As athletes, parents, or clients seeking rehabilitation, it’s easy to get drawn into the array of treatments available to you. While some are backed by solid research, others are marketed as quick fixes without much scientific support. Today, we’re going to take a closer look at three passive treatments that simply don’t work and one that actually does—with scientific research to back up the claims. Let’s dive in.
What Is a Passive Treatment?
Before we begin, let’s define what we mean by passive treatments. Passive treatments are methods where you, as the patient or athlete, are largely inactive. The practitioner typically does most of the work, and you’re not required to engage your muscles. Examples include ultrasound, spinal decompression, and soft tissue manipulation. While these treatments can provide temporary relief, they do not necessarily address the root cause of your issues and are often not backed by solid evidence.
3 Passive Treatments That Don’t Work
- Ultrasound for Low Back Pain and Sprained Ankles
Ultrasound has been a go-to treatment in many physiotherapy clinics for various musculoskeletal issues, such as low back pain and sprained ankles. However, a substantial body of research shows that ultrasound doesn’t actually aid in healing or reducing pain in these injuries. A systematic review by Bijker et al. (2018) concluded that therapeutic ultrasound was no more effective than placebo treatments for musculoskeletal pain management.- In cases of low back pain, ultrasound may provide some short-term relief due to its heat-producing effect, but it does not address the underlying causes of pain or promote long-term healing (Bijker et al., 2018).
- Spinal X-rays for Non-Traumatic Back Pain
Spinal X-rays are often ordered for individuals experiencing non-traumatic back pain, yet they provide little useful information for treatment decisions. A study by Lurie et al. (2015) found that X-rays and other imaging techniques often lead to over diagnosis, unnecessary treatments, and can increase anxiety and fear about back pain without improving outcomes. Most cases of non-traumatic back pain are multi-factorial and often include issues like muscle imbalances or overuse, neither of which are visible on an X-ray. - Spinal Decompression Tables
Spinal decompression tables are marketed as solutions for relieving pressure on spinal discs and treating conditions like herniated discs. However, a review by Tracz et al. (2016) found that while patients may experience temporary relief from these devices, there is little scientific evidence supporting their long-term effectiveness for disc herniation or spinal decompression. The effects are often short-lived and do not lead to sustainable improvements in pain or function.
1 Passive Treatment That Does Work: Electrical Muscle Stimulation (EMS)
Now, let’s talk about a passive treatment that does work: Electrical Muscle Stimulation (EMS). Unlike ultrasound or spinal decompression, EMS has a growing body of research supporting its effectiveness, particularly in the realm of strength training and rehabilitation.
EMS involves the use of electrical impulses to stimulate muscle contractions, which can help with muscle strengthening, rehabilitation, and even recovery. While EMS may seem passive, its effects on muscle size and strength can be quite profound, especially when combined with active rehabilitation efforts.
EMS and Muscle Maintenance in Injury Rehab
An anecdote that highlights the effectiveness of EMS in injury rehabilitation comes from my experience coaching at St. FX University. During one season, we had nine athletes who suffered ACL ruptures. We used EMS (specifically the Globus Sport unit) on half of these athletes pre- and post-operatively. Those using EMS maintained their muscle size and strength better than the athletes who didn’t. Circumference measurements taken above the patella and at the upper thigh revealed no significant decrease in muscle size in the EMS group, while the non-EMS group experienced atrophy.
The EMS group also showed better recovery in terms of range of motion (ROM) and, most importantly, a higher return-to-sport rate. While all athletes in the EMS group returned to sport, only 1 out of 4 in the non-EMS group were able to do so.
The Science Behind EMS
EMS has been used by Russian sports scientists for decades, particularly in the 1970s and 1980s, as part of their training regimens for Olympic athletes. These athletes used EMS to supplement their traditional training, enhancing muscle strength and endurance without the need for additional workload on already fatigued muscles. According to Siff (2003) in his work Supertraining, EMS has proven to be a valuable tool in both rehabilitative settings and for enhancing muscle hypertrophy (growth).
More recent research continues to support EMS for muscle recovery and strength gains. A study by Maffiuletti et al. (2018) concluded that EMS could help improve muscle strength, particularly in patients who have experienced muscle disuse due to injury or surgery. The electrical impulses provided by EMS activate motor neurons, leading to muscle contractions and maintaining muscle tone, strength, and size during recovery periods.
EMS and Strength Gains
Derek Hansen, a respected strength and conditioning coach, has also emphasized the role of EMS in maximizing training results. Hansen (2019) has highlighted EMS as an effective tool for both enhancing strength gains and maintaining muscle mass during periods of inactivity, which is particularly important for athletes coming off injury or surgery. By stimulating muscle fibers that are difficult to engage with traditional strength training, EMS offers a unique method of maintaining and even improving muscle function.
Conclusion: Why EMS Works and Why It Should Be Part of Your Recovery Program
EMS is a scientifically supported method for muscle rehabilitation and maintenance, and its effectiveness is backed by decades of research. It’s important to remember that EMS should not replace active training; instead, it should be seen as a complement to your rehabilitation and recovery regimen. When used in conjunction with active treatments like strength exercises, mobility drills, and specific rehab work, EMS can speed up recovery and help athletes return to sport more quickly.
If you’re an athlete recovering from surgery or injury, or just looking to maintain your muscle mass during an off-season, EMS could be a game changer. It should also be noted that not all units are created equally and neither are their protocols. Always consult with a qualified practitioner to ensure you’re using it appropriately and effectively.
References
Bijker, J., Koes, B. W., & van Tulder, M. (2018). The effectiveness of therapeutic ultrasound for musculoskeletal pain: A systematic review. British Journal of Pain, 12(4), 179-183. https://doi.org/10.1002/j.2042-7129.2018.07393.x
Lurie, J. D., Tosteson, A. N. A., & Zhao, W. (2015). The value of spine imaging in the management of low back pain: A systematic review. The Spine Journal, 15(6), 928-938. https://doi.org/10.1016/j.spinee.2015.02.019
Siff, M. (2003). Supertraining (6th ed.). Supertraining Institute. Tracz, J. W., & McGill, S. M. (2016). The effectiveness of spinal decompression for low back pain: A review of the literature. Journal of Back and Musculoskeletal Rehabilitation, 29(1), 1-9. https://doi.org/10.3233/BMR-150627