Application of Electrical Muscle Stimulation in Acute Injuries

January 2017 -

There are so many different modalities promoting decreased pain, enhanced healing, and surgery free treatment. With the majority of my rehabilitation clients I often utilize an electrical muscle stimulation (EMS) device for both early and later stages of rehabilitation (for the sake of this article, I will be specifically talking about the early stages of rehabilitation). There are many different EMS devices out on the market. Here at Kelowna Kinesiology, we use the Globus SpeedCoach Muscle Stim. Some of the benefits EMS can be used for in the early stages of rehabilitation are: muscle re-education, decreasing muscle spasm or reducing muscle tone, and decreasing edema (swelling).

Let’s take for example one of the most common knee injuries, an anterior cruciate ligament (ACL) tear. In the acute stage, it’s common to see a person on crutches with a swollen, painful looking knee. The knee is generally held in a semi-bent position, because it’s the most comfortable, pain-free position. This position shortens the hamstring muscles. Futhermore,  pain and inactivity of the leg can cause the quadriceps to “shut down” leading to loss of muscle tone (called disuse atrophy).  Whether the person will be having reconstructive surgery or not, EMS can help.

How does electrical muscle stimulation work?

EMS works by sending stimulating pulses through the skin and along the nerve that fire or activate the muscles. It does not directly activate the muscles, but activates them through neuro-muscular connections just as the brain would.

Electrostimulation uses electrical impulses acting on motor neurons and nerve terminals to promote a muscle contraction in a manner similar to a voluntary contraction. Electrostimulation can be used in two different ways: muscular stimulation (for the development of force), and nerve terminal stimulation (for treatments to alleviate pain).

Muscle Re-Education

If we look back at the example of the acute stage ACL injury, one of the things we want to do right away is stimulate the quadricep muscles to fire, so that we can maintain muscle tone. Maintaining the quadricep muscles in the acute stage is beneficial in later stages when the person becomes weight-bearing, so that they can move on to more traditional weight training as soon as possible.

Decreasing muscle spasm/tone reduction

Any time a joint is “stuck” in one position for an extended period of time, the muscles that surround that joint can become shortened and/or spasm, which can cause more pain and decrease the range of motion of that joint. In the example of the ACL injury and the semi-bent position it sits in, the hamstring and calf will be affected. EMS can increase blood flow to the area, remove metabolic waste and stimulate the muscle fibers. This allows the muscle(s) to relax, decreasing pain and increasing range of motion.

Decreasing edema

 The lymphatic system is in charge of removing waste products from the swollen joint and muscle contractions are in charge of stimulating the lymphatic flow. However, if an injured person is unable to contract their muscles or move the joint, then an EMS can be used to produce twitch muscle contractions to act like a pumping system to get the swelling out of the joint.

Whether you have injured your knee, your ankle, or another body part, electrical muscle stimulation can help. It can maintain muscle tone, decrease muscle spasm (thereby decreasing pain), and help decrease swelling in the affected joint. If you or someone you know could benefit from EMS, get in touch with us at Kelowna Kinesiology.

Check back soon, I will talk about EMS and later stages of rehabilitation!

Marina White- BSc. HK, CAT(C), CSCS

Certified Athletic Therapist