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Electromagnetic Stimulator of the Microcirculation  "
ESTMC™ Tecnology by Human Tecar "
WHTcare Switzerland "
Applications in Sports Medicine "

© Marc Michnowski - 23 av Niel 75017 Paris - France - marcophysio@yahoo.fr
Electromagnetic Stimulator of the Micro Circulation "

§ 

Uses an electromagnetic signal 485 Mhz (intermediate
frequency radio wave) produced by a generator

§ 

Applied directly to human tissues without space propagation
by two differents types of conducing electrodes

§ 

Mobilizes electrical charges into tissues and creates a deep
high or low modification of the temperature and
conseguently an increase of the microcirculation 

§ 

For different therapeutical effects
Using RadioFrequency (RF) in medicine: a bit of history"

§  Introduced in 1920: Bovie and Gusting for
electro cauterization

§  1950: in neuro surgery to create localized
lesions of the central nervous system
§  1960: in cardiac surgery to remove nodules
RF used to treat tumour masses"

Leveen et al, 1976"
creating hyperthermia in order to destroy
	

central cells (wich have less active
metabolism and are less vascularized)

Ley et al, 1992"
show central necrosis and reduction of
	

peripheral edema of carcinomatous mass
suggested possibility to use RF for other
tissues
Using RF in tissues subject to inflammatory reactions"
§ 

with appropriate proportions of intensity and time

§ 

to not reach temperature who leads to cellular necrosis
observed in tumour therapy 

"

§  1953 Lehmann: "
40-45 °C have therapeutic effects in various
pathological conditions 

➜ NON-INVASIVE Therapeutic RadioFrequency
Other uses: dermatology and aesthetic"

§ 

Heat the deep dermis and subcutaneous tissue

§  Treat

the sagging skin of face and body

§  Reduce
§  Acne

local fat and cellulitis
Physical Principles. Electromagnetic wave."

§ 

Product of an electrostatic field and
a magnetic field produced by an
alternating electrical current.

§  Transport

energy and is not
perceptible by senses 
All conductive structure subjected
to electromagnetic wave will undergo
an energy increase as an increase of
the ion movements 
§ 

§  Temperature

increases where the
wave condenses
The HCR 1001 generator of ESTMC™ Technology "
§ 

Signal is trasmitted to the human body by 2 different
electrodes

§ 

High impedance or capacitive (lympho dynamic or thermo
dynamic)

§ 

Low impedance or resistive

§ 

A metal conductor sheet closes the circuit
Electricity"

Capacitor: elementary electrical component 
constituted of two conductive frames
(electrodes) separated by a dielectric polarizable
insulator

Property: to store opposite electrical charges
on their frames by electrostatic effect 
Capacitive effect
High Impedance (Capacitive) effect"

Capacitor is made up of: 

§ 

one frame - a metal electrode
with an insulating layer placed
on tissue surface

§ 

one other frame - the metal
conductor sheet which closes
the circuit with the human
tissues as insulator
§ 

Charges tend to condense mainly
around the insulated electrode

§ 

Energy tend to increase gradually
around it with subconsequence
increase the microcirculaton and
temperature (if desidered)

The energy depends on the voltage
applied by the generator (Volts) and the
size of the electrode. The movement
changes the endothermic response.
High impedance electrodes Lympho or Thermo dynamic
(Capacitive)"
§ 

The electrodes are constituted by:

§ 

inside different type of conductive metallic
material,
outside biocompatible insulating material
applied with a technique of overlap.

§ 

The geometry : flat or convex 

§ 

Two different models:

§ 

Lymphodynamic : allows action to low
intensity and causes small temperature
variations ➞ lymphatic system;
Thermodynamic allows action to high
intensity and causes higher temperature
variations ➞ other fluidic components
Electrical Resistance"
Property of a conductive material to slow
down the passage of an electrical current

Responsible for energy dissipation as heat

Certain materials are offering more or less
resistance 

Resistive effect
Low impedance electrode (Resistive):"
•  Within

the structures subjected to
the radio frequency signal
comprises a movement of ions

•  Where

the waves condense
(bones, ligaments, tendons …)
energy increase, temperature and
microcirculation too (if desired)
§ 

The RF signal produced by
HCR 1001 is administered to
the tissues through a manual
therapy

§ 

The conductive electrolyte
emulsion between electrodes
and the skin reduces the skin
resistance 

§ 

hydrates tissues and
facilitates electrode sliding

§ 

Facilitates a deep action
Technology’s actions"
Action on the tissue’s temperature
either superficial or deep on a localized
or larger area.

