How to Use a Muscle Stimulator for Recovery & Pain Relief

By MaryAnn DePietro CRT

Are sore muscles from working out or sports slowing you down? Most people have developed muscle soreness at one point or another. Discover how a muscle stimulator can be your secret weapon for recovery.


Electrical muscle stimulation, or EMS, uses a device that sends electrical impulses. These impulses go through electrodes on the skin to reach specific muscles. The idea behind EMS is to cause muscle contractions like those from exercise.


EMS can have several benefits, including muscle strengthening, improved circulation, and pain relief. It may also aid in muscle recovery and the prevention of atrophy.


EMS has a wide range of uses. For example, muscle stimulation can benefit athletes interested in improving strength. EMS can also be helpful for people recovering from injuries and individuals with chronic pain.


One benefit of electrical muscle stimulation (EMS) is pain relief. Since 2008, TENS 7000 has offered EMS devices clinically designed to rehabilitate muscles, relieve pain, and enhance healing.


The guide below provides in-depth information on how to use a muscle stimulator, electrode placement, and settings.

II. Understanding Muscle Stimulators

Electrical muscle stimulation delivers electrical impulses to the muscle fibers to cause muscle contraction. This contraction is like what occurs when you deliberately move muscles. EMS can strengthen muscles and promote blood flow to the muscles. This increase in circulation helps reduce soreness and repair.


An electrical muscle stimulation device sends an electrical signal through the electrodes you place on the skin. The electrical signal travels from the device through the electrodes to the motor neuron in the muscle fibers.


The impulse, known as an action potential, causes the neurons to depolarize. Depolarization means the inside of the muscle cell becomes more positive than the outside. This triggers the release of calcium ions, which causes muscle contraction.

Benefits

  • Pain Relief (Acute and Chronic): EMS may help block pain signals and promote the release of endorphins, relieving acute and chronic pain.

  • Muscle Recovery: Muscle stimulation can increase blood flow, which helps deliver nutrients and oxygen to muscles. This may help reduce soreness and inflammation and speed up healing.

  • Muscle Strengthening and Toning: EMS triggers muscle contraction that mimics exercise. Stimulating muscle contraction can lead to improved muscle strength and toning.

  • Improved Circulation: Stimulating muscle contraction through EMS enhances blood flow, leading to better circulation.

  • Reducing Muscle Atrophy: EMS may help improve muscle strength and reduce muscle atrophy. EMS promotes the reorganization of neural pathways, which may play a role in muscle retraining after an injury

An illustration of a man with electrodes on his shoulders. Text, "How EMS Devices Help with Muscle Recovery and Pain Relief"

How EMS Devices Help with Muscle Recovery and Pain Relief

Endorphin Release

Pain Gaiting

Muscle Contraction:

- Increased Blood Flow

- Muscle Strengthening

- Reduced Muscle Atrophy

Safety Precautions and Contraindications

EMS may not be appropriate in every situation. For example, contraindications for EMS include specific conditions such as:

  • Pregnancy

  • Pacemaker

  • Peripheral vascular disease

  • Epilepsy

  • History of arrhythmia

III. Getting Started: Preparing for Use

It's essential to understand how to use a muscle stimulator. This way, you can get the most benefits and the fewest side effects.

Understanding the Device Components

Becoming familiar with the device's components is essential when learning how to use a muscle stimulator machine.

Device components include the following:

  • Electrodes/pads: The electrodes are the conductive pads that adhere to the skin above the targeted muscle. Electrodes may come in different sizes, so selecting the right size for your target muscle is essential.

  • Wires: The wires connect the unit to the electrodes to transmit the electrical impulse from the device to the muscle.

  • Control unit: The central unit controls the pulse generator that creates the electrical signals. This is also where you will adjust the various stimulation parameters.


