Dr. Nick Martin in Expert Interview: Benefits of EMS Technology in Orthopedic Care

Dr. Martin has extensive expertise in the treatment of hip and knee conditions, as well as orthopedic traumatology. He is known for his patient-centered approach and the use of state-of-the-art surgical techniques, including robot-assisted surgery. In addition, he is actively involved in medical education and charitable projects that provide access to high-quality orthopedic interventions for patients with limited financial resources.

We sincerely thank Dr. Nick Martin for granting this interview for myostyle. His knowledge and experience help us provide well-founded information on the application of EMS technology, its benefits, and its safety.

myostyle: Can you tell us about your professional background and your specialization as an orthopedic surgeon?

Dr. Nick Martin: I studied medicine at the University of Cape Town, South Africa. After working in the United Kingdom and Ireland, I specialised as an orthopaedic surgeon Cape Town and went into full-time private practice after completing an 18 month hip and knee reconstruction- and arthroplasty fellowship. I have worked as a hip and knee replacement/reconstruction and sports injury surgeon at Constantiaberg MediClinic for the last 16 years. I am involved in various private-state partnership initiatives and training programs with a view to provide orthopaedic surgical access to the entire South African population.

myostyle: What are the typical challenges you encounter in orthopedic care?

Dr. Nick Martin: Orthopaedic surgical practice in South Africa has many, ever increasing challenges. With respect to the clinical challenges, which I face regularly, I would say that osteoporosis and poor mobility in the elderly population stand out. These are treatable conditions, which, if neglected, lead to increased fragility fracture risk, which, despite optimal surgical management, carries with it significant morbidity and mortality rate increases.

myostyle: What experiences have you had with EMS (electrical muscle stimulation)? In which areas has it been applied?

Dr. Nick Martin: We have begun using myostyle EMS suit therapy with many of our post-operative hip fracture patients. We have noted anecdotal results of decreased hospital stays and improved mobilisation. It is too early to say whether this short term intervention will improve fall-or refracture risk. A pilot study in this regard is currently being planned.

myostyle: How would you describe the benefits of EMS in the orthopedic field, particularly for rehabilitation or prevention?

Dr. Nick Martin: EMS use in orthopaedics makes sense across almost my entire patient profile.

Osteoporosis prevention / maintenance of bone density is paramount in postmenopausal women and older men. Resistance training has been shown to positively contribute to these goals and EMS training allows for this in the relevant patient populations, where capacity for conventional exercise may be limited.

Conservative management of degenerative joint disease involves continued exercises with decreased load through the affected joints. Decreased exercise increases the risk of developing/worsening general medical problems, while continued load-bearing exercise through arthritic joints causes more rapid deterioration, resulting in end-stage arthritis. EMS training optimally addresses both these problems and thereby allows avoidance of joint replacement procedures or surgery in lower-risk patients.

Rehabilitation post fragility fracture and potential decreased future fracture risk through improved coordination and strength, increased muscle mass and improved bone mineral density have been discussed above.

myostyle: For which individuals do you consider EMS to be particularly suitable? Are there any limitations or risks?

Dr. Nick Martin: Multiple studies have shown the beneficial effects of EMS use with sports injury surgery. Improved outcomes have been documented in both immediate post-surgical management, as well as during sports specific rehabilitation. In these patients, a hybrid training model is optimal. Similar advantages apply to conservative injury management, should this be indicated.

In our current setting, we have found myostyle use to be safe for all comers. We usually run a short control session with patients being monitored by a doctor, prior to instituting a treatment regime. Pretty much all these patients have multiple medical co-morbidities, specifically patients with pace-makers have shown no adverse effects and have been able to comply with in-hospital treatment. We have empirically excluded patients with decreased levels of consciousness, psychiatric conditions, incontinence and those where suit application was problematic, as well as any who refused to give informed consent.

myostyle: Do you think EMS is safe and useful for everyday use, or should it only be used under professional guidance? Apart from orthopedic purposes, which target groups do you think EMS could be useful for?

Dr. Nick Martin: EMS use does not require clinical supervision and I would encourage it in all patients over the age of 35 in the form of a hybrid training model, where EMS use increases relatively with age. The results of this should provide for sustained lower body fat content, increased muscle strength and quality, improved cardiovascular fitness in this age group. The indirect benefits have been touched on above and include decreased risk of developing chronic medical problems, such as maturity onset diabetes and metabolic syndrome, osteoporosis, hypertension and cardiac disease amongst many others. Psychological benefits of regular graduated exercise are also of significant benefit, especially in an ever more stressful world.

myostyle: What role does muscle stimulation play in rehabilitation after injuries or surgeries? Do you see potential for broader applications in this area?

Dr. Nick Martin: As mentioned above, there is a scientific body of evidence, which indicates that hybrid training (the use of EMS together with sports-specific training) is ideal in athletes. This not only applies those returning to sport after injury and/or surgery - positive effects have also been documented in professional athletes, who had engaged in optimal sport specific training and who's measurable performance parameters improved after the institution of hybrid training.

EMS is specifically useful in patients after acute injury or surgery, where loss of muscle bulk and quality may be counteracted immediately (i.e. no waiting period, such as used to be the case with graduated rehabilitation). Anecdotally, these patients appear to return to optimal sporting activities more rapidly and re-injury rate may be decreased.

myostyle: What do you think is the future of EMS for home use? Which potential applications could be particularly relevant here?

Dr. Nick Martin: EMS training can be seen as a next step in individualised training for health and I foresee it being mainly used in hybrid training programs in order to enjoy the best of both worlds, as it were. People often forget- or are unaware that recreational exercise has not been the norm for more than around 150 years. Initial training in its various iterations was completely anecdotal and not always beneficial in the long term, however, the scientific knowledge base has improved to such an extent, that training can now be scientifically planned and individualised. EMS stimulation provides advantages which are impossible to achieve with regular training, as discussed above.