go because I can’t inhale. Ok, I went to 80 mA on the next blast with 5 min to go, I just held my breath. It’s starting to make me cough. Exhaling was ok (it was real hard not to), inhaling was impossible. My eyes squinted and vision blurred during stim. I won’t go higher today, I mean it this time. It’s not at all painful, just one hell of a buzz! Coughing at the end or after each blast. I think I have reached a safety limit. I felt fine immediately after though. My neck circumference increased from 16 ¾ to 17” immediately after so it seems there is a bit of a pump, which I think I have measured before.

9/29/2014
Addendum to 9/27/2014 workout: I awoke today with my left thigh having some DOMS (not bad), but none in my right so 8 pads with the EV-906 is still a reasonable workout for me, 4 pads not so much I would surmise. Still, the Globus is a lot stronger.

Bodyweight 183 lb, 7.15% bodyfat.

10/20/2014
So my year long experiment is over but I’m continuing to do EMS as a workout. Perhaps not exclusively without any other strength training, but I figure I’ll keep at it because A) I think it works really well, and B) it’s convenient. I’ve worked up to higher and higher intensity levels to where I can’t say it’s easy. Also I rewrote a new program to start using with my Globus Genesy 1100. Instead of 10-50-12, I’m doing 10-50-10, which is the workout recommended by the Russian scientist Yakov Kots, and popularized by sprint coach Charlie Francis (whose book sold me on it. When I was using the EV-906 I set up a 12 minute treatment because it took me a minute or two to get everything set up right as I can only increase the intensity of one channel at a time. With the Globus I can bring up all 4 channels at once with one button, so I don’t think I need the extra 2 minutes. Shortening the treatment by 2 minutes isn’t a big deal, but it does make everything a little shorter and adds up when doing multiple bodyparts. I imagine there has to be some reason Kots came up with a 10 rep workout and not a 30 rep workout. My hips got to 65 mA and calves 50 mA (my normal lateral electrode placement) unsupported, which is about as good as I get with normal weight bearing.

I did arms separating electrodes including grip on the left arm then more normal opposing muscle group pattern (biceps triceps etc) on the right and the latter felt like harder muscle contractions. It was not a pure criss cross because i need to operate machine with one hand, and it may be that for criss cross to work best, it needs to cross right and left sides of the body. It maybe works better for larger muscle groups in the legs rather than the smaller muscles in the arms. Though, I don’t get to test bilateral criss cross on arms as mentioned before because I can’t operate the machine that way. I could maybe couple distal UE on one side with proximal muscles on the other side and still work the machine. I will have to try that.

10/21/14
Last time I did criss cross on thighs, I noticed my central quads felt real tight but the quadrants, proximal and distal to the electrodes, my vastus medialis in particular felt soft, so tonight I hit thighs again with 4 electrodes on quads and 4 on the hamstrings and it felt very intense doing 10-50-12 and the contraction in the quads in particular felt more complete. I got to 55 mA on quads and 60 mA on hamstrings for right, 70 and 75 for left on quads and hams respectively. It seems like the 2nd leg always takes more mA, probably because my body is used to it. I should probably then switch up which leg I start with. The left leg definitely felt more fatigued after so the extra mA made a difference.

Calves criss cross unsupported got to 42 mA compared to 50 regular. I’m getting fairly used to this unsupported stuff.

10/22/2014
It is interesting that this is the second time this has happened, the last time on my 9/5/2014 entry. I got to Level 13 intervals on my stepmill a couple weeks ago on accident for the first time, then after taking a break from stim for 2-3 weeks after my year trial was up, plus having missed a week of stepmill, I was unable repeat my performance, lasting only 10-12 minute per attempt in the prior week. Then, over the weekend I did total body EMS, came back to the gym and my bodyweight had increased from 181 to 184 and I lasted the full 20 minutes at level 13. I don’t think it was stim helping recovery, rather I think it was stim helping endurance performance outright, perhaps due to increasing muscle glycogen and water weight, and perhaps due to some sort of muscle potentiation that helps with endurance activities. Again I was using EMS, rather than more of a TENS pattern used in the endurance recovery studies that I am a bit skeptical of, not with regards to results anymore, but rather with regards to the explanation as to why.

10/23/2014
Did my neck 10-50-10 and noticed with the 2 minute shorter workout time that I was trying to up my intensity faster. I started at 50 mA on the first blast, then 55, 60, 70. At 70 mA I could not inhale or exhale (AT ALL) when prior I had worked up to 70 mA I could, I think because my muscles were fresher, contracting harder because they were not fatigued, but the last couple minutes I could breath a little but with more effort than it was worth.

I did RDLs for the first time yesterday (110 kg for 10 reps, lunges 3x10ea leg with 50 lb dumbbells, and hip outs with 210 lb for 3 sets of 20. The latter 2 exercises were exactly what I was doing in training prior to my year of EMS. They maybe felt a little harder, but not much. RDLs I hadn’t done very heavy at all says my log book, probably because my shoulder was bothering me then. I was only training with 80 kg, which is light for me, and I am pretty sure that EMS didn’t add 30 kg to my max. It does seem like it did a reasonable of helping me hold onto my strength over the year. I need to test front squat as I did have relatively heavy numbers (for me) in the months prior to starting EMS exclusively.

After RDLs I noticed a lot of DOMS in my upper back, where I hadn’t been stimming, but my low back, hamstrings and quads were not noticeably more sore than I was getting from the EMS itself, maybe a little. Therefore, I think the DOMS you get from EMS does insulate you to some degree from later PRE, which to me indicates the contractions/intensity have some similarity.

Core tonight went right to 55 mA on the first blast and it wasn’t too bad. 70 mA on the 2nd blast, 75 mA 3rd, was hard at first then felt easier the latter half of the 10 seconds. Heck, I might make 100 tonight, 85 next (real hard), 90 (feels like enough for tonight but 6 minutes to go), 90, 95 (almost feels unsafe), 3 minutes to go, 100 (just pushed it up even though I thought I shouldn’t, 105 mA (NEW RECORD), USING MY NEW CRISS CROSS CORE PATTERN, AND I THINK I LIKE IT BETTER. 105 mA for the last full blast was very intense. I was definitely holding my breath and bracing myself during. Last time I did 100 mA I was standing, this time I’m just relaxing (well not really) on my couch. My Globus Genesy goes to 120 mA at 450 uS and since I’m only 15 mA away, I think I will get there eventually. I think progress beyond that point can still be had by getting to higher intensity levels earlier in the workout rather than gradually adding on at the end. I’m not sure how much harder it needs to get because my abs now feel like they are the strongest they have ever been. Immediately afterwards I sat down to read my book and got up to turn the fan on, no temperature change in the house and thermostat at 73 F, but I felt hot afterwards, not dripping sweat or anything but definitely felt like I had been doing something afterwards.