An illustration showing a muscle stimulator, electrodes, and wires

Preparing the Skin

Preparing the skin will allow the electrodes to adhere and deliver the electrical stimulation. Tips to prepare the skin include:

  • Remove oils, lotions, and dirt.

  • Make sure the skin is completely dry before attaching the electrodes.

  • If excess hair is present, trim the hair to improve how well the electrodes stick to the skin.


Pad Placement Basics

Muscle stim pad placement is crucial to maximizing the benefits of EMS. For instance, placing an electrode on the motor point is advisable.


The motor point is the part of the muscle where the motor nerve connects to the muscle fiber. You can locate it by flexing the target muscle, pressing it, and finding the most sensitive spot. This is the most effective spot for placing electrodes for EMS.


A second electrode should be placed over the muscle belly, which is the fleshy part of the muscle. It's essential to avoid placing electrodes over bony areas, which will hinder muscle contraction.


Different types of EMS devices are available for pain relief, rehabilitation, and muscle strengthening. Some devices utilize four electrodes, while others use two electrodes.


An illustration of electrodes on an arm muscle

EMS Pad Placement Basics

Place One Electrode Over the Motor Point and One Electrode Over the Motor Belly of the Target Muscle

IV. Step-by-Step Guide: Using Your Muscle Stimulator

Step 1: Connecting the Electrodes/Pads

Start by prepping your skin, cleaning it with an alcohol pad, and letting it dry completely. Place the electrodes on the targeted muscle, one on the motor point, and one on the muscle belly.


Step 2: Adjusting the Settings

Adjust EMS settings for muscle stimulation according to the treatment goal. Adjustable settings include frequency, pulse width, and intensity. Detailed explanations of settings are below.


There is a wide variation of recommended settings. It's best to start with low settings and gradually increase the strength of the muscle and contraction as tolerated.


General recommendations for beginners include the following:


  • Frequency: 20-50 Hz

  • Pulse width: 150-200

  • Intensity: Low

  • Treatment time: 20 to 30 minutes


It is advisable for beginners to start with comfortable muscle contraction. This will result in a slight or gentle twitch instead of a jerky, strong contraction.


Step 3: Starting the Stimulation

Turn the machine on and start the muscle stimulation. Consider starting with low settings and gradually increasing intensity.


Step 4: Monitoring and Adjusting

Monitor your response to muscle stimulation and adjust as needed. A gradual increase in intensity is advisable to prevent painful muscle contractions. Listen to your body's response and lower the settings if required.


Step 5: Duration and Frequency

Regarding how long you should use electrical muscle stimulation, it may vary. General guidelines include a session of 20 to 30 minutes three times a week. Factors that may affect the frequency and duration of EMS include:


  • Whether you're targeting muscle strengthening or pain

  • The severity of pain

  • And your tolerance during treatment sessions.


Step 6: Cleaning and Storing the Device

Keeping the device clean and storing it is helpful for the machine's longevity. As always, follow the manufacturer's recommendation for cleaning and storing. However, general recommendations include:


  • Use a damp cloth to wipe down the wires and the central unit.

  • Wipe the electrodes with the damn cloth after every use to remove any oil from the skin.

  • Place the electrodes in their original packaging to keep them in good working condition.

A diagram showing how to use a muscle stimulator

How to Use a Muscle Stimulator

Step-by-Step Instructions

1. Clean the skin over the target muscle and let it dry completely

2. Place the electrodes on the targeted muscle, one on the motor point and one on the muscle belly

3. Connect the lead wires to each pad

4. Connect each lead wire to the device

5. Turn the device on at its lowest intensity level

6. Choose your desired settings based on your treatment goal

7. Turn the intensity level up until it is at a desired strength

8. Adjust the device settings based on the treatment results

V. Muscle Stim Pad Placement

Correct placement of the electrodes is vital for getting the best treatment. Different machines may have a different number of electrodes, which will affect placement.


