The most beneficial aspect of therapy isn’t a thing, but a relationship

For Athletix and Beauchamp Fitness

“People are always asking how it is different from a TENS machine,” says Michael Montoya. As a professional who works daily with neuromuscular stimulation, that can admittedly be a bit frustrating. Certainly Dr. Michael Ho—who markets a device known generically Transcutaneous Electrical Nerve Stimulation (TENS)—commands a disproportionate amount of attention if only for the ubiquity of his infomercials and the bikini-clad models that populate them.

While the twitching muscles might look nifty, and the bikinis, too, the infomercials trivialise the uses that electricity can have for our health and fitness. The problem is that it isn’t the whole picture, or even a significant part of it. TENS is to the world of therapeutic neurostimulation what EZ-Bake ovens are to the world of baking. It’s weaker than other therapies, topping out at frequencies often no greater than 250 hertz. More importantly, says Montoya, it uses a different type of electricity than your body does. “Your body doesn’t run on an alternating current,” which is what TENS machines typically deliver. “There’s a positive phase and a negative phase,” says Montoya. “What that means is that there’s a moment where the electric voltage is positive alternating with a moment of negative.”

The distinction is important. “This unit is creating a pulsed direct current,” he says, motioning to the device he uses in his clinic. Direct current, as opposed to alternating current, is what the body naturally uses. It’s what your body is using right now to activate muscles and drive the activity of the brain. Functional stimulation is distinct from TENS principally because it doesn’t change polarity but rather works to augment, in sympathy, what is already happening within your muscles and neural networks. It’s also vastly stronger. “This type of technology is creating upwards of five thousand percent of the chemical reaction that you would experience with a TENS unit.” It runs at a frequency of 10000 to 20000 hertz in order to create a wave form that brings blood into the muscle. Known clinically as a vasodilating waveform, “you’re pulling oxygen to those areas that have been injured, or which you’re looking to performance enhance.”

Working together

When he was working with me, Montoya asked at intervals if I felt any pain or discomfort. I’m not sure that I felt either. While I could certainly feel pressure, pain isn’t necessarily the word I would use. It feels less like electrical stimulation, whatever you might expect that to feel like—maybe like licking a 9-volt battery—than it does a deep, directed pressure. That sensation is augmented or diminished by increasing or decreasing the voltage, as well as moving the point of contact. During treatments, Montoya moves the stylus to locate points of connection and disconnection based on the feedback clients give. He works first diagnostically, to locate effects of disuse or injury within targeted muscle groups. Once the points of disconnection are located, he works over the course of weeks or months to gradually build strength and range of motion.

While you might be thinking of the pain whenever he asks, the most valuable aspect of the interaction is precisely that: he asks. Montoya doesn’t just strap you in and turn it on, because functional stimulation needs to be an active, dynamic process, not something you can buy in a box. The real the value of the therapy resides in working together, and that’s what’s responsible largely for the results as well.  Blake Williams is a client and, seeing him in the gym today, it’s hard to believe that when he first arrived he was walking with the aid of two canes. He doesn’t now. That’s the result of the treatments, which necessarily is both the use of the electricity as well as the person using it.

It’s not TENS. It doesn’t come in a box. It isn’t advertised in infomercials, with bikinis. Because it’s not about that. It’s about a relationship. And that’s why it works.

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