I tried to write a pun about bones…

But nothing humerus came to mind.

As we age, maintaining bone density becomes increasingly important, especially for women. Osteopenia, a precursor to osteoporosis, puts individuals at higher risk for fractures. While exercise is a known ally for bone health, getting enough of it can be a challenge for many older adults. But what if a time-saving technology could lend a hand? The majority of my clients are women in their 50s, and the question of whether EMS can help combat osteopenia often comes up.

A 2015 study explored just that: the potential of Whole-Body Electromyostimulation (WB-EMS) to combat osteopenia in elderly women.

What is WB-EMS?

Unlike localized electrical muscle stimulation, WB-EMS simultaneously stimulates multiple muscle groups—up to 8-12 at once—using a specialized suit with electrodes. The idea is to amplify the effects of moderate exercise on the musculoskeletal system, potentially offering a feasible option for those who can't or won't engage in strenuous conventional workouts, among many other benefits that can be read about here.

Study Summary

The study involved 76 community-living osteopenic women, aged 70 and older, from Germany. These women were randomly divided into two groups for a 54-week intervention:

• WB-EMS Group (38 participants): This group performed WB-EMS training 3 times every 14 days.
  
  • Parameters: They used a bipolar current at 85 Hz frequency with a pulse width of 350 µsec.
  • Exercises: Each 18-19 minute session involved easy, low-amplitude dynamic exercises in a standing position (e.g., squats, arm flexions, military presses). These movements were performed with 6 seconds of dynamic movement under EMS, followed by 4 seconds of static rest without current. They typically did 10-14 exercises in 1-2 sets of 8 repetitions. The total time under current was about 11 minutes per session.
  • Intensity: Current intensity was individually adjusted to a "somewhat hard" to "hard" (14-16 out of 20) Rate of Perceived Exertion (RPE).
  • Key Detail: The exercises themselves were intentionally low-intensity (e.g., squats with leg flexion less than 35 degrees) to isolate the effects of the EMS.
• Control Group (38 participants): This group engaged in a non-strenuous exercise program, performing identical low-intensity/low-amplitude movements as the WB-EMS group, but without any electrical stimulation. They attended one 60-minute session per week, with 10-week rest periods between blocks. Their sessions also included flexibility, coordination, and balance exercises, along with relaxation.

Both groups also received daily calcium (up to 1,200 mg) and Vitamin D (800 IU) supplementation.

Study Outcomes

After 54 weeks, the researchers looked at several key measures:

• Bone Mineral Density (BMD):
  
  • Lumbar Spine: The WB-EMS group saw a 0.6% increase in lumbar spine bone mineral density, while the control group experienced a 0.7% decrease. This difference was borderline non-significant.
  • Total Hip: There was no significant difference in total hip bone mineral density between the groups. Both groups showed a slight decrease (WB-EMS: -1.1%, Control: -0.8%).
• Other Positive Changes (Secondary Outcomes):
  
  • Lean Body Mass (LBM): The WB-EMS group experienced a significant gain of 1.5% in lean body mass compared to the control group (P = 0.006).
  • Grip Strength: The WB-EMS group showed a significant increase of 8.4% in grip strength compared to the control group.

What Does It All Mean?

While the study didn't show a strong, statistically significant increase in bone mineral density at the lumbar spine, and no effect at the hip, the trends for the spine are interesting. The researchers noted that WB-EMS had a more pronounced effect on muscle mass and strength, which are closely linked to bone health.

The study suggests that for elderly individuals who are unable or unwilling to participate in more intense conventional exercise programs, WB-EMS could be a viable option for maintaining BMD at the lumbar spine and improving muscle mass and strength.

Key takeaway: WB-EMS might be a helpful tool in the fight against osteopenia, particularly for those with limited exercise options, but it may not be a magic bullet for bone building compared to more intensive, varied workouts.

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My thoughts on the study: 

• I think it’s important to highlight that the control group trained for one hour per week for 54 weeks, which is a total of 54 hours if they didn’t skip any weeks. The WB-EMS group only trained for 27 hours (3 sessions of 20 minutes every 2 weeks) and still had more positive outcomes than the control group.
• We know that in order to maintain/increase bone mineral density we need: 
  
  • Lift heavy enough: To build bone density, aim for resistance training at 70–85% of your 1-rep max (1RM)—this level of intensity stimulates the bones to remodel and grow stronger.
  • Use compound movements: Focus on weight-bearing exercises like squats, deadlifts, and lunges to load the hips, spine, and legs—key areas for bone health.
  • Add impact when possible: Jumping, hopping, or brisk stair climbing can boost bone strength—especially helpful for the hips and spine—if joints allow.
  • Train consistently: For real change, train 2–4 times per week, over a period of 6–12 months. Bones take time to respond, so long-term commitment matters.

For these reasons I started to include weights when possible along side WB-EMS training with a strong recommendation of 2 sessions per week using similar parameters as they used in this study.

If you're interested in EMS training with me and live near Santa Monica, Brentwood, Palms, Beverly Hills, or Bel-Air, please send me an email at conradfitness@gmail.com or book a 15 min call with me.

If you are looking for an EMS trainer in other cities, please check my trusted network.

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