General recommendations for common targeted muscles for EMS include the following:

A diagram showing muscle stim pad placement for quadriceps. Text, "Muscle Stimulation Pad Placement: Quadriceps"

Quadriceps

Place one electrode on the vastus lateralis, which is the outer muscle of the thigh. Place the second electrode on the vastus medialis, closer to the knee.


A diagram showing muscle stim pad placement for hamstrings. Text, "Muscle Stimulation Pad Placement: Hamstrings"

Hamstrings

Electrode placement should include one electrode on the bicep femoris and one closer to the back of the knee.


A diagram showing muscle stim pad placement for back. Text, "Muscle Stimulation Pad Placement: Back"

Back

Place one electrode on each side of the spine along the painful muscle or atrophied area. Avoid the bony area of the spine.


A diagram showing muscle stim pad placement for shoulders. Text, "Muscle Stimulation Pad Placement: Shoulders"

Shoulders

Placement of electrodes may depend on the targeted muscle and intended function and can include the anterior, middle, or posterior deltoid. For example:


  • Anterior deltoid: For shoulder flexion

  • Middle deltoid: For shoulder abduction

  • Posterior deltoid: For external rotation and shoulder retraction

A diagram showing muscle stim pad placement for calves. Text, "Muscle Stimulation Pad Placement: Calves"

Calves

Place one electrode on the top of the calf muscle and one on the bottom. Space the electrodes 3 cm apart.


Pad Placement Troubleshooting

Troubleshooting tips for muscle stim pad placement include:


  • Make sure electrodes are sticky enough to stick to the skin.

  • If you are not feeling muscle contraction, ensure the electrodes are firmly attached to the wires.

  • Try to place the electrodes about 3 cm apart. Placing them close together may increase the intensity of the muscle contraction.

  • If muscle contraction is weak, reposition the electrodes to make sure you're over the muscle belly.

  • Ensure electrodes are not placed directly over the joints.


VI. EMS Settings for Muscle Stimulation

EMS settings for muscle stimulation may vary depending on the goal of treatment and individual tolerance. For example, EMS settings for strengthening may vary from settings for pain relief. The placement for pain relief may also vary depending on the cause of the discomfort.

Physicians, experts, and studies also vary on specific recommended settings. Below is general information on various settings and expert recommendations.

A diagram showing how pulse rate works

Pulse Rate (Frequency)

Measured in hertz (Hz)

Refers to the number of electrical pulses delivered to the muscle per second.

Pulse Rate/Frequency (Hz)

Frequency refers to the number of electrical pulses delivered to the muscle within a second. It is measured in hertz (Hz). Different frequencies can impact the muscle response differently.


Experts categorize frequency as low, medium, or high. The higher the frequency, the greater the muscle contraction. In some cases, low frequency may be helpful to keep treatment more comfortable.


Frequency Range Good for
Low 1-10Hz Heavily atrophied muscle
Medium 20-60 Hz  Improving muscle for functional tasks
High over 60Hz Strengthening and muscle hypertrophy and reducing chronic pain 

 

A diagram showing how pulse width works

Pulse Width (Duration)

Measured in microseconds (µs)

Refers to the time during which the electrical current flows during each pulse of stimulation

Pulse Width/Duration (µs)

Pulse width is the time or duration during which the electrical current flows during each pulse of stimulation. It is measured in micro or milliseconds and affects muscle contraction. Generally, more extended pulse widths stimulate deeper muscles. Shorter pulse widths generally target superficial muscles.

Setting Good for
Low 50-200µs Weak contraction good for smaller muscle groups
Medium 200 to 350µs Stronger contraction good for deeper muscles 
High 350-500µs Good for larger muscle groups

 

A diagram showing how intensity works

Intensity

Measured in milliamperes (mA)

Refers to the strength of the electrical impulse delivered to the muscles.

Intensity (mA)

Intensity refers to the strength of the electrical impulse delivered to the muscles. It determines the number of muscle fibers recruited to strengthen the contraction. It is measured in milliamperes.


