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. … Read more

Imbalance/Weak Hamstrings Predict Strains in Pro Soccer

Strength imbalances and prevention of hamstring injury in professional soccer players: a prospective study. Croisier JL, Ganteaume S, Binet J, Genty M, Ferret JM. Am J Sports Med. 2008 Aug;36(8):1469-75. Abstract BACKGROUND: The relationship between muscle injury and strength disorders remains a matter of controversy. PURPOSE: Professional soccer players performed a preseason isokinetic testing aimed … Read more

Muscle Strength Protective Against Arthritis

The role of muscles in joint degeneration and osteoarthritis. J Biomech. 2007;40 Suppl 1:S54-63. Epub 2007 Apr 16. Herzog W1, Longino D. Abstract The purpose of this work was to establish a controlled and reversible muscle weakness model for studying the effects of weakness on joint degeneration leading to osteoarthritis (OA). The knee extensor muscles … Read more

Tibial Stress Fractures in Runners: It’s All the Same Problem

Distinct hip and rearfoot kinematics in female runners with a history of tibial stress fracture. Journal of Orthopaedic & Sports Physical Therapy. 2010 Feb;40(2):59-66. Milner CE1, Hamill J, Davis IS. STUDY DESIGN: Cross-sectional controlled laboratory study. OBJECTIVES: To investigate the kinematics of the hip, knee, and rearfoot in the frontal and transverse planes in female … Read more

Foot Intrinsic Muscles Important for Foot Arch

Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003 Nov-Dec;42(6):327-33. Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Abstract Much of the work describing support of the medial longitudinal arch has focused on the plantar fascia and the extrinsic muscles. There is little research concerning … Read more

Cervicogenic Headaches Reduced Most with Strength Training

Effect of neck exercises on cervicogenic headache: a randomized controlled trial. J Rehabil Med. 2010 Apr;42(4):344-9. Ylinen J1, Nikander R, Nykänen M, Kautiainen H, Häkkinen A. Abstract OBJECTIVE: To compare the efficacy of three 12-month training programmes on headache and upper extremity pain in patients with chronic neck pain. METHODS: A total of 180 female … Read more

Low Back Pain, Hip Strength, and IT Band Tightness

The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropractic & Osteopathy. 2010 Jan 13;18:1. Arab AM, Nourbakhsh MR. Abstract BACKGROUND: Shortening of the iliotibial band (ITB) has been considered to be associated with low back pain (LBP). It is theorized that ITB tightness in individuals with … Read more

Patellofemoral Pain Most Associated with Hip Weakness

Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health. 2011 Sep;3(5):455-65. Meira EP, Brumitt J. Abstract CONTEXT: Patellofemoral pain syndrome (PFPS) is one of the most common conditions limiting athletes. There is a growing body of evidence suggesting that dysfunction at the hip may be a contributing factor in … Read more

Runners with Plantar Fasciitis Have Weak, Tight Calf Muscles

Functional biomechanical deficits in running athletes with plantar fasciitis. Am J Sports Med. 1991 Jan-Feb;19(1):66-71. Kibler WB1, Goldberg C, Chandler TJ. Abstract Plantar fasciitis is a relatively common injury that occurs in running athletes. The disease entity is a good example of an overloaded process of the plantar fascia at its calcaneal insertion. This study … Read more

Plantar Fasciitis Sufferers Have Weaker Foot Muscles

Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Physical Therapy. 2003 Aug;33(8):468-78. Allen RH, Gross MT. Abstract STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine if a difference exists in toe flexors strength and passive extension range of motion of the first … Read more

Neck Pain/Tender Points Reduced Most by Strength Exercise

Effect of long-term neck muscle training on pressure pain threshold: a randomized controlled trial. Eur J Pain. 2005 Dec;9(6):673-81. Ylinen J, Takala EP, Kautiainen H, Nykänen M, Häkkinen A, Pohjolainen T, Karppi SL, Airaksinen O. Abstract Muscle tenderness has been measured in several studies to evaluate effectiveness of treatment methods, but only short-term results have been … Read more

Post Total Knee Replacement; If You Can Walk Fast for 6 Minutes, You Can Walk Fast for 30.

The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty. BMC Musculoskelet Disord. 2013 Apr 24;14:145. Ko V, Naylor JM, Harris IA, Crosbie J, Yeo AE. Abstract BACKGROUND: The Six-minute walk (6 MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty … Read more

Strength Better than Stretch for Neck Pain AND Range of Motion

This was one of the earlier cervical strength training studies on neck pain that influenced my physical therapy treatments for neck pain. Active neck muscle training in the treatment of chronic neck pain in women: a randomized controlled trial. JAMA. 2003 May 21;289(19):2509-16. Ylinen J1, Takala EP, Nykänen M, Häkkinen A, Mälkiä E, Pohjolainen T, Karppi … Read more

Without Aggressive Rehabilitation Function Usually Diminished 1 Year Post-Op after Total Knee Replacement

Physical impairments and functional limitations: a comparison of individuals 1 year after total knee arthroplasty with control subjects. Physical Therapy. 1998 Mar;78(3):248-58. From the study: SUBJECTS: Twenty-nine individuals 1 year following TKA (13 women, 16 men) and 40 age- and gender-matched control subjects (18 women, 22 men) were assessed. METHODS: Walking speed, stair-climbing ability, knee … Read more

Electric Stimulation Increases Strength and Decreases Pain in Patients with Osteoarthritis

Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. J Orthop Res. 2013 Apr;31(4):511-6. From the study: “OA patients presented smaller vastus lateralis thickness (11.9 mm) and fascicle length (20.5%) than healthy subjects (14.1 mm; 24.5%), and also had a 23% smaller knee … Read more

Electric Muscle Stimulation Prevents Atrophy after Total Knee Replacement

Early neuromuscular electrical stimulation to improve quadriceps muscle strength after total knee arthroplasty: a randomized controlled trial. Physical Therapy. 2012 Feb;92(2):210-26. Stevens-Lapsley JE1, Balter JE, Wolfe P, Eckhoff DG, Kohrt WM. From the study: “Sixty-six patients, aged 50 to 85 years and planning a primary unilateral TKA, were randomly assigned to receive either standard rehabilitation … Read more

Physical Therapy after Total Knee Arthoplasty: Neuromuscular Electrical Stimulation Causes a Significant Boost in Quadriceps Strength

Neuromuscular electrical stimulation for quadriceps muscle strengthening after bilateral total knee arthroplasty: a case series. Journal of Orthopaedic & Sports Physical Therapy. 2004 Jan;34(1):21-9. Abstract STUDY DESIGN: A case series. OBJECTIVES: The purpose of this case series was to assess the effect of high-intensity neuromuscular electrical stimulation (NMES) on quadriceps strength and voluntary activation following … Read more

Physical Therapy and EMS after Total Knee Arthoplasty: More Current = More Muscle

Relationship between intensity of quadriceps muscle neuromuscular electrical stimulation and strength recovery after total knee arthroplasty. Physical Therapy. 2012 Sep;92(9):1187-96. Abstract BACKGROUND: Neuromuscular electrical stimulation (NMES) can facilitate the recovery of quadriceps muscle strength after total knee arthroplasty (TKA), yet the optimal intensity (dosage) of NMES and its effect on strength after TKA have yet … Read more

Electric Muscle Stimulation Well Tolerated by Patients at Sufficient Intensities to Strengthen Muscle after Total Knee Replacement

Response of male and female subjects after total knee arthroplasty to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle. Am J Phys Med Rehabil. 2010 Jun;89(6):464-72. Abstract OBJECTIVES: To examine responses to repeated neuromuscular electrical stimulation of the quadriceps femoris muscle in male and female subjects after total knee arthroplasty.   DESIGN: Sixty-four subjects … Read more

Electric Muscle Stimulation BEFORE Total Knee Replacement Improves Outcomes

“Effects of preoperative neuromuscular electrical stimulation on quadriceps strength and functional recovery in total knee arthroplasty. A pilot study. BMC Musculoskelet Disord. 2010 Jun 14;11:119. ” <br) BACKGROUND: Supervised preoperative muscle strengthening programmes (prehabilitation) can improve recovery after total joint arthroplasty but are considered resource intensive. Neuromuscular electrical stimulation (NMES) has been shown to improve … Read more

Electric Muscle Stimulation for Strength, How to Make It Work.

”Electromyostimulation–a systematic review of the influence of training regimens and stimulation parameters on effectiveness in electromyostimulation training of selected strength parameters. J Strength Cond Res. 2011 Nov;25(11):3218-38. ” Since I plan to discuss a number of studies on electric stimulation, I figured I should get this one out there. It gives some background as to which … Read more

Physical Therapy and EMS: Restores Activation, Strength 1 Year Post TKA

”The use of neuromuscular electrical stimulation to improve activation deficits in a patient with chronic quadriceps strength impairments following total knee arthroplasty. Journal of Orthopaedic & Sports Physical Therapy. 2006 Sep;36(9):678-85.” This was a single-patient case study of a patient who had high level function but persistent quadriceps weakness and activation deficits 13.5 months post op. … Read more

Muscle Deficits Usually Persist Long after Total Knee Replacement

“Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation. Physical Therapy. 2009 Oct;89(10):1072-9.” From the study: “Participants were 29 women and 19 men who were 55 to 75 years old and had undergone unilateral knee replacement surgery an average of 10 months earlier. The maximal torque and power of the knee extensor and … Read more

How Soon is Too Soon to Lift Weights after Total Knee Arthroplasty?

Progressive strength training (10 RM) commenced immediately after fast-track total knee arthroplasty: is it feasible? Disabil Rehabil. 2012;34(12):1034-40. From the study: “Fourteen patients with unilateral TKA were included from a fast-track orthopedic arthroplasty unit. They received rehabilitation including progressive strength training of the operated leg (leg press and knee-extension), using relative loads of 10 repetition … Read more

EMS Decreases Back Pain, Increases Core Strength, Endurance

“Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial. Rheumatol Int. 2009 Jun;29(8):947-54.” Right now this is my favorite electric muscle stimulation (EMS) study with regards to low back pain as I read it soon after I … Read more

Getting the Most out of Your Total Knee, Strength Matters

So I read ALL of Dr. Tarlow’s blog, who first suggested I start a blog on my own. It took me a few weeks but I read every post, and learned A LOT about knee surgery from the surgeon’s perspective.  One topic he wrote about that sticks in my memory showed the more you like … Read more

Hip Abduction Strength More Important to Function than Quadriceps after TKA

Hip abduction strength more important to function than quadriceps after Total Knee Arthroplasty. Physical Therapy. Feb 2011; 91(2): 225–233. From the study: Measurements Strength of quadriceps muscles and hip abductors was measured using an isokinetic dynamometer. Performance-based physical function was assessed with 4 measures: self-selected walking speed, the Figure-of-8 Walk Test, the Stair Ascend/Descend Test, … Read more