How to Use a TENS / EMS Unit for Knee Pain Relief – Ask Doctor Jo

hey everybody it’s Doctor Jo, and today I’m
going to show you how to use a TENS EMS unit for knee pain. so let’s get started. So the folks at Healthmate Forever sent me
their T12AB TENS EMS unit. they have a whole bunch of different units, wire,
Wireless, and so make sure and check them out by clicking the link up there. so for
the knee, I like to put a roll underneath just so you can do some exercises with
it. so with the electrical muscle stimulation, you can do a short arc quad.
so that’s why I like having the roll underneath. you don’t have to use the
roll, you can just put it straight out and still get a good contraction, but I
do like having it there because I feel like you can get a little better
contraction. so with the TENS, it’s different than the EMS how you would set
it up, so I’m gonna start off with the TENS. TENS is for pain mainly and TENS
just stands for a transcutaneous electrical nerve stimulation. and that
basically means the nerves on the top, the surface. so this isn’t a muscle
contraction, you don’t want to get or see a muscle contraction. sometimes you’ll
see a little quivering with ten’s, but if you’re actually getting a contraction,
you’re not quite doing it right because this is to get the pain to go down. this
isn’t to get the muscle to contract. and so basically in theory what it does is
the vibration that you’re feeling through the tens unit follow the same
pathway as a pain pathway, and kind of cancels it out. so it’s a great way to
kind of get some of that pain down to be able to do stretches and exercises that
you need to get better. so for the knee what you want to do is you have four
electrodes, which is two channels. and so they’re going to cross each other like
an X. so let’s say I’m just having general knee pain kind of around the
kneecap or you know maybe a little bit lower on that patellar tendon. I want to
like encircle and compass that area. so as you can see here there’s two
different channels, and each channel has two electrodes. you want them to do the
crossing. so if I’m to put it on my knee, I want this channel to be across from
each other. so not like this, but have one on the opposite side of the other and
then the other channel is going to cross it. so you want to make that X. it makes a
difference. if it’s just here and here, you’re just going to get them talking to
each other that way, and you’re not really getting that pain area in there.
so again if the pain’s here, you want to make sure that it crosses at that spot.
so I’m gonna put the the electrodes crossing each other. it doesn’t have to
be in an exact spot for the tens. sometimes you might want to even move it
around a little bit once it gets started, and that’s fine. you can do that. so I’m
just going to kind of cross it here, and then I’m going to take the other channel
and cross it as well. and so you can see I haven’t turned the unit on yet. you can,
but I usually kind of get everything set up before I turn the unit on. you don’t
have to it’s not going to start right away or anything, but that’s just usually
what I do. I get everything nice and set up first. so again as you can see here,
this channel is crossing, and this channel is crossing. so you want to make
that X. again that’s really important. so once you get that set up with the tens
depending on what unit you have, if it’s a tens / ems unit, usually it has a bunch of
different settings here. so for this particular unit, the ten and eleven
setting are the ones that are actually for the muscle stimulation and the other
ones are for the tens. so the lower numbers are for the tens. there are
different settings, there are different feelings. some feel like a little
pinpricking you, some kind of feels like a massage, some revs up and goes down. people ask me all the time which settings should I use.
to be honest, with the tens it really is just your comfort level. this is designed
to decrease the pain, so if you like one better than four, it’s really not going
to make a whole lot of difference in the long run of “I should be using the four
because it does this.” some people will tell you that the different frequencies
do different things, but I don’t really think that’s true because you’re just
trying to decrease the pain, and you’re trying to feel better. so if you like one
better than the other, that’s what you want to do. so what I’m gonna do is I’m
just going to start off with the first one here, and you can set your time so
it’s automatic, and it’ll automatically cutoff, which is really cool too.
and then you can just start. it has the a and the B Channel, and I’m just doing the
a channel right now, and then so I’m just gonna start. really you want to start
slowly, don’t just start cranking it up even if you don’t feel anything. this is
just on setting one and I’m already feeling something. I feel it even kind of kind of going down into my foot a little bit, and that’s just because the
surface nerves are all connected. so this is comfortable. this isn’t painful. if
it’s hurting, if you’re doing like this, it’s too much. it’s not about how high you
can go. it’s about how good it feels for you. so it should be strong, but
comfortable. that’s what you really really want. so you can see here mine’s
just on one right now, there’s no muscle contraction. there shouldn’t be a muscle
contraction. I’m going to try and take it up so you can see a little bit of a
contraction, and just show you. that’s probably too much because again if
you’re getting that muscle contraction you’re fatiguing out the muscle and
that’s not the goal of the tens. so I’m just going to kind of start taking it up
a little bit more, and so you can kind of see now I don’t know if you can see the
inner one because it’s kind of about my VMO, it’s making a little bit of a
contraction. you can see my foot, I’m not doing that voluntarily. that’s that’s the
unit doing it, so probably what’s happening is this is just over my nerve
here on the fibula, and that’s the peroneal nerve. and so it just goes down
that leg, and so that’s what it’s doing. It’s just activate that, so what I might do
is if I’m getting some of that, I would just pause it, and then just move this
electrode over a little bit. so you can definitely do that as well. and so get it
off the nerve, start it up again and you can see it’s not moving like it was. but
if I were to keep taking it up to go stronger, now you can see that I’m
starting to get more muscle contractions. I’m getting it on the inside that VMO
over there. that’s not what you want. again that’s not what you want for the
TENS. so I would definitely take it down, or again I would kind of move those
electrodes around a little bit to get a better placement. so that’s just kind of
how you would use the TENS, and that’s again making sure that those muscles
don’t contract. now you can just use one channel with two electrodes, and
use the tens unit. you don’t have to use all four. sometimes people feel like
that’s a lot, so I’m gonna go ahead and pause this, and just kind of show you I’m
gonna go ahead and just take the whole thing away here. and so with this one, if
you want to get maybe a more specific area, like let’s say the pain is on your
patellar tendon down there, and it’s not really your knee hurting at all, but it’s
that patella patellar tendon. so if you want to get a specific spot, then I
usually say just use one channel or the two electrodes. so if you’re hurting
right here, if you’re having some pretty significant pain, I would get the
electrodes a little bit closer cuz that’s just gonna make it more intense.
