Recently, KPI have invested in sports technology ensuring they are able to provide the highest level of care to all athletes. Whether that be some of the latest testing modalities, recovery tools or neuromuscular electrical stimulation (NMES) such as ‘Compex’ to assist in the athletic development of all athletes who train at KPI.
This article is going to go into more detail and provide an overview of NMES whilst specifically looking at the Compex.
Definition and application of NMES
Neuromuscular electrical stimulation (NMES) involves skeletal muscle receiving a series of intermittent stimuli with the objective to trigger muscular contractions which occur because of activation to intramuscular nerve branches (Hultman et al., 1983). Activation to these nerve branches is delivered through the placement of electrodes and pre-programmed stimulation units. NMES has been adopted as a tool used in both research and rehabilitation/training environments. With this article focusing on the use of NMES within a training setting, specifically looking at its effectiveness and how it can aid; rehabilitation, performance and recovery of elite athletes.
Use of NMES in a rehabilitation environment
NMES is commonly used in a rehabilitation environment especially immediately post injury and post operations. The main aims of using NMES during rehabilitation are:
- Promote low-level contractions to assist in the removal of oedema
- Stimulation of high threshold motor units which aid in minimising muscle atrophy/strength
- Stimulation of pain-gate mechanism to reduce athlete pain levels
Specifically looking at anterior cruciate ligament injuries, research has shown that NMES combined with strength training may be more effective in improving quadricep strength rather than just strength training alone (Kim et al., 2010). Similar positive findings have been found in athletes with chronic ankle instability (CAI). CAI can lead to muscle weakness, altered movement patterns and therefore an increased risk of injury and reduction in performance levels. Findings from this particular study suggest that NMES can assist in preventing muscle atrophy and improve balance scores (Choi & Jun, 2024).
NMES to improve athletic performance
Over the years within high-performance field-based sports there has been a trend towards faster game play (Filipovic et al., 2012). This trend has therefore meant that there has been an increase in athlete's performance levels resulting in an increased requirements of strength, power, and speed. Evidence suggests that NMES can be used to help improve an athlete; strength, power and speed outputs in training and/or competitive games.
Research has shown that the use of NMES can be effective in improving maximal strength, speed strength/rate of force development and power within elite athletes (Filipovic et al., 2012).
The development of these parameters therefore resulted in improvements in; sprinting ability, vertical jump height, drop jump and countermovement jump scores which are vital for aiding athletic development. Specifically looking into football, further research demonstrates that NMES can be used to help facilitate improvements in a player’s kicking capacity and jumping (Filipovic et al., 2016). NMES is also an advantageous training tool for athletes who may have to manage their training loads due to injury history as it allows for improvement in physical qualities whilst they are unable to train maximally.
Effectiveness of NMES in recovery
According to Bishop et al. there are 3 forms of recovery;
- Immediate – recovery between muscle contractions or movements
- Short Term – recovery between bouts of exercise
- Training Recovery – recovery period required between successive sessions
Inadequate recovery of any of the above forms especially short-term and training recovery then the athlete is going to be at an increased risk of injury but they may also experience a negative effect on their performance output (Barnett, 2006). For athletes ensuring that they achieve an adequate recovery status that is individual to them is vital. Especially given the competitive nature of elite sport where the margins between winning and losing are small and there are high financial gains to be had (Malone et al., 2014). There has been some limited evidence to suggest that NMES can help facilitate recovery with three different studies illustrating positive subjective measures of muscle pain following the use of NMES (Malone et al., 2014).
References:
Barnett, A. (2006). Using recovery modalities between training sessions in elite athletes: Does it help? Sports Medicine, 36(9), 781–796. https://doi.org/10.2165/00007256-200636090-00005
Bishop, P. A., Jones, E., & Woods, A. K. (2008). Recovery from training: A brief review: brief review. Journal of Strength and Conditioning Research, 22(3), 1015–1024. https://doi.org/10.1519/JSC.0b013e31816eb518
Choi, S., & Jun, H. (2024). Effects of rehabilitative exercise and neuromuscular electrical stimulation on muscle morphology and dynamic balance in individuals with chronic ankle instability. Medicina, 60(7), 1187. https://doi.org/10.3390/medicina60071187
Filipovic, A., Grau, M., Kleinöder, H., Zimmer, P., Hollmann, W., & Bloch, W. (2016). Effects of a whole-body electrostimulation program on strength, sprinting, jumping, and kicking capacity in elite soccer players. Journal of Sports Science & Medicine, 15(4), 639–648. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5131218/
Filipovic, A., Kleinöder, H., Dörmann, U., & Mester, J. (2012). Electromyostimulation—A systematic review of the effects of different electromyostimulation methods on selected strength parameters in trained and elite athletes. Journal of Strength and Conditioning Research, 26(9), 2600–2614. https://doi.org/10.1519/JSC.0b013e31823f2cd1
Hultman, E., Sjöholm, H., Jäderholm-Ek, I., & Krynicki, J. (1983). Evaluation of methods for electrical stimulation of human skeletal muscle in situ. Pflugers Archiv European Journal of Physiology, 398(2), 139–141. https://doi.org/10.1007/BF00581062
Kim, K.-M., Croy, T., Hertel, J., & Saliba, S. (2010). Effects of neuromuscular electrical stimulation after anterior cruciate ligament reconstruction on quadriceps strength, function, and patient-oriented outcomes: A systematic review. Journal of Orthopaedic & Sports Physical Therapy, 40(7), 383–391. https://doi.org/10.2519/jospt.2010.3184
Malone, J. K., Blake, C., & Caulfield, B. M. (2014). Neuromuscular electrical stimulation during recovery from exercise: A systematic review. Journal of Strength and Conditioning Research, 28(9), 2478–2506. https://doi.org/10.1519/JSC.0000000000000426
