Prof. Dr. med. Bernd Wegener in an expert interview: EMS training for orthopedic problems

The human body needs movement. In times of Home Office and more and more sedentary work, the spine is extremely stressed and orthopedic problems are rising. Can EMS Training, which is popular in the Fitness sector, also contribute to the prevention and treatment of orthopedic problems? We asked Prof. Bernd Wegener, MD, about these and other questions. He is Head of the Spine Department at the LMU Clinic in Munich and works there as a Senior Physician in the Orthopedic Clinic. In addition, he has already conducted numerous Scientific Studies about the topic of Electrical Muscle Stimulation and published numerous articles.

myostyle: In your daily work, you see the consequences of too little exercise. What is your personal assessment - is there still a need for education on how harmful too little exercise is?

Prof. Dr. Wegener: Exercise and physical training are fundamental to a healthy body - both for the prevention of orthopedic problems and for the prevention and treatment of common diseases such as High blood Pressure and Diabetes. Intensive education for more exercise has already been carried out for several years, for example by the media, Medical Institutions or Health Insurances. Nevertheless, it is still very important to carry out continuous education. The Fitness industry can have a far-reaching influence here, because it reaches broad sections of the population and at the same time can make a very concrete offer.

myostyle: Before we go into more detail regarding the results of your study on EMS, please tell us for the benefit of uninformed readers: What is EMS and where is it used? Why is EMS training used for orthopedic problems?

Prof. Dr. Wegener: The effect of electrical impulses on the Muscles has been known since ancient times. EMS training as we know it today developed from the discovery that an electrical stimulus can trigger a muscle contraction. Since the 1970s, EMS training has been systematically developed further and has since been used primarily in competitive sports and the rehabilitation of injuries. In this process, targeted electrical impulses cause the muscles to contract in a cyclical manner that is similar to targeted muscle training. Electrical Muscle Stimulation is therefore really nothing more than intensive Strength Training, except that the work is done by electricity and not by the user's own effort. The electric impulses are properly dosed, noticeable, but not painful.

Many orthopedic Problems are related to a not well developed or not well functioning Musculature. Especially for Back pain, it is known that it can be prevented and successfully treated by regular training of the Abdominal and Back muscles. In this context, regular training in combination with relaxation techniques is more effective than medication, especially in the long term. The problem, however, is that many people have physical impairments that prevent them from exercising. In addition, bogus arguments such as lack of time or fear of pain can cause people to avoid exercise.

myostyle: In a Paper from 2020, you investigate the effect of EMS Training, once a week for 20 minutes, to combat non-specific chronic Back Pain. Why do you see a time limit as useful here? How does EMS training affect the muscles and what advantage does it offer over conventional training?

Prof. Dr. Wegener: The effectiveness of Electrical Muscle Stimulation for Chronic Back Pain has been proven by several scientific studies. The principle of "a lot helps a lot" does not apply. The training time of 1x per week 20 minutes can be found in different training protocols. The risk of too frequent, too long and too intensive training is that the muscle can be damaged by too much strain. People notice this by intensely aching muscles in the days after training, similar to sore muscles. However, not all muscle soreness is harmful. A real overload can be recognized by laboratory values. Through sensible training control, which in my opinion is probably best ensured through uniform training protocols in facilities with trained personnel, EMS training can be described as a safe and effective method of Strength Training. Specific recommendations for recreational sports have already been developed by a panel of experts.

myostyle: In a Study from 2019, the Training Results of two groups of Recreational Ice Hockey Players were observed. One control group was trained with EMS, the other was not. Can you briefly outline again what you found?

Prof. Dr. Wegener: As part of a Doctoral thesis, we were able to show that the physical fitness of recreational athletes could be improved with the regular use of whole-body EMS training. Specifically, this was shown in improved jumping strength and jumping height as well as a shortened sprinting time. In contrast, there was no improvement in technical skills, such as puck shooting speed. The athletes themselves also reported an improved feeling of muscular stability. From this, we could conclude that EMS training can primarily improve strength parameters. It is well known that improved fitness and muscular stability reduces the risk of injury in sports. In professional sports, methods for injury prevention have been known for a long time, but in Recreational sports there is still a need to catch up.

myostyle: What benefits can people who are not Professional Athletes but are considering EMS training expect?

Prof. Dr. Wegener: The effectiveness of Whole Body EMS training has been proven not only for Ice Hockey Players. These positive effects have been demonstrated in almost every type of sport studied. And this is especially true for Recreational Athletes, because they have more training potential than well-trained Competitive Athletes.

Whole-body EMS training has proven to be a safe and effective method of Strength Training. It makes sense to combine it with Endurance Training. Then the best training results can be achieved. Good Strength and Endurance are important prerequisites for a healthy and efficient body. Whole-body EMS training can contribute to this.

myostyle: Various Studies have looked at potential health risks that can occur during EMS Training. These are mainly about the risks of using it without trained professionals. You have been involved in recommendations for EMS Training. Why is expert supervision important?

Prof. Dr. Wegener: Whole-body EMS training in sensible doses is beneficial for physical performance and general health. However, it is not always easy for inexperienced users to find the appropriate amount in terms of strain. The use of trained Training personnel can reduce the risk of overload. Suppliers of EMS equipment often cooperate with academies that also run trainer courses specifically for EMS training. To provide a suitable basis here, national, and international expert recommendations have been published on how safe training should proceed. There are conditions for which EMS training is contraindicated. For some, such training is indeed not appropriate, but others benefit from full-body EMS training. However, for safety, this should be managed and monitored by medically trained personnel. Therefore, a distinction should be made between recreational use of whole-body EMS and medical exercise therapy.

myostyle: Finally, a glance into the future: Why do you think EMS is a future-oriented Training method?

Prof. Dr. Wegener: If one follows the recommendations for performing Whole Body EMS Training, I have very few concerns that damage to health could occur. Ignorance, unhealthy ambition, and carelessness can result in damage to health. This is just as possible with any other workout and in other life. Therefore, I believe that healthy people will benefit from a guided and sensibly dosed Whole-Body EMS workout. Those who acquire this knowledge on their own will probably be able to train successfully on their own with the devices available on the market. There are no study results on this yet. People with medical conditions that are on the list of contraindications should only perform whole-body EMS training after consulting their treating physicians trained in sports medicine and under the supervision of medically trained personnel.