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How to use a TENS units & EMS machines for tendonitis pain? Placement of electrode pads

Tendonitis is one of the most common ailments that you can suffer, it is mainly associated with sports injuries. Although, in principle, it is not a serious injury, it is necessary to take certain measures both for the treatment and rehabilitation of the injury and for the symptoms it may cause, among which a feeling of acute pain in the affected area stands out.

One of the most popular treatments for tendonitis symptoms is electrotherapy, which uses electrical impulses to reduce the sensation of pain. In the following paragraphs, you will learn all you need to know about tendonitis, and how to use TENS and EMS electrotherapy devices to treat its symptoms.

How to use TENS machines to relieve tendonitis pain?

Tendonitis pain can be sudden or progressive, depending on the type of injury and the area in which it occurs, so it is necessary to have a thorough knowledge of the location of the vulnerable tendons in the joints, in addition to knowing how the devices work.

Fortunately, right now we will teach you everything you need to know in order to apply effective TENS therapy and treat the symptoms of tendonitis in any of its presentations.

Where to place the electrodes?

One of the main characteristics of tendonitis is that it can affect almost any joint. However, there are certain joints that are more prone to suffer this injury. These are the shoulder, elbow, wrist, knee and heels.

Below, we will teach you the positions to treat tendonitis pain in all of these locations:

  • Shoulders: one of the most common is rotator cuff tendonitis, for which you should position one electrode on the border of the trapezius muscle and the deltoid, while the other three will be positioned on the posterior deltoid, lateral anterior, thus interacting with the supraclavicular and circumflex grooms.
  • Elbows: the most common conditions of tendonitis in the elbow are epicondylitis and epitrochleitis, for which the ideal positions for the electrodes are the vastus externus of the triceps brachii, the pronator teres muscle, the medial head of the triceps brachii, and the brachioradialis muscle.
  • Wrists: tendonitis in the wrist can be treated by placing the electrodes on the wrist joint, and on the forearm just below the ulnar fossa, in order to cover the full extent of the wrist tendon.
  • Knees: the treatment of pain caused by patellar tendonitis can be treated by positioning the electrodes on the vastus medialis, rectus femoris and tibialis anterior muscle, interacting with the vastus medialis and lateral femorocutaneous nerve, reducing the sensation of pain.
  • Ankles: Achilles tendonitis is the most common cause of heel pain, and to treat this injury, it is necessary to position the first electrode on the portion of the tendon just below the calf, while the second is positioned on the calcaneal tendon, above the heel.

Which current to use?

The pain caused by tendonitis can have a variable intensity, however, as it is an ailment caused by inflammation of a tendon, it is necessary to use low frequencies to achieve a more lasting pain relief effect.

The ideal frequency to treat tendonitis in most of its presentations ranges from 2 to 10 Hz, a burst frequency that promotes the release of endorphins and treats the ailments caused by tendonitis.

Best TENS units to treat nerve damage

Treatment of tendonitis damage should be carried out by a specialist, as TENS machines are only designed to treat the pain caused by these injuries. However, their use makes the rehabilitation process much more bearable, and it is possible to focus TENS units suitable for this treatment, among which we can mention the following:

AUVON - Dual Channel TENS Pain Relief Machine and Muscle Stimulator with 20 modes and 8 pads
  • Type: TENS
  • Channels: Dual
  • Modes/Programs: 20 Modes
  • Intensity: 20 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 10 hours)
  • Electrodes: 8 Pads
  • Display: Digital
  • Size: Not specified
  • Accelerates recovery from sports injuries
  • Improves blood circulation
  • Rechargeable battery
  • Portable and small size
  • Includes user manual
  • Does not specify measurements and weight
  • Not suitable for muscle hypertrophy
  • No heat therapy
The AUVON electrostimulation unit is one of the best options for the treatment of nerve and muscle ailments, as well as a great addition to fitness. This is because it combines transcutaneous electrical nerve stimulation technology with muscle electrostimulation, making it one of the most versatile devices on the market.

