In a previous post, I promised to explain the little black box, or rather what’s inside, that’s made such a difference with my therapy this time around. So here it is. Here’s what’s inside the black box.
It’s a neuromuscular electrical stimulation (NMES) unit. Or shock therapy in a box. I’ve mentioned the shock therapy my PT’s have put me through before (here and here), and now I get to do it at home, too. How fun.
Actually, it’s not. It’s just this side of really painful. This small, hand-held unit can really pack a punch. When I saw the size and realized that it runs on a 9-volt battery, I didn’t think it could do much. Seemed pretty innocuous to me. So, being the intelligent human being I am, I set it way past the halfway point to start. I nearly jumped out of my skin. Holy crap. It was exactly like I imagine torture to be; I was paralyzed with the pain.
Part of the initial problem was that they gave me very small (about 1-inch by 1-inch) electrodes to try and fire up my quads. The quads are rather big muscles, so trying to fire them up with small electrodes isn’t a very pleasant experience. My therapist looked kind of incredulous when I showed her the electrodes they’d given me and threw some larger, more appropriately sized electrodes at me. Thank goodness. Otherwise, I don’t know that I would have willingly shocked myself a second time. You can see the difference in the size of the electrodes below.
Basically, I hook this bad boy up to my leg, and it helps retrain my brain to fire my VMO at the right time. I don’t just sit there and let it do all the work, though. I wear it while doing some of my exercises so that the brain gets retrained in the right way. For example, I started out wearing it while doing simple quad sets. I contract the muscles as soon as I felt the tingling begin (which signals the shock is about to happen), and I hold the contraction for as long as the shock lasts. Now, I also do short quad arcs and straight leg raises, and I use the NMES unit for 20 minutes at a time. My PT set the unit up to administer a 10-second shock every 20 seconds. The unit allows for quite a bit of flexibility, but I haven’t changed this setting as I’ve progressed.
I started out using the NMES unit every night for the two weeks while I did my exercises. Once my exercises started to involve enough equipment that I had to go to the gym, I had to stop wearing the unit while I did my exercises. I wore it one time to the gym, but I really hated people looking at me. I tried to hide it under my clothes, but I had to adjust it between exercises, so it wasn’t completely hidden. Once I decided I wasn’t wearing it to the gym, I stopped using it daily. I would put it on and do a few quad sets and straight leg raises a couple of times a week in addition to my exercises.
It made enough of a difference inside of two weeks that my PT could actually see the progress. At three weeks, even I could see the difference. Now, my right VMO–the bad one–is actually slightly more defined than my left. I’m getting a lot more control over it than I’ve had… probably since the initial injury. In fact, during our last session, my PT said that recruitment of the muscle isn’t a problem anymore; now we’re really working on strength. She wants me to continue using the NMES unit for now because she wants to really push the muscle.
This particular unit has settings of 1 to 10 for the strength of the shock. When I first started, I could hardly manage a 3. Now, I’m working up to a 4. But that’s about it. The shock is so strong that it makes my muscles contract to a point where I literally couldn’t bend my knee, if I wanted to, during a shock. I don’t know that it would do me any good to try a higher number. But… the competitor in me kind of wants to find out how much I can take.
I was joking around with one of my friends before the first session because I was, admittedly, nervous. I was sitting there with the thing all hooked up, but I wasn’t in a hurry to turn it on. When I explained what it was and what it did, my friend started making plans to market YouTube videos of the self-administered shock therapy. We decided there’s likely a niche audience out there that’s interested in this sort of thing and that they’d probably pay to see me shock myself. I’d probably have to jack it up to 10 to elicit a good cinematic response, but whatevs. Worth it. This therapy is going to pay for itself.