10/28/2014
Maxed out on front squat, got 115 kg for a single, and I had to go back in my workout log book to 1/21/2013 where I did 120 kg for 5 reps and I stopped at that point, (~8 months prior to starting EMS) due to right shoulder pain. So probably my front squat wasn’t very different one year prior when I had started my experiment. Which reminds of one of the main reasons I wanted to do EMS in the first place, because of my old dirt bike accident resulting 3 shoulder surgeries, and front squats hurting my shoulder.


[Update 5-11-17]

I’m slow in doing so but I just put up my continued electric stimulation notes since from 2014 onward. It’s not planned out like above, but it’s what I’m continuing to learn by researching, trying and applying electric stimulation (with a greater emphasis on things other than standard strength training). Anyway, it’s RIGHT HERE.

As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.

Chad Reilly, Physical Therapist

40 thoughts on “Notes from My Year of Electric Muscle Stimulation”

  1. Hello Chad,

    Thanks for answering some of my questions with your research. I have a labral tear in my hip and can’t work legs. I weight 232lbs at 5’11” @ 10% bodyfat – I look like a freakin chicken!!!

    I have the Russian Stim and it is extremely painful at setting 10 (which I assume I need to get real results). I didn’t want to start a program if I wasn’t sure of the outcome. You have gave me enough proof that it will succeed to increase my legs size somewhere near when I could lift with my legs.

    Have you tried ems combining with weight training?

    I read an article where in Bulgaria they had advanced lifter hook up the Russian stim to tri’s, chest for 10 secs at max. followed immediately by max bench of 405’lbs.

    Results: previous max was 405 for 1 rep….immediately after stim he got 3 reps!!!

    Something about electric….something …nerve…potenation

    Cheers!!!

    • Hi William,

      To answer your question about the potentiation, I think it might be a thing, subjectively I felt like I had it from one day to the next with EMS before cardio as you probably saw I noted above. I know there were a couple studies that looked at EMS for recovery between repeated bouts of exercise (I think it was swimming and running) and if I recall correctly they didn’t find much of an effect over that of just active rest but they weren’t doing a 10-50-10 protocol.

      A friend of mine says he felt stronger on high pulls after doing EMS to his core, but I can’t say I have tried it myself. Subjectively my muscles will feel really fatigued after 10-50-10. Maybe like you say with the Bulgarian with a single 10 second blast it might wake things up without tiring things out. I’d love to read more about that so if you can find a citation on it, please post it. Perhaps it worked due to greater brain/muscle connection which there is evidence of. There are a number of studies that found EMS combined with strength training led to better strength improvements which were detailed in this paper. I know in Charlie Francis’ book when training his sprinters he had them do EMS several hours AFTER weight training. In my physical therapy practice I do it on patients immediately after because that’s what’s most convenient and it seems to work well. For myself, now I’m training with weights for most of my body, but I have been continuing with EMS for core and neck strengthening because for those muscles (abs in particular) EMS works better than any exercise I have ever tried.

      As for your pain with Russian Stim, if you haven’t tried it yet, I think you can increase your gains relative to pain by using larger carbonized rubber electrodes. The rubber electrodes about double the amount of muscle contraction you get relative to sticky gel electrodes of the same size. If you use larger electrodes, there is less current going through a given number of skin sensors, again giving a better contraction with less pain. Also while I like Yakov Kots 10-50-10 duty cycle, I have never found a true Russian Stim current type that I liked. Reportedly the original machines stung a lot, but all of the ones I have been able to get my hands on in the USA felt really underpowered. The newer biphasic square wave (as wide as possible with my favorite being the Globus maxed out with a pulse duration of 450 uS) gives VERY strong muscle contractions with relative comfort. I would think four (3.5 to 4” diameter) electrodes criss crossed on your quads and another four criss crossed on your hamstrings would go a long way towards restoring/retraining thigh strength/hypertrophy while you can’t lift. EMS to the hips would help too, and of course abs. Hope that helps!

  2. Hey Chad! I have the Globus Premium Sport EMS device and was wondering what the correct electrode placement would be for the posterior tibialis. I am currently recovering from deltoid ligament/partial posterior tibial tendon repair and want to strengthen the tibialis posterior muscle without irritating the tendon. Thanks!

    • Hi Umair,

      Below are a couple diagrams for what I might do. Isolating the tibialis posterior with EMS I’m sure is impossible because it’s way too ‘buried’ beneath almost all the other muscles in the lower leg, like the gastrocnemius or soleus which are a lot bigger and thus likely to contract unbearably hard before you effectively hit the tibialis posterior. I think you would also want to be careful because while some people think of EMS as resulting in light contractions, your Globus is very powerful and maybe powerful enough to damage a healing tendon. So use caution working up the intensity, particularly at first.

      Given the above here are some ideas. The first pic is what I’ll sometimes use with plantar fasciitis to basically hit everything in the lower leg. You definitely want to be standing to prevent your foot and ankle from cramping and even then the channel 3 electrodes might have to be kept light so you can keep your heal on the ground (it just depends how strong your calves are relative to the EMS intensity.) The second one is a pattern I just made up if I was trying to specifically hit the posterior tibialis (knowing I’m still going to get a lot of other muscles too) but I criss-crossed the electrodes from front to back to try and get the current to go deeper through the leg to hit the tibialis posterior, which is way deep.

      PlantarFasciititis

      TibialisPosterior?

  3. Hi Chad,
    Just reading about Genesy 1100. I am desperately looking for someone who has tried out the microcurrent program!
    I have written a few replies on other articles as well. (I am writing you from the Netherlands).

    I have a Compex Mi-Sport, which has EMS/TENS programs, but not all these Globus Genesy programs such as micro currents, Russsian waves etc.
    Apparently microcurrent (like muscle restoration) helps a lot in recovery and microcurrent appears to be something widely used in Medical/clinical settings.