Greater intensity levels usually lead to stronger muscle contractions and may be helpful for building strength. Lower intensity levels may be advisable for pain relief. It's also vital for individuals to start with a lower intensity and gradually increase to find the right level.

Program Modes

EMS devices may also have different modes, including:

A diagram showing how normal mode works

Normal

Pain Type: Acute

Effect: Provides a constant stimulation

Ideal for: Muscle strengthening, neuromuscular re-education, spasm reduction, increasing blood flow

Normal mode

This mode provides constant stimulation in the selected settings. It gives you complete control over settings such as pulse width and rate. It may be helpful for individuals with acute pain.

A diagram showing how modulation mode works

Modulation

Pain Type: Acute or Chronic

Effect: Cycles between pulse width and rate settings

Ideal for: prolonged treatment sessions, pain management, reducing muscle adaptation

Modulation mode

The device cycles between pulse width and rate to shock your nerves and relieve pain. It may be helpful for individuals with acute or chronic pain if their nerves tend to adapt to treatment.

A diagram showing how burst mode works

Burst

Pain Type: Chronic

Effect: Provides bursts of stimulation

Ideal for: Eliciting stronger muscle contractions, mimicking physiological muscle activation, reducing muscle fatigue

Burst Mode

This mode delivers a burst of pulses with breaks in between. The user can adjust the rate and width of the bursts to tailor it to their specific needs. It can be helpful for individuals with chronic pain.


VII. Maximizing Results and Long-Term Use

To maximize results and for long-term use, consider the following suggestions:


  • Combining with Other Therapies: EMS works best with other therapies such as stretching, heat or cold treatment, and regular exercise. Exercise can help strengthen muscles, and stretching can promote improved range of motion and ease muscle tension. Alternating heat or cold therapy can decrease inflammation and promote blood flow, which helps healing.

  • Creating a Routine: Incorporate EMS into your before or after-exercise routine to create a consistent routine. EMS before your workout induces light muscle contractions, and post-workout, it can help promote muscle recovery.

  • Track Your Progress: Monitor your pain level before and after treatment to monitor your improvement.

  • Seek Professional Advice When Needed: It's vital to consult a doctor or physical therapist for your specific condition to determine optimal settings. If you are unsure whether EMS is appropriate for you, consult your physician.

VIII. Conclusion

EMS devices can benefit individuals recovering from an injury, athletes working to increase strength, and people with chronic pain. They can strengthen muscles, improve circulation, reduce muscle atrophy, and aid in rehabilitation.


A muscle stimulator can be an excellent way to promote muscle recovery without medication. For more options, check out TENS 7000 products, which offer a variety of units to meet your needs.


Keep in mind:


  • Incorporate additional muscle recovery methods to get the most from your therapy.

  • Always follow the manufacturer's recommendations when using an EMS device.

  • Try different settings to get the optimal treatment for your situation.

  • Be patient with your treatment. It may take a few sessions to have pain relief.

Brandon Landgraf

About the Author

MaryAnn DePietro CRT is a licensed respiratory therapist with over 15 years of clinical experience in critical care, emergency medicine, and pulmonary rehabilitation. She is also an American Council on Exercise certified personal trainer and holds specialty certifications in orthopedics, senior fitness, and weight management. MaryAnn has a degree in Rehabilitation from Penn State University and a degree in respiratory therapy.


In addition to her clinical experience, she has written extensively about all things medical, as well as health, fitness, and aging for various websites, magazines, and newspapers.

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About TENS 7000

Pain sucks. It affects millions of people each year with adverse physical and mental side effects. TENS 7000 provides tools to combat pain and let people live life on their terms, pain-free. Our TENS 7000 TENS Unit is one of the top-rated over-the-counter TENS units, having sold over two million since 2008. Stop letting aches and pain hold you back — live life on your terms.

Brandon Landgraf