20-Day EMS/TENS Physiotherapy Program
Patient Summary & Diagnosis
Patient Name: Samina (43 y/o Female)
Date of Report: 15-11-24
Diagnosis Summary:
- Experiencing pain in the RIGHT HIP.
- X-ray indicates degenerative joint disease in the LEFT HIP (reduced joint space).
- Other pain areas: bilateral quadriceps, hamstrings, pelvic region, and tailbone.
Treatment Approach:
Right hip receives primary pain relief.
Left hip receives structural muscle support therapy.
EMS/TENS 20-Day Therapy Plan
Days 1-5:
- TENS: Right hip (pain management), pelvic region, tailbone
- EMS: Left glutes, hamstrings (support), quads (moderate)
Days 6-10:
- TENS: Alternate between right hip and hamstrings
- EMS: Quads (both), left glutes, bilateral hamstrings
Days 11-15:
- TENS: Right hip and lower back
20-Day EMS/TENS Physiotherapy Program
- EMS: Pelvis (both sides), quads, hamstrings
Days 16-20:
- Integrated Mode (MASS): Glutes and hamstrings for recovery
- TENS: As needed based on pain
- EMS: Strength maintenance
Precautions
- Avoid EMS over areas with metal implants or fractures
- Do not place electrodes over open wounds or infected skin
- Avoid TENS/EMS use near the heart or carotid artery
- Not recommended during menstruation over pelvic area
- Stop immediately if dizziness, increased pain, or irritation occurs
Electrode Placement Images
20-Day EMS/TENS Physiotherapy Program
20-Day EMS/TENS Physiotherapy Program
Physician Notes & Radiology
20-Day EMS/TENS Physiotherapy Program
20-Day EMS/TENS Physiotherapy Program
X-ray Impression: Evident joint space narrowing in LEFT hip, indicating osteoarthritis.
Plan adjusted for RIGHT-sided pain while supporting LEFT hip structurally.
20-Day EMS/TENS Physiotherapy Program
Physiotherapy Plan Summary (with EMS/TENS)
Day Mode Area Treated Electrode Placement Duration (min) Notes
1-5 TENS Right Hip, Tailbone Right lateral hip, sacral area 20 Pain relief, inflammation
EMS Quads, Hamstrings Front and back of thighs 20 Muscle re-education
6-10 TENS Pelvic + Right Hip Pelvis center, right hip 20 Pain modulation
EMS Hamstrings Back of thighs 20 Strengthening
11-15 TENS Right Hip Lateral hip 20 Symptomatic relief
EMS Glutes, Lower Back Buttocks and lumbar area 20 Postural control
16-20 TENS Tailbone, Right Hip Sacral and lateral hip 20 Desensitization
EMS Quads + Hamstrings Front and back of thighs 20 Endurance build-up
Precautions & Contraindications
- Avoid EMS/TENS on broken skin or open wounds.
- Do not apply electrodes over the heart, neck (carotid sinus), or directly over the spine.
- Avoid EMS during pregnancy (abdominal/pelvic areas).
- Patients with pacemakers or cardiac arrhythmias should NOT use EMS/TENS.
- Remove metal jewelry near treatment site.
- Do not use TENS/EMS while operating heavy machinery or driving.
20-Day EMS/TENS Physiotherapy Program
Supplementary Physiotherapy Exercises
Recommended Physiotherapy Exercises (To be done daily after EMS/TENS session):
1. **Bridging** - Lie on back, bend knees, lift hips. Hold for 5 seconds. Repeat 10x.
2. **Clamshells** - Lie on side, knees bent, lift top knee. Strengthens glutes.
3. **Straight Leg Raise** - Tighten thigh and lift leg. Helps quads activation.
4. **Seated Hamstring Stretch** - Stretch back of thigh, hold 20 seconds.
5. **Pelvic Tilts** - Lie on back, tilt pelvis gently. Strengthens core.
6. **Standing Hip Abduction** - Lift leg sideways, keep posture straight.
7. **Wall Sits (isometric)** - Strengthen thighs without joint load.
8. **Tailbone Release (on foam roller or soft ball)** - For localized pain.
*Do exercises under supervision initially. Adjust based on pain or discomfort.*