    Thank you very much for your informative site and thanks in advance for a reply here.
    Best regards,
    Thomas

    • Hi Thomas, I’ve tried micro-current and I don’t feel a thing, which is part of the point but I honestly don’t think it does anything beyond psychological/placebo effects. Since I have a Genesy 1100 I can put it on any patient I want, or myself but I never do. I think the best currents are high intensity biphasic symmetrical square wave, which is what is the primary current of all the Globus machines and your Compex too I think. I do like the Globus better than the Compex because it’s a bit stronger (maybe stronger than necessary) and because it’s programmable, which means everything to me as I don’t like anyone’s preset programs. I like the Russian duty cycle (ten seconds on 50 seconds off for 10 minutes) but rather than use the Russian waveform I use biphasic square wave programmed with a 2.5 second ramp on, a 0.5 second ramp down, 450 uS pulse width and 120 hz, turned up AS HIGH AS POSSIBLE! I do that for both strength gains and pain.

      I think the research on muscle recovery is sketchy but anecdotally people like it. Also anecdotally I felt the above 10-50-10 program made my cardio better, but I can’t say that was because of muscle recovery, I remember commenting that it felt more like muscle “potentiation.” However, if I wanted to improve circulation to a muscle and hope that helped recovery, I’d use a 5 hz constant stimulation with a 450 uS pulse width rather than microcurrent.

  4. Hi Chad,
    Thank you very much for your clear and informative answer. Like you, I would also prefer to have a programmable unit and indeed apply the 10-50-10. For recovery I will also use your suggestion to use a 5Hz constant pulse for a recovery. If I understand from Compex’ explanation
    they call the 5hz frequency an endorphine release (between 4-6hz) release. Endorphine release is a preset 20 program in the Mi-Sport
    and I like that one too.
    Thank you for your valuable information on the microcurrents. I am actually trying some Pain master patches as of today (as they are inexpensive (like around 30 Euro / 30-35USD) and see what it does. I am usually aware and not so sensitive to placebo effect, will just see what it does.
    Something similar which is promoted as a “bit of a new hype” is whole body cryo: person goes into a cabin for 3 minutes at – 110° C (Celsius) and that seems to trigger all kinds of effects and aiding recovery.
    I have tried that (for almost a month (in Amsterdam, it is called Freezlab) and actually I did not notice anything at all in faster recovery aspects, so I am dropping that. It was fun to try out, but I would not spend further money/effort on this anymore.

    Best regards, Thomas

    • Interesting comments about the Compex 4-6 hz parameters for recovery. I did a blog on EMS for aerobic exercise and tested out 4, 5, and 6 hz separately to see what they felt like and what the response was on my heart rate. For me 5 hz was best. 6 hz felt like my muscles never fully relaxed, 4 hz felt like there was a slight pause, and 5 hz felt just right (a full relaxation with no waisting of time to get the next contraction started) and resulted in my highest increase in heart rate. I’m not sure if that equates to improved recovery as the research on EMS and recovery isn’t that impressive.

      If you don’t mind sharing what kind of pain you are taking the patches for I might be able to offer some better input as to what I would do if it were me at least.

  5. Hi Chad,

    Thank you much for your quick reply!
    I fully agree with you that research on EMS and recovery is not that impressive. The same goes for microcurrents. I have spent a few
    long days and weekends, reading all kinds of articles, clinical studies and then usually find that I know much more about this subject than
    e.g. physiotherapists (who I can ask). A typical reply: ‘Never heard of (e.g.) microcurrents’. So I guess only at elite levels (which is outside my contacts scope) there is not that impressive knowledge in medical ‘people’ either, unfortunately.
    In USA there is a Globus tech site where they have the Globus Speedcoach. It apparently has recovery which is called Mobilita, but it does not show details on what it is. However I have a bit of feeling they want to sell me this speedcoach. (what I do know is that e.g. Genesy 3000 has a ‘muscle restoration’ setting in its microcurrents program, which Genesy 1100 does not have.
    Possibly the only way I could find out, is see that I can get a unit to try out.

    I am, just for a try, using the patches (now) for a small navel fracture (above navel, it is not problematic at all) and a few weeks ago
    when doing standing long jumps, I sort of overstretched abdominal muscle (left) and it led to a small superficial) tear.
    I am just trying if it would speed up recovery (because microcurrents seem to promote ATP production and therefore protein synthesis)
    I read that in more clinical studies that microcurrents are great in would healing, bone healing, tissue repair.

    Another thing that I will try is; I know I have a triggerpoint (or more) on my left shoulder blade (I have an education with triggerpoints)
    and will locate it and place the patches on both sides of triggerpoint. And then just see if it helps. I have less strength in left arm/hand when holding bigger weights (e.g. as in deadlift/ from floor and/or partials) So if it really helps, it would show in improved/returned strength.

    Finally my pain point would be: speeding up recovery and/or support for my calves. Usually the number of acceleration runs for sprint training is limited by what my calves/Achilles can handle. The tendons themselves are fine, but tense calf muscles as well as triggerpoints, which I can now manage myself, by using Compex ‘decontracture’ + treating the triggerpoints works, but it is time consuming.
    From the training the calf muscles tend to become stiff, in the sense of like it should be treated with myo fascial massage.

    Thank you in advance for your reply!
    Have a great weekend! Thomas

    • Yeah I’m not a big fan of all the programs for power, hypertrophy, capillarization, restoration rejuvenation, whatever. Not that the programs are necessarily bad, it’s that the none of those names are descriptive to me. The programs I use regularly which is maybe 3-5, I name for time on, time off, length of treatment and or rate as much as possible. I think there is a lot overlap with regards to pain reduction and nobody knows what the absolute ideal parameters for a given situation are.

      With that said, I don’t think microcurrent is worth doing, but if you get a machine that has it you might as well try it. My 1100 has it, which is why I don’t like it, and why I know Russian current isn’t as good as biphasic square wave. And yeah most physical therapists are only minimally trained in the application of electrical stimulation. Unfortunately, to my knowledge nobody else is trained better. So it’s more of a study, try, and learn on your own type of thing.

      Regarding abdominal hypertrophy and strengthening, if it were me, I’d do a 10-50-10 program on it. Maybe check out some of my electrode placements for abdominals. I would be worried that if there is a tear that might become a hernia, 10-50-10 if applied too intensely might cause over-tension and worsen the tear so use caution. Microcurrent wouldn’t have this risk, but I don’t think it has measurable benefits.

