TENS vs. REST? Should you invest on an Electrical Stim Machine?

TENS vs. REST? Should you invest on an Electrical Stim Machine?

Adequate recovery is essential in order to achieve better performance in any sport. Muscle fatigue is a result of changes at the level of the muscle, such as micro tears, depletion of creatine phosphate, accumulation of metabolites, mismatch of oxygen supply/demand or even central nervous system fatigue. The question is, is TENS an effective method to enhance the rate of recovery after exercise? Based on 10 different articles I reviewed, the results are rather disappointing


Milne 2001 negative review of 5 trials of TENS for chronic low back pain
Johnson 2007 positive review of 38 trials of TENS for chronic musculoskeletal pain, “effective”
Nnoaham 2008 inconclusive review of 25 studies of TENS for chronic pain
Khadilkar 2008 inconclusive review of 4 trials of TENS for chronic low back pain
Walsh 2009 inconclusive review of 12 trials of TENS for acute pain
Hurlow 2012 inconclusive review of 3 trials of TENS for cancer pain
Vance 2014 mixed review: “it’s complicated”?? but promising
Chen 2015 negative review of 18 trials of TENS for knee osteoarthritis
Desmeules 2016 inconclusive (but discouraging) review of 6 trials of TENS for rotator cuff tendinopathy

How does TENS work?


Pain is a result of alarm systems that reach your brain. These alarms go off way too loud and way too often, sometimes even without tissue damage. The brain decides what hurts and what doesn’t. The TENS machine blasts the nervous system with “sensory white noise”, and by stimulating the nerves in this way it distracts the brain (temporarily) from pain. Unless you turn the machine up enough to disable your brain, if it thinks you’re in pain , the alarm will go off again sooner or later, most likely shortly after the TENS is turned off.

 Vance et al. believe that “TENS has been shown to provide analgesia specifically when applied at a strong, non-painful intensity.”

This particular study compared the effects of electrical muscle stimulation, massage and passive rest in athletes after 6 different bouts of exhausting supra maximal training. The chart on the left shows the peak power production following each of these modalities. The chart on the right shoes the blood lactate concentrations following the exercise bouts. As you can see, no significant differences were demonstrated between the effects of EMS, massage and passive rest on recovery markers or peak power output.


Even though there is controversy over the topic, some people can find symptom relief following TENS. If your goal is pain reduction, you can buy a TENS machine for less than $100 at your nearest pharmacy!

Stefanie Cohen


Martin N.A., Zoeller R.F., Robertson R.J. The comparative effects of sports massage, active recovery, and rest in promoting blood lactate clearance after supramaximal leg exercise. J. Athl. Train. 1998;33:30-35.



A recent study suggested that 2/3 female lifters, and 1/3 male lifters prefer sumo over conventional. Has any of you sumo-ers been blamed of “cheating” because of preferring this technique? I certainly have. People claim that sumo is easier than conventional all the time, without taking into account hip structure, femoral angles, muscular tension and energy systems.

The main claim I hear is that sumo is easier because it requires less range of motion to complete a lift. This is not entirely false. Sumo deadlift has approximately 25% less range of motion than a conventional deadlift. This difference however matters very little when it comes to a one rep max- MAJOR KEY. Your muscles have more than enough energy stored to produce 8-10 seconds of maximal effort contractions, which is approximately how many seconds a deadlift grind last for. Range of motion would matter, if we are talking about deadlifting for maximal REPS.

Other factors like the shape of your pelvis, orientation of your hip socket and femur will determine your hip range of motion AND the amount of muscular tension you can develop by placing your legs in different positions. Refer to my older articles for more info on this! If you don’t know which style works better for you, you don’t really need an advanced measurement system. Simply try both methods and see which positions feel stronger for you.


Knee moment is 3x higher in sumo than conventional, this just means that Sumo’s hit your quads harder. EMG studies found that there is 10% more activity in your spinal erectors in conventional, so this form is harder on your erectors. My favorite quote by Greg Nuckols is “You miss a lift because you were too weak through your very weakest part of the movement”. This is applicable because if you do prefer sumo over conventional, maybe you need to strengthen your back, and if you prefer conventional, maybe you can incorporate more exercises to strengthen your quads.

In conclusion, NEITHER ONE IS HARDER THAN THE ORDER!!  If sumo were truly easier than conventional, why would Eddy Hall chose to pull conventional when he broke the world record deadlift at 1100 pounds?



