FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

ELECTRICAL STIMULATION CAN'T REPLACE SWEAT FOR MUSCLE BUILDING

Question: I've seen advertisements for electromuscular stimulation devices that are claimed to build muscles. Of course, all of the ads I've seen show men and women with Mr. Universe quality abdominals, arms, etc., who we are led to believe got their muscles without breaking a sweat. I've had low back problems most of my life and consequently have been unable to properly condition my back and abdominal muscles. I've asked several physical therapists about these devices. Most of them say that they use similar devices to exhaust a muscle group for massage, but they haven't been used to specifically develop muscle strength. So, do these devices actually work, and would they help me improve my weak muscles?

Answer: I see that you have developed a healthy measure of skepticism for claims you see in advertisements. Good for you! In this case, as in most, there is some measure of truth to the claims, however.

The electrical stimulation devices produce an electrical current of just the right characteristics of voltage, amperage and frequency around the skin electrode to cause the muscles in that region to contract. These contractions, when continued for a period of time, will fatigue the involved muscles just as repeated exercise does. I think you misunderstood the physical therapist, because repeatedly exercising a muscle to fatigue is how you strengthen that muscle group. Therefore, electrical muscle stimulation is one way to build muscle strength.

However, (you were waiting for the "however", weren't you) this technique only works for those muscles that are directly stimulated. That is important since it isn't possible to get sufficient current to induce contractions in deep muscles by use of standard skin electrodes.

Our backs are supported and moved by a large number of muscles. Some of the most important ones in back pain are those that are short, just spanning from one vertebra to the next. These muscles are deep within the body and not reachable with electrical stimulation without the use of currents so great that damage to more superficial muscles would result. Perhaps electrical muscle stimulation has some value in your back condition. This could be true if it helps you condition the superficial muscles of the abdomen and back to a point where you can participate in a more successful physical conditioning program that stresses flexibility as well as muscle strength. That program needs to be specifically tailored to your back problem by your physical therapist. The exercise regimen will stretch and tone the large muscle groups and -- unlike the electrical stimulation -- will also do the same for the short, deep ones.

The old adage of "no pain -- no gain" is not true in conditioning. Pain is an indication that you have overworked muscles or joints. Sure, you will eventually build muscle if you exercise this hard, but greater success is achieved with exercise that stresses muscles almost to -- rather than past -- the point of pain. Sweat, on the other hand, is a necessity for cardiovascular conditioning and also accompanies all but the most minimal strengthening exercises.

Talk to your doctor and physical therapist about a total conditioning program that is best for you. While this program may include electrical muscle stimulation, I'm quite certain that traditional exercise and some sweat will be the major centerpiece.

"Family Medicine" is a weekly column.

To submit questions, write to John C. Wolf, D.O., at Post Office Box 110, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.