      I use 10-50-10 over trigger points all the time and people like it. They also like frequency modulated TENS with my favorite parameters programmable into a Genesy model unit. I preset them into the 300 Pro units I sell, but since you are overseas if you can get one local, let me know and I’ll share my settings with you. With trap trigger points, EMS might just be treating the symptoms and you really want to look into what’s causing them. Usually that’s from too much neck flexion, looking down too much at books, computer monitors, cell phones, etc. So it might be a bulged/herniated cervical disc that’s causing both the trigger points and arm weakness on the one side. So a safe recommendation is to try and keep your neck neutral throughout your day, and not look up or down too much during exercise either.

      EMS to the calves is not my favorite because at least on me, my calves overpower any other muscle group and I plantarflex intolerably unless I’m locked into a calf raise machine, for which if I’m going to do that I figure I might as well do calf raises. So if it were me, I’d probably just do calf raises to increase calf strength.

  6. Hi Chad,
    Thank you for your clear answer and explanation on e.g. using 10-50-10 over triggerpoints etc. Thank you so much for the link to
    electrode placements for abdominals etc. I will check this out a lot when I am at home. E.g. Core 2 is an interesting placement.

    About the pre-programmed functions in Compex, the time on, time off are preset (e.g. explosive strength time off’s are around 30 sec., time on 3-4 sec. But if you keep pressing the + and – buttons during time on, it keeps being on, so this way is a sort of work around to influence/lengthen time on. However much better to have a programmable unit to fix 10-50-10 as a setting.

    Regarding microcurrents, it is not as a means of training as it would be with biphasic square wave (yes indeed, as long as it was a tear, I was aware of risking it to become worse when applying 10-50-10) microcurrent would be to subtle to notice.
    From what I understand it is very critical to have the right set of frequencies for microcurrent. In some of the studies they mention frequencies of 0.3 Hz and 0.5Hz which seem to have the desired (wound healing, bone healing, soft tissue etc.) and that at appr. 500 microA ATP production is optimal.
    I found two user manuals (in French) of the Globus Genesy 1500 and 3000 and there already on the technical specification page I noticed a (vital important(?)) difference looking at the microcurrent specs:

    Genesy 1500: Frequency 5-200 Hz (so not less possible then 5Hz)
    Genesy 3000: Frequency 0.2 PPS (pulses per second) – 200 PPS (it would be something to try out, but it seems that this model has the possibility to use 0.3 and/or 0.5 Hz frequencies.

    I do not know what your Genesy 1100 would have, it might actually be in the user manual which should have come with the machine. As you say, it is a matter of trial and error and finding out what works and what does not. I guess I’d contact Globus Italia if there are therapists/users (and if there is a dealer in Netherlands) to try out this device, before investing in it.

    One reason to apply EMS to calves is because (as been advised/ told by a coach) I have to improve the bounce/rebound (reflex) from
    ankle/calf/ Achilles. As noticed from standing jump ups. Something which should normally be trained with bounding, hopping I guess. I have not done a lot of these yet. (usually a result of being busy at work, training at gym 2-3x week (in evening) and then not enough time for this type of exercises.

    • Core 2 is my favorite pad placement for training abs myself and decreasing low back pain in my patients. All the criss crossing of electrodes maximizes the distance between them, which in theory makes for deeper transmission of the electricity, thus reaching deeper muscle fibers. In practice it’s the hardest abdominal workout ever. In fact it’s all I ever do for abs anymore. I think Core 1 is better for people just starting out though, so they can better adjust intensity among the core muscle groups.

      I’m still skeptical of the microcurrent. I know there is research on it, I just can’t tell if that research is any good, or if it transmits well from petri dishes and rats to people, or even if it does work, does it work as well as what I’m doing already with *macro*current. I was thinking even if you could try one, it will still be hard to tell if it helps, since you can’t feel anything when it’s on. With regular EMS for strength or endurance, it wasn’t so much the research that convinced me, it was feeling muscle contractions that were sometimes harder than I could get lifting weights, and measuring my heart rate increase with aerobic TENS.

      My Genesy 1100 has several microcurrent settings, unfortunately none of the parameters are listed with regards to frequency, and unfortunately I can’t find my manual to see if it gives more details. I’ll try and get another copy though. However if I were trying to increase blood flow to an area to aid healing, but with minimal risk of damage, I would use the 5 hz aerobic TENS.

      EMS to the calves to increase rate of force development might work, but I think you’ll really have to lock your ankles in place to prevent intolerable plantar flexion cramping. It was the only time I was able to max out my Globus at 120 mA with 450 uS 10-50-10, but I had my legs/feet locked in place on my leg press with the full weight stack so the stim couldn’t move me. If you try it you’ll have to let me know what you think.

  7. Hi Chad,

    I agree as you say, one can’t tell if research is any good. It is indeed individual experience that can really tell something. I am surprised and happy, because these patches work!
    After starting a new EMS session on calves I had a normal response, muscle soreness for a couple of days and then I put Painmaster
    (for 24 hours only) on right leg.
    The next morning the difference was remarkable and unquestionable. After that, past Saturday did a max. speed work out and Sunday another EMS on calves.

    Then the patches on both calves. Again the difference is so clear, that I am surprised. No any reaction on these work outs and/or stiffness or pain which would normally be. This individual experience tells me that microcurrent at 0.5 hz at around 30-40 μA (Painmaster specs) works for me. (this low intensity is I guess why it is generally recommended to keep the patches on for 2-3 days).

    From years of training experience I know that my legs are equal in strength and will recover from e.g. muscle soreness or DOMS in similar time. This to rule out a possibility that if one leg is stronger than the other, it recovers faster than the other.

    Just today, I just realized that, after a busy working week, not thinking about patches anymore, there is some kind of ongoing Improvement. I always have, when getting up in the morning, that the first few steps are with a little minor discomfort, like some stiffness around the ankles, achilles. Usually goes away in minutes, so one does not think about it further. Also I have this, when being in office for some time behind desk, that the first few steps sometimes are slightly uncomfortable. But this is gone.
    Next experiment will be: through contact with Globus Italia, I found a distributor in Belgium (Gymna) and they rent out equipment as well. Through them, I will rent a Genesy 1200 Pro and will start testing and accurately comparing if it really works or not. I will let you know when I have the unit.