By: Stefanie Cohen, SPT

Bench plateau? Try changing your bar path

Bench plateau? Try changing your bar path


After reading McLaughlin’s book, which is probably one of the best resource for the bench press I have ever encountered, I ran across one of Greg Nuckols article, where he talks about some key points from this book. He does a great job going over the biomechanics of the bench a lot more in depth than I will cover in this article so if that is something that interests you I highly recommend you check it out!

McLaughlin pointed out a really good observation about the difference in bar path between novice and advanced lifters. He showed that both groups lower the bar using a similar pattern, almost a straight line, but the path changed dramatically during the ascent. Novice lifters move the bar straight UP THEN BACK, while advanced lifters do the opposite. They move the bar up AND BACK right off the bat and finish the lift by pressing almost in a straight line up.


                                                      Image property of Greg Nuckols- Strength Theory

He pointed out that elite lifters were able to add pounds to their bench, with no real change in total force output. This is done by  changing their bar path by shortening the moment arm, which is the distance from the bar to your shoulder in the frontal plane (from your armpit to an imaginary line that drops straight down from your hand at the point that you hold the bar). You can accomplish this by decreasing the distance between the bar and your shoulder faster during the ascent part of the lift. This doesn’t necessarily change the amount of work you are doing, but its simply a more efficient way to push.

bar path

In conclusion, McLaughlin noted in his research that elite lifters didn’t increase their maximum force output that much year after year, but the ones that continue making the most progress where the ones that make adjustments on their bar path.

The “total work” done won’t necessarily change, as this is defined as the VERTICAL distance that the bar travels, and not the total distance. This is not a question about reducing work or decreasing range of motion but rather about finding a position that will be the most efficient to bench press in. 


Stefanie Cohen,  SPT

Pretty Squats vs. Ugly Squats

Pretty Squats vs. Ugly Squats
Recently I’ve been hearing a lot of talking about what constitutes a “perfect” squat.  What’s often overlooked is the fact that the proportions of your femur and torso play an important role on what your squat’s gonna look like.
Someone with short femurs relative to their torso, will be able to keep chest up during a squat, without leaning forward. Someone with long femurs will dramatically lean forward, almost like a good morning, due to their proportions. What I’m trying to get to is, if your biomechanics are a result of your morphology, then don’t worry. If you developed faulty movement patterns as a result of poor coaching or muscle imbalances, then you better get it fixed before it becomes an issue.

Because femur length can affect torso positioning during squatting, there really is no “one size fits all squat”. Hopefully the images above and this explanation will help further clarify these points. Dr. Ryan DeBell of The Movement Fix wrote a great article discussing in detail how hip anatomy changes squat mechanics, and inspired me to make this follow up post.

Besides mobility, which is known as the pliability of our muscles and connective tissue, anatomy differences can explain why some people can squat deeper than others, why some point their toes out, why some squat wide and some squat narrow. These anatomical differences will dictate form and comfort of the athlete. We can all agree on what a proper squat should look like, right?

  1. Back neutral
  2. Knees tracking your toes
  3. Keep your core tight

Click to see slideshow 

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Pic 1- one femur head points up, one points down

Pic 2- one neck is a lot longer than the other

Pic 3- the angle between the shaft and the ball is greater in one femur than the other

Pic 4- large versus small hip socket, one oriented up, one oriented down

Trying to force a movement pattern upon someone who’s anatomy isn’t conductive for it can be disastrous. If the athlete is uncomfortable in their stance despite how much mobility work they do, it’s important to look at their anatomy and let the stance and depth be dictated by comfort. The key point is to rule out mobility deficits first and making sure the athlete is taught how to perform a squat with proper form.


Stefanie Cohen, SPT


Great dead lifters are born, not made. Or are they?

Great dead lifters are born, not made. Or are they?

Because of this belief amongst the fitness community, it is not uncommon for athletes to blame a less than optimal deadlift on poor genetics. Things like the length of your bones and muscle fiber composition are difficult and impossible to alter. However, each lifter should explore different styles to find the one that better suits their bio-mechanical characteristics.

We all know that If you have long arms and short torso, you should pull conventional. If you have long torso and short arms, you should pull sumo. That’s common sense. Or is it?

But how do you know whether your arms or torso are long or short?

Direct comparison of your arm length to the arm of someone who is 5’8 doesn’t mean anything unless you are also 5’8. Arm-torso length need to be expressed as PROPORTION to of your height.

