EMS training: the dose makes the poison!

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EMS-TrainingDue to current events: F&G examines the "EMS market"

In spring 2015, EMS training is one of the hottest topics, both in the public eye and in the professional fitness and health industry. As a fitness professional, you rub your eyes in amazement because EMS as a form of training is not new and has been labeled by experts as "ineffective training from the socket". However, this has not detracted from the success of the training system: EMS took up more space at FIBO 2015 than ever before. It is probably precisely because EMS is firmly established that more and more stories have recently popped up in the popular press pointing out the dangers of over-intensive EMS training. F&G got to the bottom of these stories.


As publisher and editor-in-chief of the industry's highest-circulation B2B title, I was once again on the lookout for new trends at FIBO.

At first glance, the impression I had already gained at FIBO 2014 was reinforced: the digitalization of the industry is advancing inexorably and the topics of prevention and rehabilitation are still on the rise.
It was only after my second tour of the trade fair that I noticed that, compared to last year's FIBO, there were a large number of exhibitors in the EMS sector this year. Although, as an industry insider, I am actually very aware of all developments and trends in the sector, I was surprised by the large number of exhibitors from this segment. In addition to the established providers, I discovered many newcomers.

FIBO has also recognized this trend and is reacting accordingly. Starting with FIBO 2016, the EMS providers will be accommodated in their own EMS hall and will also be honored with a specific lecture forum, among other things.

Spiegel: Dangerous electric shocks
But how does this rapid development fit in with the article "Muscle strength through EMS training: Dangerous electric shocks", which recently appeared on Spiegel-Online.
I came across this article on 7 April, just before FIBO 2015. The author of the article warns against possible overexertion through EMS training. As a cautionary tale, she uses the example of a trainee who had such severe circulatory problems after a few EMS training sessions that she had to seek medical treatment. The lady was found to have an elevated CK value (CK, creatine kinase = indicator in the blood for physical exertion) in her body.
The case of another person who suffered from palpitations and pain after training was also described. What I find interesting is the fact that the information for this article was researched a few weeks ago. The franchisor Bodystreet was also asked about the researched results back in February. However, the article "coincidentally" appeared before FIBO 2015.
In keeping with the motto of the Order of the Garter, "Honi soit qui mal y pense", F&G readers can ask themselves what this might be all about.

Special training makes for special sore muscles
I have been training regularly with an EMS device for several years. At the beginning of my EMS training sessions, I also had the odd muscle ache, as I was now training muscles that I didn't even know I had.
However, before using it, I read the contraindications described by the manufacturer carefully to rule out the possibility that the training would harm me. In the Spiegel article, I got the impression that they were only looking for the harmful effects of EMS training or that they only discussed them without looking at the whole picture.

NDR: Sensible EMS training
I was therefore extremely positively surprised by a television program on NDR. The health magazine VISITE presented the topic of EMS training objectively on April 14, directly after FIBO.
"EMS training is generally not dangerous," said Prof. Uwe Tegtbur, a sports physician at Hanover Medical School, in the NDR TV report. "Of course, you can really overload yourself by turning up the duration and intensity, i.e. the stimulus intensity, to the maximum. This can then lead to health problems in individual cases," he continues.
This program also showed how exercisers are looked after in a well-run EMS studio. The current levels are individually adjusted by a trainer so that overloading is avoided as far as possible.

The attentive editor of the article also asked a kidney specialist about CK values in order to find out whether and to what extent increased CK values could be harmful. The author of the Spiegel article reported that an elevated CK value can impair kidney function.
Prof. Hermann Haller from Hannover Medical School commented on this in the program VISITE, which was broadcast on April 14:
"The elevation of the CK is not bad per se. After strenuous exercise, you can generally assume that the continuous muscle tension causes an increase in CK, so that you don't actually have to pay attention to the CK, but you do have to make sure that you are sufficiently hydrated after exercise. You have to drink enough after exercise".
According to NDR editor Ulrike Helmes, the experts agree: EMS training makes sense if you don't overdo it, i.e. train a maximum of 1 - 2 times a week under supervision.

Science check
However, I didn't want to be satisfied with this level of knowledge and was looking for more reliable information on the subject of CK values in connection with EMS training. I therefore contacted the head of muscle research at the German Sport University Cologne, Dr. Michael Behringer, and asked him for a statement.

Dr. BehringerI received the following statement from Dr. Behringer:
Elevated CK levels in the blood as a result of electrical muscle stimulation (EMS)
"Creatine kinase (CK) is a relatively large molecule that is normally found inside the muscle cell and is prevented from entering the bloodstream by the cell membrane. Within the muscle cell, this enzyme is involved in providing energy.
If the CK levels in the blood rise, this is seen as indirect evidence that the membrane of the muscle cell has been damaged. At the same time, the relatively small protein myoglobin enters the circulation, which is excreted via the kidneys and can cause acute kidney failure at very high concentrations. The latter is a life-threatening situation. This type of condition is known in medicine as a result of bruising of large muscle parts, such as occurs after serious traffic accidents.

Unaccustomed physical exertion also frequently leads to strong CK increases in the blood. Eccentric and electrically induced contractions in particular appear to provoke an increase in muscle damage markers in the blood. However, studies conducted to date on this topic indicate that physical exertion does lead to significant increases in CK, but without damaging the kidneys. These results could indicate that other nephrotoxic factors must be present for kidney damage to actually occur.
It should also be noted that even one training session has a protective effect on subsequent training sessions, so that the CK deflections are significantly lower in the second session. This so-called "repeated bout effect" can be observed with both eccentric and electrically induced contractions. In other words, the risk of kidney damage can be significantly reduced by prior EMS training. Such "pre-training" should therefore always precede a more intensive unit - especially for inexperienced test subjects.

However, if symptoms such as severe muscle pain, nausea, vomiting, confusion or an increased heart rate occur as a result of EMS training or if the urine turns dark in color, medical advice must always be sought in order to prevent consequential damage. However, this warning also applies to unusual/high-intensity training sessions without the use of EMS!"

EMS-TrainingConclusion
As editor-in-chief of F&G and a long-time EMS user, this information leads me to believe that the dose is the difference between good and bad! This generally applies to all forms of training as well as to the use of alcohol and medication.

EMS is highly efficient, but it absolutely belongs in trained hands. There is a great risk of overexertion. Training should always take place under supervision. Training alone without a trainer represents an irresponsible risk.
Patrick Schlenz

Source: F&G

Published on: 21 May 2015

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