    • Hi Harsh, that unit should be a decent one, I have a sample unit in my office. The specs are all good. It’s programmable and relatively powerful for the price. It depends on what you want to do with it. If you are trying to focus on isolated muscle groups it should work pretty well. For larger muscles, because it’s just two channels you’ll probably have to use it over and over but it will work. Rubber carbon electrodes will make it work and fee way better. Since it’s a biphasic “asymmetric” square wave you’ll find the red wires aren’t as strong as the black, but I used the same type of current when I first started using EMS.

  8. Thanks Chad for the detailed reply, this information is very helpful. Since reading your post i went in search for 4 channel stimulators. and found one at fraction of cost higher. (probably because this is made in India and not imported model)

    https://joharidigital.com/medical-devices/portable-electrotherapy-device-stim-3/

    Waveforms are : Sine Wave & Symm. Bi-Phasic Square Wave
    Pulse Width : 50-250 μS(TENS);200-450 μS (EMS)

    450 μS is what is used in more powerful EMS so this looks descent. This have lot more things like Russian EMS and IFT

    Thanks once again

    • Hi again Harsh,

      That model sounds interesting but there a few things that would concern me just reading about it. First, it has a 450 uS pulse with, which is great, but it does not say how many milliamps (mA) it goes to. Such that programming it with 450 uS is great, but if it maxes out at 30 mA, it’s not going to be very strong. Also, while it says it’s a 2/4 channel machine, I only see two plug outlets. That makes me think that if you want it to be 4 channels, the electric stim will be split using split cords (two channels from one plug) which would likely half the power output to each channel, potentially making it weaker still. Third, it says rest period maxes out a 30 seconds. To mimic the Russian Stimulation ‘duty cycle’ (which is my preferred duty cycle) you need 50 seconds of rest following a 10 second contraction. It sounds like that’s a program it just can’t do. Lastly, every machine I have tried (even my Globus) that says it does “Russian Stimulation” does a duty cycle that is other than Yakov Kots’ 10-50-10. Plus, the simulation intensity feels so weak as to be absolutely ineffective, so I don’t think it’s what the Kot’s actually did. I think Kots, if using today’s machines, would use biphasic symmetrical square wave.

      Otherwise, despite the limitations, that machine sounds interesting. It’s hard to find an inexpensive two channel machine that is biphasic symmetrical square wave, so if you can get a good deal on it, maybe buy it and tell me what you think.

  9. Thanks Chad,

    The above info was really helpful. I was able to demo the product last week and here are the impressions.

    1. Its a 4 channel and it maxes out at 100 mA, which is good i assume.
    2. The rest / contraction times goes up to 60 seconds so the kots protocol can be implemented without any problem
    3. I am not sure whats the difference between the Russian stim and the conventional mode but i was able to set on/off rate in both the modes. I found russian stim to be more intense. I was not able to take more than 20 mA on my forearms with pulse width set at 450.

    The stim device will cost little under 200 $ and he is going to throw in 3.5 inch Rubber carbon electrodes for free. Which seems to be a good deal. I will gave a more detailed impression and results when i get it delivered.

    I would be going through your notes in detail and would be sharing more inputs. Thanks once again

  10. Hi Chad,
    Trying out the Globus Genesy 1200 Pro is fantastic. Microcurrents really work. Especially the “Muscle Restoration”.
    I am now considering my options, which model to buy. Currently only the high end Genesy, like 3000 have this muscle restoration. However, it costs 999,- Euro (via German distributor). And I do not see any use (in my situation) for Russian waves, Iontophorese, Interferential etc. as I tend to believe that biphasic square (EMS) can cover these as well. (of course not iontophorese).
    The fact is that I would only buy the Genesy 3000 for its training EMS parameters, microcurrents ‘muscle restoration’ and it is possible to program personalized settings. However, a Globus Activa 700, has a price of 499,- Euro, that’s half the price. It has also microcurrents, but a limited set of programs. My question to you is: In above article (5/31/2014) you wrote that you bought Speedcoach programs. What kind of format is this? Is it something as a software pack? Software upgrade? Thank you in advance!
    Best regards,
    Thomas

  11. I’m glad I found your site. My 2+ year journey has finally brought me here. Long story short, I packed and moved a house a couple years back and immediately came down with prostatitis. That morphed over time into piriformis syndrome and snapping hip. 8 doctors, 6 prescriptions and 3 ill-placed cortisone shots later and I finally found an ortho who ran an MRI that showed stenosis, disc slippage and osteoarthritis in s1l5 and l5l4. At 42 this is a pretty crappy diagnosis but I’m trying to deal with it.

    That said, I am working to figure out how to strengthen my core after spending 2 years trying to chase the red herring that was pelvic pain. I’m hoping this isn’t basically a long-term death sentence and am hoping this EMS treatment might work. I certainly don’t want to pump myself full of drugs and have had enough IB in the last year to last a lifetime. I can get back to walking the treadmill and doing an elliptical workout but want to do as much as I can to strengthen the core and slow this thing down in addition.

    What is your opinion on this Compex device?

    https://www.amazon.com/Compex-Electronic-Stimulator-Performance-Electrodes/dp/B003BFXP7Q/ref=cm_cr_arp_d_product_top?ie=UTF8

  12. Hi Chad,

    There is not much info about Globus devices. Thank you for your blog, and training tips. I have osteoarthritis with constant pain and weak muscles. I hope to decreace pain and strengthen muscles with tens/ems machine. I was choosing between ev-906 and Genesy 300 Pro. Could you please help me to decide between these two is ev-906 will be enough in my case? Thanks again.

    Best regards,
    Eduard

    • Hi Eduard,

      I think if it’s a machine you are going to use regularly the Globus is by far the better device, but it costs about three times as much so it depends on your budget. The Globus is about twice as powerful, it’s considerably easier to use because you can turn up all the channels with a single button, the wires are different colors and thicker so they don’t get tangled near as much (this is a bigger deal than you might think with four channels) and besides the 91 preset programs on the Genesy 300 (that I never use) I can and do write in and save my favorite programs that I use all the time, that you can just pick and use. With the EV-906 I can preset my favorite single program (generally 10-50-10) but to try something else you have to go in and manually change some or all the settings.

      The EV-906 is no slouch. I used it for months before I felt like I needed more power but when I was using them in the office we broke wires all the time (not a huge deal because new ones are only $12 a pair) and batteries went dead quickly. The EV-906 can just be plugged into the wall, which because of the short battery life is how we always use it now.