It has an independent dual-channel control mode, which allows you to treat different parts of the body with different settings and intensities as required. You can select from 20 preset massage modes, each designed to relieve certain types of pain and produce an overall sense of relief.

Patterson Medical - Dual Channel TENS Machine with self-adhesive electrodes for pain relief
  • Type: TENS
  • Channels: Dual
  • Modes/Programs: 3 Modes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Battery
  • Electrodes: 4 Pads
  • Display: No display
  • Size: Not specified
  • Includes carrying bag
  • Includes user manual
  • Improves joint mobility
  • Accelerates recovery from sports injuries
  • Reduces pain symptoms
  • Battery type not specified
  • No size and weight specified
  • No intensity levels specified
The Patterson Medical Premier Plus electrostimulation unit is one of the most complete and functional devices you can find, thanks to its simple design focused on ease of use and its great versatility when applying TENS electrostimulation, it is designed with an analog operation system that makes it considerably easier for anyone to use it.

Its incredible dual channel function allows you to set different modes of use for dual channels A and B, so you can massage separate areas of the body simultaneously. Its compact size makes it incredibly portable, and it includes a belt clip that allows you to use your electro stimulator whenever and wherever you want.

Med-Fit - Dual channel TENS machine for fast, effective and accurate pain relief ideal for home use
  • Type: TENS
  • Channels: Dual
  • Modes/Programs: 5 Modes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Batteries
  • Electrodes: 8 Pads
  • Display: Digital
  • Size: Not specified
  • Reduces pain symptoms
  • Improves joint mobility
  • Improves blood circulation
  • Accelerates recovery from sports injuries
  • Includes user manual
  • Does not specify intensity levels
  • Does not specify which type of batteries to use
  • Does not specify measurements and weight
The Med-Fit 3 electrostimulator is a powerful electrostimulation unit that is at the forefront of electrotherapy technology, combining TENS and EMS stimulation technologies with a dual channel function, so you can treat different parts of the body individually, either to treat ailments of any kind or to stimulate muscle development.

Its transcutaneous electrical stimulation function offers an infallible form of acute and chronic pain relief through electrical impulses that block pain signals and promote the production of endorphins, making it ideal for treating the symptoms of arthritis, sciatica, muscle pain, joint pain and much more.

Med-Fit - Rechargeable 4-channel wireless TENS machine with 9 clinically validated programmes
  • Type: TENS
  • Channels: 4
  • Modes: 9 Programmes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat therapy: No
  • Battery: Rechargeable
  • Electrodes: 16 Pads
  • Display: Digital
  • Size: Not specified
  • Wireless Device
  • Includes 16 electrodes of 4 different sizes
  • 4 independent channels
  • Promotes tissue healing
  • Reduces pain and improves blood circulation
  • Few modes/programs
  • No battery life specified
  • Does not specify intensity and size
The Med-Fit electrostimulation unit is the best option to increase the efficiency of workouts, thanks to its incredible 4-channel function, through which you can apply different modes of use to different areas of the body. It includes 9 clinically proven training programs and each of them has a predefined duration time of 3 hours.

It uses a combination of TENS and EMS stimulation technologies, which are completely safe and natural methods to alleviate various types of ailments and improve physical condition by stimulating the growth of muscle fibers. It is the best option for long-term management of chronic pain, allowing you to lead a completely normal life and perform all your daily activities.

Med-Fit - Dual Channel TENS Machine for Pain Relief and Pain Management Therapy
  • Type: TENS
  • Channels: Dual
  • Modes/Programs: 3 Modes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: 2 AA Batteries
  • Electrodes: 16 Pads
  • Display: No display
  • Size: Not specified
  • Includes user manual
  • Reduces pain symptoms
  • Improves joint mobility
  • Improves blood circulation
  • Accelerates recovery from sports injuries
  • No intensity levels specified
  • Does not specify measurements and weight
  • Display not included
The Med-Fit TENS unit is presented as the most viable and sophisticated option for the treatment of ailments of any kind, thanks to its innovative dual-channel function that allows you to treat the symptoms of diseases such as sciatica, arthritis, and muscle injuries in different areas of the body simultaneously.