and then just put it right there like that. so again then you just can
start it back up, and do the same thing. so it might not be as strong, you might
have to then go a little bit higher. so I’m on the one, and I can just barely
feel it because it’s just that one channel, so then I would just kind of
take it up a little bit and so that is three for me right there. so you still
see there’s no muscle contraction, but I’m getting a nice comfortable feeling
and that’s what I would want. that’s going to hopefully help take that pain
away. so if you want to do an EMS or the electrical muscle stimulation for the
knee pain, I would usually say go for the quads or the VMO because if you’re
trying to strengthen that muscle if it’s really weak, that’s gonna help with knee
pain too. you can do the tens and the EMS on your calf muscles, you can move on
your hamstrings, you can do it on your anterior tibialis, all those muscles have
to do with the knee because these muscles are crossing and coming into
that joint. but for me I would say the quads probably the biggest one because
it’s usually a tracking issue of that patella or that kneecap. so if you have
something like patella femoral pain, syndrome, chondromalacia where it’s not
tracking properly, that’s going to cause knee pain. and so getting some strength
in there is gonna help with that. so if you’re in the clinic and you probably
want to have this try it out buy a physical therapist first, you don’t want
to be using a TENS or an EMS until you talk to your healthcare professional
because sometimes you’re not supposed to do it. there’s certain things if you have
you’re not supposed to be using these units especially the electrical muscle stimulation where you’re actually getting that contraction. so make sure you check with
your healthcare professional that it’s okay.
so for this one, I’m gonna try and get that specific muscle belly. so I’m just
going to use two electrodes again. so I like to kind of cross it if you’re in
the clinic, I was going back to say a lot of times they’ll use a probe to find
exactly where those trigger points are to get the muscle contraction. you don’t
always have to be exact, again what I like is you can kind of
move the electrodes as you go. so if you do a placement, I’m just kind of crossing
to get that whole quad muscle, but if you don’t feel like it’s working, you can
kind of move it as you go. so again for this unit, and make sure you’re reading
the directions the ten and the eleven are the muscle actual stimulation, so I’m
going to go on two, and the cool thing about this is it it shows weight so to
me you know if you’re lifting weights you’re kind of strengthening the muscles,
so that’s that’s a nice way to kind of show that you’re doing that. so I’m gonna
go back and I’m gonna go over to the ten here, and so just starting off, make sure
you’re just going to kind of feel. I’m feeling it but it’s not doing a
contraction yet, so as I go with electrical muscle stimulation you want
it to be strong. so I always say go as high as you can tolerate, and sometimes
you know that might not be a whole lot. for people sometimes it’s a lot, so I’m
starting to get the contractor you can see that my legs starting to pull a
little bit, and starting to get a little quiver, and then I’m just going to go a
little bit more, and once I get that contraction you can see right there that
big contraction. if you can tolerate this is really strong, go up one more because
you want it, you want this to be uncomfortable, you’re trying to
strengthen this muscle, and so when I go up and I give this contraction, if you
want to do an exercise with it then you’re doing the exercise as you
feel it. so if this is contracting that quad as is contracting, I want to kick
that leg up, and do it, and so that’s how I’m just, I’m not even holding it, so you
know just drop back down. so it’s helping me do the work. so if you’re at a point
where your muscle you, that’s that’s really weak, and you can’t do it,
this will help activate that muscle so you can do it. so that’s just a way to
do it. so for this, sum, it you’ll have different protocols. some people say do
10 minutes worth. I say you know don’t do quite that much because it’s really
going to make those muscles tired. I would just try a couple of minutes in
the beginning, and see how it feels, and then let that muscle recover and relax.
because if you’re not giving it time to recover, you’re gonna be really really
sore and painful. so make sure and talk with your physical therapist to get a
good protocol for this because you can overdo it because it is really
contracting that muscle. so if you’re interested in purchasing one of the tens
EMS units from Healthmate Forever, make sure and click on the link up there, and
don’t forget to subscribe by clicking down there. and remember, be safe (don’t go
to high), have fun, and I hope you feel better better soon.

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