      So overall I would say the EV-906 is capable if you are on a budget and you can learn a lot about EMS and whether you like it or not by using one, however if you can afford the Globus it’s more than worth the extra money. I sell both but the Globus is all I use in the office because of power, ease of use, battery life, and durability. The Globus comes with better sticky electrodes, but I don’t think that matters much because I use the same rubber carbon electrodes with either.

      Hope that helps.

  13. Thanks Chad,

    Are you saying that all you need for pain stimulation is just 1 program and it works in both cases? Is there any difference between tens and ems anyway? All these units with 100+ programs is just marketing? Do waveform types influence the result when you choose 10/50/10 program?

    I found two options with about the same price Globus Premium 200 (534 programs, not programmable) and ev-906 (version:AXION STIM PRO X9+ ) Don’t know which one to choose. Or maybe just wait for other options. Globus Premium 200 looks good, but there is a big chance that it doesn’t have your fav program known as the 10/50/10 protocol.

    Thanks for your help. I really appreciate that.

    • Hi Eduard,
      Yes for the most part, one EMS program works for both pain and strengthening. So most of the time I put my patients on 10-50-10 because I am usually trying to increase strength and decrease pain at the same time. There are exceptions though. For example, if someone just had surgery or a very fresh muscle strain, I might do a TENS program with the goal to decrease pain without intense muscle contractions that might be damaging or might cause anxiety in a new patient. Somewhere in my notes that I may not have put online yet, I was playing around with settings on my Globus until I came up with a program that felt best to me, and I started using it on patients for it’s feel good properties only, and my patients just love it! So I still use 10-50-10 about 90% of the time but I have greater appreciation of a good TENS program.

      Most EMS machines are combo machines that can do TENS too, however many TENS machines are not strong enough or programmed correctly to do EMS. For EMS, you want enough current delivered from the machine to get a strong muscle contraction, with enough rest between contractions to allow the muscle to recover and contract hard again. EMS is programmed with the intent to increase muscle strength, endurance or power, while TENS is programmed with the intention to decrease pain. EMS being more intense, however, often decreases pain more (because of a higher delivery of current) than TENS. However, when I started dialing up my TENS with stronger currents, better and larger electrodes that I learned about in my EMS experiments (so you can more comfortably deliver higher current), plus frequency modulation of current I started getting better pain reduction with TENS too.

      Yes, I think the 100 plus programs are mostly marketing. What’s ironic is that of all those programs, none of them are things that I really like. I think I have 10 programs written into my Genesy 300s and I only use 3 or 4 of them regularly, so I’m planning on clearing out the extras at some point.

      Waveforms do influence results to some extent. I tried out a monophasic unit with as close to my favorite parameters as I could get and it burned my skin, taking weeks to heal. Biphasic asymmetrical square wave seems to be what’s available in lower cost units like the EV-906 and it works reasonably well, but the red wire of each channel feels noticeably weaker. Biphasic symmetrical square wave is even and strong between the wires of a channel and thus on average feel noticeably more powerful even if the other listed parameters are similar.

      Depending on how much power you need between the Globus Premium 200 Pro and the EV-906, you have to make a choice between quality and power for which the Globus is better, vs the ability to program it yourself for which the EV-906 wins. If it were me, I’d look for a Globus Genesy model (for which the 300 is the least expensive) which gives you the best of both worlds. If you’re local to the United States you could get one that I sell in my shop, which I put my preferred presets on already. Otherwise any Genesy is good and I can share any of the parameters that I’m using now.

  14. Hey Chad,

    Thank you for your help with programming my Globus 400. After two weeks of working with it, I’m already experiencing results. I will start to incorporate it into my post workout routine. I saw someone mention the effect of Ems on rate of force development, which I’m very interested in. I’ll make sure to explore this further. This may be trivial, but I noticed that the cords for my channels have a positive and negative indicator on them. Does this make a difference on the electrode placement with your charts?

    • Hi Lewis,

      You’re very welcome regarding the programming. The positive and negative markings don’t matter for you and your machine as long as you are using a alternating biphasic symmetrical current. That should be the default current type on most if not all of the program written on your machine. It’s also the current type used for all the programs I write. With alternating biphasic symmetrical current what’s positive and what’s negative is switching back and forth equally, so flip flopping the electrodes or wires won’t make any difference.

  15. Hi Chad,

    Thank you for the detailed information on EMS usage, settings and the rationale behind your experiments/training/therapy that you’ve provided in this and other entries in your blog. You’ve provided the most extensive range of information on EMS that I’ve found. I really appreciate your work! If you decide to publish a book, I’l buy one.

    I’ve been treating some very severe sciatic impingement using the Globus Genesy 300 as well as massage and PT. The symptoms have gone away and now I’m back to basic strengthening and regaining the lost range of motion. My abs are actually stronger after the sciatic episode from the EMS usage, though my flexibility took a big hit. I’m working with a personal trainer on form and movement sequencing before I start going heavy again. Those 125 lb bales of hay just don’t seem to get any lighter.

    I found a trick that helped me tolerate an increase in the intensity setting. I wanted to get above 60 and was not enjoying ramping the intensity to 60 and then having the 10 second contraction. What I do is ramp it up to 40 or so, wait until one second remains in the 10 second period, and then continue the intensity ramp to 60+, followed by the final second or two of contraction.

    Again, thank you for your writings and information. Best wishes for a successful and profitable new year!

    • Hi Todd, thanks for the compliment about my notes! I wasn’t sure if anyone would read them. I am trying to organize all that and more into a how-to book so hopefully I’ll get that done, or at least I want to put it into a detailed electric stimulation FAQ online.

      A couple thoughts about your situation. If you have low back pain/sciatica that means you are likely getting some nerve root irritation secondary to a disc bulge or herniation. That means you have been getting too much back range of motion somewhere, most likely spine flexion and maybe twisting. So your back is stiffening to prevent further damage. That stiffness is helping the discs heal, and if you go back to moving like you did before the injury, you’ll get injured again just like you did before. As you have noticed the EMS is AWESOME for increasing abdominal strength. However if it doesn’t occur to you not to flex your spine as much during your day, the EMS will only make you more comfortable as you further degenerate your discs. The increased core strength can help prevent damaging spine flexion, but only if you use those muscles to brace, rather than move your spine. Good spine motor control is generally learning to get more range of motion around your hips and less through your spine, keeping it “neutral.” Unfortunately most personal trainers don’t know that, and more unfortunately, most physical therapist don’t know that either. I’ve written a lot about all that in this blog, with my best material being where I answered people’s questions. So maybe check that out, and feel free to ask if you have any questions not covered.