Its electrostimulation method allows you to relieve chronic ailments through the application of mild electrical stimuli that inhibit pain signals and stimulate the production of endorphins. The best results are obtained when using this unit for 60 to 90 minutes. The use of this device is widely recommended because it does not interfere with any medical treatment and is completely safe.

How to use EMS to strengthen muscles and avoid tendon damage?

Although muscle electrostimulation is not recommended for the treatment of tendonitis in any of its forms, using it as a training method is an excellent way to prevent these injuries thanks to the strengthening of the muscles that can be achieved.

Where to place the electrodes?

The positions to improve joint resistance are classified as follows:

  • Shoulders: the electrodes will be positioned on the trapezius muscle, the anterior, lateral and posterior deltoids, and the infraspinatus muscle.
  • Elbows: the ideal position for the electrodes are the biceps brachii, the anterior brachialis muscle and the biceps brachii muscle.
  • Wrist: in this area, the location is more complicated due to the low muscle mass. However, the ideal positions are the brachioradialis muscle and the deep flexor.
  • Knee: training of the muscles adjacent to the knee is achieved by positioning the electrodes on the vastus medialis, rectus femoris and tibialis anterior muscle.
  • Ankles: electrodes should be positioned along the Achilles tendon, on the back of the calf and just above the heel.

What intensity to use?

The general treatment for physical conditioning of the muscles that give support and stability to the joints varies very little from one extremity to another, since to obtain optimal results, the frequency range to apply oscillates between 65 and 85 Hz, which generate contractions that increase muscle capacity, strengthening the joints and helping to prevent injuries such as tendonitis.

Best EMS machines to prevent tendon inflammation

Physical training is vital to avoid most injuries, yet paradoxically, the repetitive movements of most workouts can cause tendonitis. In contrast, EMS devices provide a way to strengthen muscles safely, without risk of injury, allowing you to decrease the likelihood of tendonitis. Among the best EMS machines for this we can highlight the following:

Compex Sport 6.0 - Wireless Muscle Stimulator with 4 channels, 30 programmes and 4 electrodes
  • Type: EMS
  • Channels: 4
  • Modes/Programs: 30 Programmes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable
  • Electrodes: 4 electrodes
  • Display: Digital
  • Size: 31 x 34 x 15 cm
  • Prevents muscle atrophy
  • Wireless electrodes
  • Includes user manual
  • Portable and small size
  • Includes carrying bag
  • No weight specified
  • No battery life specified
  • No intensity levels specified
The versatile Compex SP 6.0 electrostimulator is one of the best options for increasing physical performance thanks to its 10 conditioning programs and 5 fitness training programs, allowing you to increase both the strength and volume of your muscles quickly and naturally, through electrical impulses that stimulate the growth of muscle fibers.

It also has 5 recovery massage programs, 8 pain management modes and 2 rehabilitation programs, through which the Compex SP 6.0 facilitates rapid physical recovery and promotes muscle relaxation after exercise. It is the best electric massage unit for athletes who practice their discipline more frequently than 3 times a week.

Beurer - Digital dual channel TENS/EMS device with heat therapy, 70 programs and 50 intensity levels
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 70 Programs
  • Intensity: 50 Levels
  • Wireless: Yes
  • Heat Therapy: Yes
  • Battery: Rechargeable Lithium
  • Electrodes: 4 Pads
  • Display: Digital
  • Size: Not specified
  • With heat therapy
  • Incl. user manual
  • TENS+EMS combo
  • Accelerates recovery from sports injuries
  • Reduces pain symptoms
  • No battery life specified
  • Transport bag not included
  • Does not specify dimensions and weight
The physiotherapy brand Beurer offers its users one of the most versatile electrostimulation devices that can be found on the market. It is the Beurer EM59, which contains an incredible 4-in-1 function that allows you to apply therapeutic massage, muscle stimulation, nerve stimulation and heat therapy, providing a completely different level of relief to its users with its more than 70 programs and 50 intensity levels.

