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Why To Exercise Today: Journal Warns Zapping Your Muscles At Gym Not Safe

Confession: I didn't know this was already a thing. I thought it was still purely my fantasy: I lie down on a padded table and tell the electrode technician, "Please give me the equivalent of an hour of CrossFit." Then I relax as my muscles and nerves are zapped into activity that approximates an actual workout, but sweat-free.

I'm filing that fantasy away with my hopes for a pill that will someday activate my brown fat so brilliantly that the need for actual exercise is utterly obviated. Because a letter just out in the journal BMJ warns that the relatively novel practice of "whole-body electrical stimulation" at the gym can land you in the hospital with rhabdomyolysis, or muscle breakdown.

(Of course, non-electric CrossFit can apparently lead to the dreaded "Uncle Rhabdo" too, if you really overdo it. Also, I should note that the electrical stimulation discussed in the BMJ letter is the kind used during a workout, not instead of one as in my fantasy.)

The letter, titled "It's time to regulate the use of whole-body electrical stimulation," opens with the background:

Transcutaneous electrical stimulation (ES) of human nerves and muscles has long been used as a non-pharmacological treatment for pain relief, and for rehabilitation after disuse. Whole body ES has recently emerged as an alternative form of physical exercise for improving fitness and health in healthy people. Despite limited scientific evidence on the safety and effectiveness of this form of exercise, several ES company sponsored fitness centers have recently been opened in different countries worldwide, making this technology easily accessible to the general population.

Now for the no-free-lunch part:

On 4 August 2015, a 20-year-old man presented to our hospital with severe muscle pain shortly after a session of gym based whole body ES exercise supervised by a fitness professional. Rhabdomyolysis was diagnosed, and he was treated with intravenous 0.9% saline for five days.

In Israel, a TV documentary publicized the potential risks of electrical stimulation, reporting that thousands of Israelis have tried it. The BMJ letter notes that several problematic cases have arisen and the Health Ministry issued an official public warning against the practice in January. The warning said bluntly: "The devices must not be used in gyms. Use without medical supervision could cause danger to health."

The BMJ letter suggests that other health authorities follow suit. I asked its senior author, Dr. Nicola Maffiuletti, head of the Human Performance Lab at the Schulthess Clinic in Zurich, three quick questions by email:

Do you happen to know how common it has become for gyms to offer electrical muscle stimulation, and has it arrived in the United States yet?

Maffiuletti: "'Whole body EMS' is increasingly offered worldwide, also in the U.S. (there are three main brands that are distributed in more than 40 countries worldwide, including the U.S.). As an example, more than 500 centers have been opened in Spain in the last five years that offer whole body EMS. (Spain is one of the countries where EMS is more used.)"

What is the science on whether EMS actually works to replicate the effects of exercise? Is there any good research on that? How does the actual science compare with the marketing/advertising claims?

Maffiuletti: "There is good research on the acute and chronic effects of single-muscle EMS (the quadriceps, in particular) not on "whole body EMS." EMS is not able to induce the same contractions as normal (voluntary) exercise, but there are some interests of EMS (particularly for patients during and after a period of disuse). Claims are always too optimistic compared to actual (good) science."

Do you think this could ever work, to obtain the benefits of exercise with electrical stimulation?

Maffiuletti: "It already works for some patient populations (intensive care unit, respiratory failure, orthopedic) but I guess it will never be more effective than normal (voluntary) exercise for healthy people."

Dr. Maffiuletti declined to name the big brands, but this paper's references list three: Efit Spain, MihaBodytec and X-Body.

Bottom line: At this point, it's back to the conventional gym for me — unelectrified.

Carey Goldberg Twitter Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth blog.

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