      And yeah, I like your trick to increase EMS intensity work. As the contraction gets near the end of the 10 second blast the muscle fibers (and likely nerves) fatigue making it easier to add mA to the machine and activate new fibers, just as you report. I try and increase the EMS as fast as possible, whether at the beginning or end of the 10 second blast because with the Globus each time you hit the button to increase the intensity it prolongs that contraction about 3 more seconds. So for me I’ll usually move it up real quick, maybe 5 times at once so that my 10 second contraction doesn’t turn into a 30 second contraction.

      Best wishes to you for the new year too!

  16. Hi Chad,

    Your thoughts about my low back pain/sciatica were accurate. I’ve severe stenosis and a cyst in the L3/L4 region, with facet (sp?) damage as well. I’ve been strengthening my core area with EMS and stuff like Romanians, good mornings, simple kettlebell deads, and multiple other movements, under periodic coaching from a trainer. The intense pain is gone and am now experiencing tightness/aches/pains in random areas around my pelvis and lower back. I’m 63 and not young and immortal like I was at 20. Having an expert look at my technique really helped, as he was able to identify changes in my pelvis tilt when I changed direction at the bottom of a kettlebell deadlift. We could then see similar negative movement habits, almost always at a movement/directional transition.

    I managed to stress/strain an Achilles tendon after several hours at a golf range and then multiple heavy turkish getups two days later. The doctor says nothing was torn and to ice/rest it. As I have the Globus EMS unit, is there a particular set of electrode placements that you’d recommend for strengthening the area? Any particular foot/tendon position? Thanks!

    I’d seen a PT regarding my low back. She had me start with McKensie (sp?) movements but it made the problem worse. We then changed to table work with trigger point release and similar things. After a few sessions, she put a ball on the ground and asked me to pick it up. I knew that she wanted to see my back stability as I bent over. Just for fun, I did a full ass-to-grass front squat and picked up the ball. Her jaw dropped and it took three attempts for her to say something. I managed to keep a straight face…

    Thanks again!

    • Hi again, Todd,

      I’m glad to hear your back is doing well! The bad news is that calves are one of my least favorite muscles to do EMS on. When I do EMS l usually like to balance one opposing muscle against another (quads against hamstrings, low back against abs) but with calves the muscle that opposes the calves (the tibialis anterior) is too weak to do much good and my calf muscles cramp uncontrollably even if I’m standing on them. The only time I was able to really get it to work was with my feet braced against the foot plate of my leg press with a 400 lb weight stack holding me flat. For all the trouble I thought I might as well just do calf raises. I’ll still sometimes try EMS to calves in patients if their muscles aren’t that strong so if you can get away with it, without the cramping, it might help. Also I don’t notice that EMS helps tendinopathy type pain as much as it does with chronic back pain issues. EMS maybe reduces tendinopathy pain a point or two on a 10 point scale. That said if you already have the machine there is no harm in trying. I do think EMS is great for working foot intrinsic muscles, I just don’t know if you have any weakness there. Some of my favorite calf/foot electrode placements are here.

      The good news is that I think daily single leg bodyweight calf raises working up to 3 sets of 15-20 reps does a remarkable job of healing the condition. How long it takes probably depends on how bad you have it, and since the exercises seem to make the pain go away faster than it takes for the tendon to fully heal I’m starting to tell people to keep the exercise up for a full month after the pain is gone to decrease the chance of symptoms returning. I described how I do it in a response to a question here.

  17. Hi Chad, I had a brain lesion 6 months ago which left me with left side weakness. I am recovering quite well, however lost tons of muscle while in hospital for 2 months. I am arunner and was training for a marathon. I was hoping some EMS would help me get some muscle mass back while I do my rehab exercises. I feel if my muscles were stronger I would walk better/easier. I am not trying to be a body builder, just trying to get my glutes back to a reasonable size. Any thoughts on whether these machines can help with muscle atrophy.

    • Hi Cheri,

      I expect the EMS could help you a great deal. Ideally I still think you should lift weights, maybe do some machine training like leg press where you can work each leg individually. That way you’ll know when your left side catches up to the right. Then when strength get near equal you could shift to more functional free-weight exercises like squats, lunges and RDLs without everything being lopsided. I would think EMS with the good straps and electrodes would do a lot to bring up your weak side to match your good side, while you continue to train your good side to be a better side. That’s how I do it in my office at least. Of the two machines I have in my shop the Globus is definitely stronger and easier to use. I think the carbonized rubber electrodes are essential to get the most out of it for reasons you can read about in my notes, plus this study. If you have any other questions, let me know.

  18. Hi Chad.
    I was wondering if you do alternate the Hz settings. I see in your video that you use 80Hz, and mostly 300usS/ 450 if you can. But you rarely speak about Hz..i was just wondering if that was something i should keep my focus on..i mainly use my machine for building, strengthening etc and to relieve pain..where i guess 4-6 Hz as mentioned above is best for the latter.
    Thank you for an amazing story and all your knowledge!

    • Hi Christina!

      Thank you so much for appreciating my blog! I think I rarely talk about Hz because early on I set my machines at 120 Hz (I read somewhere that I can’t find anymore) that that’s what Charlie Francis liked, so I just copied him. So I’m not sure where I talked about 80 Hz, but most of my programs for strength are set at 120 Hz. 120 Hz is more than most recommend but I know it works and I have tried less, and anything over 80 Hz for strength is probably fine. I’d rather have too much than too little. I did a blog about high frequency fatigue and higher stimulation frequencies that might interest you.

      Since you mention pain, I have found EMS with 10-50-10 (for strength) was GREAT for pain, and it is. However, I have come to really appreciate “frequency modulated” TENS if I really want to make a patient feel good. I sat at home one night playing with all the TENS parameters and trying to come up with settings that felt best to me. After coming up with what I liked best I started trying it on my patients and they LOVED it! So I use it all the time now if I don’t want to put high forces through a joint, or if the person has anxiety about electric stimulation or physical therapy in general. One person said it was like an hour massage in ten minutes. Once I have won them over and they are feeling better, they almost always happily shift to EMS.