This powerful electrostimulation equipment offers immediate relief for almost any type of ailment using stimulation methods that stimulate the production of natural pain relieving agents within the body. It also works as an effective methods to accelerate muscle growth and regeneration, while combining with heat therapy to provide one of the most complete treatments you will find.

Omron - Dual TENS Machine with rechargeable heat therapy and 9 modes with 22 intensity levels
  • Type: TENS
  • Channels: Not specified
  • Modes/Programs: 9 Modes
  • Intensity: 22 Levels
  • Wireless: Yes
  • Heat Therapy: Yes
  • Battery: Rechargeable Lithium
  • Electrodes: 2 Pads
  • Display: Digital
  • Size: Not specified
  • Includes user manual
  • Rechargeable battery
  • With heat therapy
  • Improves joint mobility
  • Reduces pain symptoms
  • Carrying bag not included
  • Battery life not specified
  • Dimensions and weight not specified
Omron has a wide range of electrostimulation devices in stock, including Omron HeatTens, which combines the therapeutic effects of transcutaneous electrical nerve stimulation with the effective method of heat therapy, resulting in one of the most complete relaxation and pain relief effects available on the market.

Its operation is really simplified, having 6 preset programs that focus on treating different areas of the body, which you can customize by modifying the 3 TENS massage modes, in combination with the 3 heat therapy modes. It is the best choice for joint and muscle ailments and you will get 1 Omrom HeatTens, 2 Omron gel pads, 1 power adapter and an instruction manual.

TechCare Massager - 2-output EMS & TENS muscle stimulator device with protective sleeve and 6 electrodes
  • Type: Combo
  • Channels: 2
  • Modes/Programs: 24 Modes
  • Intensity: Not specified
  • Wireless: No
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 20 hours)
  • Electrodes: 6 electrodes
  • Display: LCD
  • Size: Not specified
  • Includes user manual
  • Reduces pain symptoms
  • Long battery life (up to 20 hours)
  • Portable and small size
  • Good quality
  • Few intensity levels
  • Does not specify size and weight
  • Not suitable for muscle hypertrophy
The TechCare Plus 24 muscle massager is one of the most comfortable and compact models available on the market. It offers the best solution for any type of muscle pain through its electrotherapy massages, which are a combination of TENS and EMS modalities, which apply low intensity currents to greatly reduce the sensation of pain in the treated area.

It includes 24 modes of use that apply different types of massages focused on dealing with particular ailments. Its lithium battery allows continuous use for more than 20 hours, and has a session timer that can be set from 10 to 60 minutes. The purchase includes 1 mini Plus 24 electro stimulator, 1 carrying case, 6 large electrodes, 2 guide cables, 1 user manual and 1 USB charger.

OSITO - Dual channel TENS and EMS massager with 25 modes, 50 intensities and 10 pads
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 25 Modes
  • Intensity: 50 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 10 hours)
  • Electrodes: 10 Pads
  • Display: Digital
  • Size: Not specified
  • Rechargeable battery
  • Prevents muscle atrophy
  • Portable and small size
  • Improves joint mobility
  • TENS+EMS Combo
  • Does not specify dimensions and weight
  • Transport bag not included
  • Touch screen not included
A perfect combination of TENS and EMS massager. Massages a wide area of the body with a dual output design that sends electrical impulses through electrode pads placed on the skin. To relieve pain in back, knees, shoulders, ankles, neck, wrists and elbows, relieve fatigue and stimulate muscles, improve blood circulation, strengthen the immune system and improve sleep quality.