Divide your arm length by your height, and your torso length by your height.

  • Your torso should be measured from the bony prominence on the side of your thigh at the top (greater trochanter) to the top of your head.
  • Your arm is measured from the top of your shoulder (head of the humerus) to the middle finger, holding your arm out straight.
  • Take your height barefoot standing against a wall



So using that information if you have short arms relative to your torso, you’re better off pulling sumo.  If you have long arms relative to your torso, pull conventional. If your arm length matches  your torso length, you can pull both styles and experiment on which works better for you.

That being said, this is not a rule to end all discussion. We are not just made up of bones. Strength and mobility will also affect your deadlifting style.


People with strong glutes, hamstrings and lower back (posterior chain) favor conventional pulls. People with strong quads and adductors (and adductor  flexibility) are better sumo pullers.

In conclusion, beginner lifters can benefit from the information presented above to decide which pulling style could suit them better. If you are an advanced lifter, and the recommendations above don’t match your pulling style, maybe you have already developed your strength and flexibility to counter the influence of your structure. Or maybe, just maybe you have an untapped potential in deadlifting in the style in which your bones are best suited for.


Stefi Cohen

Posture Matters

Posture Matters

Posture matters. Improving your posture allows you to move bigger weights, improve performance and stay injury free. Do you train with a purpose? Do you know why you squat for example? You most likely squat with the purpose of getting a bigger squat, bigger legs, a bigger booty. You include the squat in the program for a reason. The same should hold true for your ENTIRE training program. Every mobility exercise, soft tissue technique, foam rolling, stretch should be included with a SPECIFIC goal in mind.

Hamstring stretch and Glute stretch

In my latest post I spoke about the importance of understanding the cause of your dysfunction in order to manage the symptoms appropriately. What happens in your pelvis affects what goes on in the rest of the body.

Having a posterior pelvic tilt means your hamstrings are short and stiff, which in-turn decreases your lumbar curvature, leaving you at an increased risk for herniations. The upper back will then compensate with an exaggerated upper back rounding and a forward neck, which puts you at risk for upper extremity and shoulder issues. Keeping your hips and spine aligned means less injuries, better health, optimal muscle recruitment, and better performance.


If you are a student, or work a desk job you most likely sit with slumped shoulders, round upper back and a neck that sticks out. Your upper body is a slave to the lower body. Fix the lower body and the upper body will improve. I hope you get it.

When we sit in a posterior pelvic tilt, we run into a lot of issues. 1) flattening of the lumbar spine, which leads to an increased propensity of moving into lumbar flexion. We’ve covered this point before, the lumbar spine doesn’t like to go into flexion, especially under load. 2) it leads to having a slouched upper back and a “head forward” posture, a position which puts your rotator cuff at higher risk for injury, and contributes to neck pain.

10931345_828448477193199_7080016482411996429_nStop stretching without a purpose. Be mindful about the way you move, sit, stand and incorporate the stretches and exercises that YOU need. By now you should already be wondering
what to do to correct your posterior pelvic tilt, if you have one. Focus on STRENGTHENING your spinal erectors, quads, hip flexors, and TFL, and STRETCHING your hamstrings and glutes.
–>Add these Banded Glute Bridge to strengthen you glutes, hamstrings and TFL


Stefi Cohen, SPT

Recording yourself while you lift: more than just vanity?

Recording yourself while you lift: more than just vanity?

In sports the effect of observation and visual imagery (mental practice) is well studied. Studies show that athletes who mentally train their specific task, improves their skillfulness, to similar levels to those physically practice it. Motor imagery and observation are both driven by the same basic mechanism.

Motor imagery is a tool in which a person imagines that he/she is performing the movement without even moving a finger . I can imagine I’m walking in the beach, while I sit in my 4-hour long lecture. I can imagine scenes or objects that are not really there. I can mentally perform actions I couldn’t do in reality.  The areas in your brain that control skillful movement are activated internally, the same way they would if you physically performed a movement. The same thing happens when you observe someone else or a video of someone else perform a task.

In conclusion, recording yourself while you lift is a very useful tool to improve your snatch, clean and jerk, squat or any other movement pattern you wish to work on. Not only would it allow you recognize pieces of it that can be improved on, but it will help you engrain that movement pattern. For beginner lifters, watching videos of talented lifters, or even watching attentively at your most advanced teammates technique can significantly aid in your development and maturation as an athlete.

Stefanie .C, SPT