      I described those exact parameters in the 7-30-15 entry of my continued electric stimulation notes that weren’t online, (till now since you motivated me). The only difference is treatment time I usually use for physical therapy is 10 minutes vs the 30 minutes I wrote in my program then. On the Globus Genesy stimulators I sell I pre-program them with all my favorites to include FMTENS-10 and FMTENS-30 (what I call it now, standing for Frequency Modulated TENS, for 10 or 30 minutes).

      4-6 Hz I use pretty much for circulation, and if you read through my newer notes you’ll see why I settled on 5 Hz as best. In fact with the Globus stimulators I was able to pre-program a 5 Hz pulse during the “rest” period between the 2-10 second blasts of EMS. That’s something I only recently started doing and I’m still testing out what I think about that on myself and patients. However, with the Globus I can turn the 5 Hz rest period up as high as I want between EMS blasts, or if I or a patient doesn’t like that I can turn it all the way down without affecting the strength of the EMS. I used to think that combination stimulation was a dumb idea but I want to revisit my TENS vs EMS blog entry and talk about my greater appreciation for having both at the same time.

      Anyway, I hope having access to my newer notes will clarify things, but please feel free to hit me with some more questions if you have them.

  19. Chad,

    Excellent blog. Very informative and helpful. I’d like to follow your protocols with the equipment you used. How many straps (and what length) and how many rubber electrodes do I need to follow your protocol? Can I buy a Globus Genesy 300 Pro, 4″ velcro straps and 4″ rubber electrodes from you? If not, would you recommend where I purchase them?

    Thanks,
    Chris

    • Hi Chris, thanks for the kind words about my blog.

      It’s a long story on the EMS machines. I took down my store because I’m moving to India at the end of the year to work on my new project SpinalFlowYoga.com and as such I’ll be shutting down my physical therapy office. However, the only reason I started selling my own machines was you couldn’t buy them with the electrodes I use in the same place, and good straps to go with the electrodes? I literally had to have made to order and shipped from China and I’m still sitting on boxers of them.

      However, I think I found someone who can maybe take that part of the business over while I’m away and as such I told my web guy to put my web-store back online. I would have to order the machine, which if you want one (price is $600) plus my pads and straps kit is $100 (eight of the 4″ electrodes, two 8″ by 24 in straps that when connected span most waistlines for core stim, and 4 of the 4″x24″ straps that cover stimming the arms and legs.

      I think I can still get the Genesy 300 Pro machines, but that one is a “medical device” and requires a doctors prescription. However, for the same price I have been getting the Globus “Triathlon” machines, which in the USA have to be “unlocked” to allow my favorite programs to be installed, but in that configuration does everything the 300 does and more (tho more doesn’t matter because I only use my programs). Hopefully the shop will be back up later today, and I would ask that you be patient since I’m right in the middle of a transitional stage.

  20. Hi Chad,
    I finally brought Globus Premium 400. Could you please share your settings for pain relief. I have major osteoarthritis problem. I would really appreciate it. Thank you.

    • Hi Eduard!

      Here are the program settings I currently use. The FMTENS programs are the ones that “feel” the best so I’ll often use them for pain if I don’t want to strengthen anything. However, I almost always want to strengthen, and the strength programs like 10-50-10 or 5-15-10 usually make people feel just as well, and sometimes better afterwards than FMTENS.

      Name: 10-50-10
      Type of stimulation: EMS
      Number of phases: 1
      Phase duration: 10
      Type of stimulation: Intermittent
      Type of modulation: Constant
      Workout frequency: 120Hz
      Workout pulse width: 450 uS
      Ramp up duration: 2500 mS
      Workout duration: 10s
      Ramp down duration: 500mS
      Rest stimulation: type: Constant
      Rest frequency: 5Hz
      Rest duration: 50s

      Name: 5-15-10
      Type of stimulation: EMS
      Number of phases: 1
      Phase duration: 10
      Type of stimulation: Intermittent
      Type of modulation: Constant
      Workout frequency: 120Hz
      Workout pulse width: 450 uS
      Ramp up duration: 2500 mS
      Workout duration: 5s
      Ramp down duration: 500mS
      Rest stimulation: type: Constant
      Rest frequency: 5Hz
      Rest duration: 15s

      Name: 10-10-10 (headache favorite)
      Type of stimulation: EMS
      Number of phases: 1
      Phase duration: 10
      Type of stimulation: Intermittent
      Type of modulation: Constant
      Workout frequency: 120Hz
      Workout pulse width: 450 uS
      Ramp up duration: 2500 mS
      Workout duration: 10s
      Ramp down duration: 500mS
      Rest stimulation: type: Constant
      Rest frequency: 5Hz
      Rest duration: 10s

      Name: 2-2-10
      Type of stimulation: EMS
      Number of phases: 1
      Phase duration: 10
      Type of stimulation: Intermittent
      Type of modulation: Constant
      Workout frequency: 120Hz
      Workout pulse width: 450 uS
      Ramp up duration: 2500 mS
      Workout duration: 2s
      Ramp down duration: 500mS
      Rest stimulation: type: Constant
      Rest frequency: 5Hz
      Rest duration: 2s

      Name: 5hz-10
      Type of stimulation: TENS
      Number of phases: 1
      Phase Duration: 10’
      Program Name: Symmetric TENS
      Type of modulation: Continuous (START)
      Workout freq: 5Hz
      Workout pulse width: 450 uS

      Name: 5hz-30
      Type of stimulation: TENS
      Number of phases: 1
      Phase Duration: 30’
      Program Name: Symmetric TENS
      Type of modulation: Continuous (START)
      Workout freq: 5Hz
      Workout pulse width: 450 uS

      Name: FMTENS-10
      Type of stimulation: TENS
      Number of phases: 1
      Phase Duration: 10’
      Program Name: Symmetric TENS
      Type of modulation: Frequency Modul.
      Start workout freq: 2Hz
      End workout freq: 80 Hz
      Workout pulse width: 450 uS
      Workout duration: 5s

      Name: FMTENS-30
      Type of stimulation: TENS
      Number of phases: 1
      Phase Duration: 30’
      Program Name: Symmetric TENS
      Type of modulation: Frequency Modul.
      Start workout freq: 2Hz
      End workout freq: 80 Hz
      Workout pulse width: 450uS
      Workout duration: 5s

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