The 50-level intensity allows you to explore for another unique experience, while the preset timer can be easily adjusted from 5 to 60 minutes. Safe enough to relax at home or in the office. Hydrogel with multi-layer technology, reusable 70 to 110 times when used correctly. Built-in rechargeable lithium battery, 10 hours continuous use after a full charge with USB cable.

Video: How to place electrodes pads for tendonitis pain?

Electrodes for shoulder

Electrodes for shoulder
Electrodes for shoulder
Electrodes for shoulder

Electrodes for elbow

Electrodes for elbow
Electrodes for elbow

Electrodes for wrist

Electrodes for wrist

Electrodes for knee

Electrodes for knee
Electrodes for knee
Electrodes for knee

Electrodes for ankle

Electrodes for ankle
Electrodes for ankle

More types of EMS electrostimulators and TENS machines you should know

What is tendonitis and what are the causes?

Tendonitis is defined as a severe inflammation of a tendon, and usually occurs in joints that have been exposed to excessive stress, overload or recurrent injury. It can occur in any joint, although it is most common in shoulders, elbows, wrists, knees and heels.

Among the main causes of tendonitis, we can highlight the following:

Trauma

A sudden injury to a joint can injure it enough to cause the fibrous tissue to swell and generate a stabbing pain, the sensation of stiffness and difficulty of movement characteristic of tendonitis.

The injuries that most commonly lead to tendonitis are:

  • Sprains
  • Fractures
  • Impingement
  • Excessive twisting

Overuse

Excess weight on a joint generates stress on the tendon of the joint, and while the tendon strength is almost always sufficient to resist the stress caused, damage can occur.

Repetitive movements

Sports such as swimming or tennis are very common causes of tendinitis due to the fact that these sports consist of repetitive, high-intensity movements that place great stress on the joint.

The sports that report the most cases of tendonitis are:

  • Soccer
  • Athletics
  • Swimming
  • Racquet sports

On the other hand, tendonitis is also very common in work environments that promote constant repetition of movements.

Among the jobs that most commonly produce tendinitis, we can find:

  • Bricklayers
  • Clerks
  • Mechanics
  • Athletes

Incorrect technique

At this point, regardless of whether it is in the sports field or in the workplace, the performance of repetitive movements coupled with poor technique can accelerate the rate of wear of the fibrous tissue, increasing the possibility of acquiring tendinitis. For example, applying too much tension on the elbow, lifting objects above the head, bending the wrist incorrectly and repetitively.

What are the most common types of tendonitis?

The human body has a large number of joints in which tendons are key parts in their movement, so they are all vulnerable to some extent to tendonitis.

Having said this, it is necessary to highlight that there are joints that are more vulnerable than others, which can suffer from different types of tendonitis depending on the area they affect. Among the most common types of tendinitis we can find:

  • Achilles tendonitis is an overuse injury to the Achilles tendon that frequently occurs in runners who make sudden changes in intensity or sudden turns. It can cause a painful sensation above the ankle and stiffness.
  • Epicondylitis: Epicondylitis is the inflammation of the epicondyle tendon, located in the elbow. It is very common in athletes who play racquet sports (hence the name tennis elbow), and is characterized by pain on the outside of the elbow.
  • Epitrochleitis: inflammation of the epitrochlea tendon, which causes pain, stiffness and swelling on the inner aspect of the elbow and forearm. Similar to epicondylitis, epitrochleitis, or golfer's elbow, is common in those who practice racquet sports, throwing sports or weight training.
  • Patellar tendonitis: is an injury that causes inflammation in the tendon that connects the patella and tibia. It is very common in athletes whose disciplines involve jumping, such as volleyball, athletics or basketball. Hence the name "jumper's knee"
  • Rotator cuff tendonitis: refers to inflammation of the tendons of this muscle, which can cause pain, visible swelling and limited movement. Its most common cause is repetitive motion overload, which causes wear and tear and subsequent weakness in the tendon area.

