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Creatine Kinase Levels during EMS Training

After a full-body EMS training session (strength program) your Creatine Kinase Levels (CK-levels) can be excessively high, far beyond the normal average value. In case you have your blood analysed 2-6 days after your last EMS-session, it is important to inform the responsible doctor of your recent EMS-training activity to prevent incorrect interpretation of your increased CK-levels.

Conventional Training vs. EMS Training

In conventional Training when one performs any exercise, their brain sends a message down the spinal cord through the nerves innervating all the muscles causing them to contract

In EMS Training an outside electrical source stimulates the nerves to send these signals to your muscle to contract. This is achieved by passing electrical currents through electrode pads placed over a muscle. The current passes through electrode pads placed over a muscle. The current passes through the skin to the nerves in the contact area, stimulating the connecting muscles to contract. Electrodes are attached to muscles and wired to the XBody device that sends low-level electricity through the skin to stimulate nerve and muscle fibers.


Assessing CK levels

Muscular damage resulting from vigorous exercise is a common and normal event. Athletes often feel muscular soreness between 8 and 48 hours postexcercise, with peak levels occuring at around 48 hours. This soreness is thought to be the result of the muscular damage that can occur with any type of high-intensity workout. Although it is normal to sustain muscular damage with excercise, excessive damage can cause a condtion kown as extertional rhabdomyolysis, the degeneration of skeletal muscle caused by ecxessive unaccustomed excerise.

One of the most valid and reliable methods for assessing muscular damage is to check for increases in blood serum levels of creatine kinase (CK), the primary enzyme regulating anaerobic metabolism, because a high percentage of the body´s CK is present in skeletal muscle tissue. Assessing CK levels has been commonplace for more than 3 decades in studies investigsting muscular damage.


Rhabdomylysis is a primary concern for clients training with EMS

Risk factors for extertional rhabdomylysis includes exercising in very hot and humid environments, not drinking enough water (dehydration), weight lifting, CrossFit, poor physical conditioning, fatigue and prior history of heat exhaustion. Although the prevalence and incidence of exterrional rhabdomylysis are not known due to the inherent fatigue, dehydration and blunt trauma that occur while playing football, exertional rhabdomylysis is a primary concern for clients training with EMS.

Solution for EMS clients

We have made several researches on the risk of high creatine kinase (CK) values and ended up with creating a client consent that includes all the factors and preautions to avoid severe health problems. A rise in the CK activity can be found 4 to 8 hours after the training. CK activity reaches a maximum after 12 to 24 hours and then falls back to the normal range after 3 to 4 days.

High CK levels because of:

  • Brain injury or stroke, scizophrenia
  • Bonvulsions
  • Delirium tremens, alcohol consumption
  • Polymyositis
  • Heart attack
  • Myocarditis
  • Pulmonary infarction
  • Muscular dystrophies
  • Myopathy
  • Cancer treatment

Recommendation for studio owners

Therefore we recommend having an interview with the clients in depth when starting with training based on EMS technology. The trainer must be aware of all consequences caused by EMS Training. Hortobabyi/ Denehan (1989) showed that is not uncommon for healthy excercising athletes to have high blood CK levels. High resting CK levels were attributed to decreased enzyme removal from the blood, permantly damaged muscle cell membranes as a result of chronic physical stress. This is a result also in higher level of protein breakdown and higher lean body mass of athletes.


To sum up, elevated levels of myoglobin in the blood can have toxic effect on the glomerular filtration rate (kidney fuction) causing potential failure of the organ, especially in dehydration cases. Therefore EMS trainers need to provide proactive rehydration (Program Water Drinking) for thier clients.

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