Electrotherapy

Now that we have discussed the different types of heat and cold therapy, I am going to introduce you to a modality that uses electrical currents to help with injuries. This modality is known as electrical stimulation and is popular among trainers. There are several different types of e-stim that can be used, including TENS (transcutaneous electrical nerve stimulation), IFC (interferential current therapy), NMES (neuromuscular electrical stimulation) and HVPC (high-volt pulsed current). Along with having multiple types of e-stim, there are also several reason as to why e-stim would be used. The TENS unit is a portable stim machine that can be used for acute or chronic pain. The disadvantage of the TENS unit is that it may not always treat the pain and could also mask a more serious problem.

IFC is “the application of two separate medium-frequency sinusoidal currents of different frequencies to the same area.”2 The main use for IFC is for pain relief, although it can sometimes be used for edema control and muscle reeducation. The main advantage of using IFC over TENS is the “ability to cover a large area and perhaps its ability to penetrate deeper into the tissues.”2 IFC is able to cover a larger area because of the crisscross placement of the electrodes.

Electrical stimulation can also function as a way to “stimulate weaker muscles to contract during exercise to improve strength more quickly.”1 This type of stim is called NMES and is fairly common when it comes to ACL reconstruction rehab. For example, the electrodes can be placed on the quads (preferably the vastus medialis oblique) causing contraction all while the athlete does a simple exercise. This helps the muscle(s) to start working (firing) again after the reconstruction.

HVPC, which is mainly used for wound healing, has the ability to “speed up healing by promoting the natural healing process.”2 High-volt however cannot provide a contraction as strong as NMES and has gotten mixed reviews on how it affects edema management.

When thinking about using a certain type of electrical stim, it is important to be aware of some reason as to why you wouldn’t use stim. Do not use stim of the patient has a pacemaker and don’t use stim over the heart, brain, potential malignancies or over the abdominal area of a pregnant women.  Overall, electrical stimulation has many advantages and is a great tool to use in the training room.

1Electrical stimulation: Opinions of sports medicine experts | Dr. David Geier - Sports Medicine Simplified. (2012). Retrieved October 06, 2016, from http://www.drdavidgeier.com/e-stim-electrical-stimulation-advice-sports-medicine-experts/

2Knight, K. L., &
Draper, D. O. (2008). Therapeutic modalities: The art and the science.
Baltimore, MD: Lippincott Williams & Wilkins.

@. (n.d.). NexWave IFC TENS NMES. Retrieved October 07, 2016, from https://www.win-health.com/nexwave-interferential.html

E-stim for Post-op Rehab - ADVANCE for Physical Therapy ... (n.d.). Retrieved October 23, 2016, from http://physical-therapy.advanceweb.com/Features/Articles/Current-Evidence.aspx