Differences between TENS and EMS: Which is better for treating tendon inflammation?

Tendonitis is an injury that can cause considerable pain depending on its severity, so it is necessary to apply treatments to minimize the pain in case it is too intense, in order to facilitate the recovery process.

For this purpose, electrotherapy machines are used, since they have proven to be effective in the treatment of pain in various types of injuries. However, it is important to note that TENS and EMS therapies have very different effects since they are designed for different treatments.

Transcutaneous Electrical Nerve Stimulation (TENS) is a physical therapy modality that uses electrical impulses to treat pain, and is characterized by the following properties:

  • It uses low-frequency and low-intensity electrical impulses (between 1 and 250 Hz).
  • It interacts directly with the nerve endings of the affected area, blocking the pain receptors of the branches that innervate the area, considerably reducing the sensation of pain.
  • It is a method to treat the symptoms, but it cannot directly deal with the injury or disorder that causes them.
  • There are a variety of devices of different shapes and intensities focused on treating different areas.

In contrast to this, Electrical Muscle Stimulation (Electrical Muscle Stimulation) or EMS, is a training technique aimed at improving physical condition through electrical impulses that improve muscle resistance and elasticity.

EMS can be identified by the following characteristics:

  • Its effect is focused on muscle stimulation by means of electrical impulses.
  • It applies discharges with a medium-high intensity that varies between 70 and 150 Hz.
  • It can generate indirect stimuli in the nerves due to the muscle contractions generated.
  • It is widely used by sports medical teams and high level teams.

These characteristics of each type of therapy allow us to conclude that the appropriate therapy for the treatment of tendonitis pain is TENS therapy, thanks to the fact that its electrical impulses propitiate the relaxation of fibrous tissues, decreasing the sensation of pain and dealing with tendon inflammation.

EMS therapy, on the other hand, is not recommended for the treatment of tendonitis, because its electrical impulses of such intensity generate contractions in the muscles that can be counterproductive for the relief of tendonitis pain, since they can stimulate the nerves adjacent to the affected area.

Contraindications to the use of electrodes and electrotherapy

Contraindications for electrode placement

The placement of the electrodes is of utmost importance in electrotherapy, whether TENS or EMS, so here are some things to keep in mind before starting a session:

  • Symmetrical placement: the negative and positive poles of each electrode must be connected symmetrically. That is to say, if we use two pads, we should use one positive and one negative pole in each one, while if we use four, the equivalence should be two positive and two negative.
  • Do not cross the electrodes: one electrode cannot be used on the lower train and another on the upper train and more importantly, never cross the electrodes from the left side to the right side of the body and vice versa, since the current path can negatively affect the patient's health. For this reason it is always recommended to use the electrodes in a localized way.
  • Motor point: at least one of the electrodes, whether positive or negative, must be positioned over the motor point, which is the point where the greatest force is achieved in the muscle in question.
  • Control the intensity: the size of the muscle must be taken into account when choosing the intensity of the current, since the less volume and size the muscle has, the lower the tolerated intensity will be.
  • Be careful with the skin: EMS or TENS units should not be used on recently depilated areas since the pores will be open and this could generate skin sensitivity. Do not use on irritated or reddened areas, open wounds or recent scars.

Contraindications for the use of electrostimulation

Being a therapy that applies currents to the body, it cannot be used for all conditions, therefore its use should be avoided in cases where the user suffers from the following conditions:

  • Epilepsy.
  • Cardiac pacemakers.
  • Circulation disorders and problems.
  • Abdominal or inguinal hernias.
  • Neurological disturbances.
  • Tendency to bleed.
  • Skin irritation, burns or wounds.
  • Diseases that affect muscle metabolism, such as diabetes.
  • Metabolic syndrome (diabetes, hypertension and obesity).
  • High uric acid levels.
  • Metabolic disorders and metabolic pathologies.
  • Inflammatory pathologies.

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