HCR 1001 induces an important or
very small temperature variation
depending on the delivered intensity

Objectives: 

 	

-  to increase the vasodilatation 


- to increase the blood microcirculation
-  to increase the tissue metabolism 
-  to cause biological reactions 

- =>to stimulate mechanisms of repair
In combination with a manual therapy and in
rehabilitation programs"
§ 

Increase extensibility of collagen tissue by the
modification of viscosity

§ 

Reduce pain and release endorphins

§ 

Reduce muscle spasms and contractures 

§ 

Help the reduction of edema and hemorrhagic
collections
Studies"
Healing"
§ 

“Good orthopeadic health” is a
state of balance of our systems

§ 

Under various aggression effects
(intrinsec or extrinsec) trauma, over
uses, sport training, ageing, fatigue,
stress… 

§ 

Balance changes ➞system

adaptations to new balance until a
decompensation ➞ pathology ➞ 
inflammation ➞ healing process ➞
same or new system balance
Natural Healing Cascade "
Inflammation = usefull for healing

	



Physiological response to aggression,
Necessary to lead to tissue reconstruction and healing

2 phases"
§ 

Vascular : vasodilatation and vascular permeability increase
release of molecules, activation of proteines, secretion of chemical mediators

§ 

	

	


Cellular : local vasodilatation to increase blood flow to:
# evacuate dead cells and toxins

#

#

bring necessary elements for reconstruction	

§ 

Clinic :

	


	

vasodilatation ➞ redness and heat

	


	

aqueous fluid from blood plasma 	


by osmosis to tissues ➞ edema
	

	

	

	


	


	

edema ➞ nerves compression ➞pain
Synergistic Healthcare Methodology"
§ 

Use of this technique since 10 years in high level
sports (football, tennis, motorsports, athletics….) has
helped us to develop a method of treatment called
SHM 



§ 

Athletes need fast recovery, precision and security
from physiotherapy to treat and prevent imbalances 

§ 

SHM helps us to accelerate bio repairing processes,
control pain without inhibiting inflammation often
necessary
SHM combines the action of :
technologies
products with functional ingredients
special manual techniques 
Rehabilitation programs

To assist therapist’s and give their
hands power to help tissues to :

§  regain a new balance initially
lost"
"

§  create other balance if it
permanently lost (rheumatology)"
"

§  restore a balance before
pathology occurring (prevention)"
Practical applications"
Trauma "
•  London

2012 , women pault vault qualification

•  Athlete

felt acute pain on heel during impulse

•  Clinical

exam : 

pain on manual pressure of posterior and lateral
heel area
pain on plantar fascias stretching / contraction
walking difficulties
Athlete wants to try to compete the olympic
final 36 hours later
US (3h) : fat lesion with sub cutaneous edema "
no visible strain on plantar fascias"
Treatment with ESTMC"
•  Low

Impedance electrode application with high intensity on calf
and popliteal area to :!

- 

Create important temperature variation up the heel !

- 

Stimulate blood flow increase, relax calf muscles and help
drainage!

•  High

Impedance electrode application with really low intensity on
heel area to : !

Analgesie and drain edema!
Others : Ice applications / compressive bandage!
30 minutes treatment 3 times a day!
US after 36 hours : edema resorbtion"
conclusion"

•  Clinical

exam :

Pressure pain was less
No pain during stretching / contraction / walking
Running 60 % result : 
Treatment with SHM help for analgesic and edema resorbtion
No enough time for healing
Acute pathology : Achille’s tenosynovitis"
"
"
Acute occuring during running or
jumping
Pain and oedema 
US ➞ oedema in sheath / fibre
thickening or strains 
Fonctionnal disability: fast walking /
stairs / foot impulse
Clinical examination"

•  Tendon

palpation to evaluate where is the most painfull
area ( lateral, medial side, depth or superficial …) and
oedema tonicity

•  Calf

palpation to research muscle spasm : soleus +++

•  Evaluate

the ankle, subtalar and foot join motions 

•  Evaluate

the stretch range before onset of pain
Preparation"
Mild application of lymphoarticular oil on
popliteal area, on achilles tendon and on
ankle and foot joins
application of thermoactivante oil on the calf
muscles
➞


lymphatic stimulation and reduce

resistances

application of dermopurifiante solution to
cleansing the skin
Treatment
Objectives:"

Reduce pain and
oedema
1/ Thermodynamic High Impedance Electrode"
High intensity, cranially, on calf muscles and
poplitéal area :
➞ Creating signifiant temperature difference
between 2 areas
➞ Improving lymphatic drainage
➞ Increasing blood circulation in muscles to
relief tensions and relax
➞ Application associated with massage and
slow and soft stretching if possible
2/ Low Impedance Electrode "

Low intensity on tendon, paratenon,
ankle, foot joints :
➞ Inducing a small increase in
temperature 
➞ Associated with massage (Cyriax)
stretching or eccentric techniques
➞ Manual therapy for joint loss of
mobility
3/ Convex Lymphodynamic High Impedance Electrode"

Low intensity"
➞ inducing a minimal temperature variation to
activate lymphatic drainage
➞ mild massage to reduce space between
tendon and sheath
Chronic pathologie: knee arthrosis"
Clinical examination"
§ 

Cartilage and meniscus degeneration of
patellofemoral and/or tibiofemoral joint(s)

§ 

Beside inflammatory phase where pain can
be severe if sub chondral achievement 

§ 

Fibrosis synovial / flexum / ligament stifness

§ 

Thigh muscular stiffening

§ 

Muscle atrophy / loss of strengh and
elasticity
Treatment "
Thermodynamic High Impedance"
Electrode"
"

High intensity on the thigh muscles for
increasing blood flow to

➞ Reduce spasms
➞ Prepare to strecthing and
strenghtening
Low Impedance Electrode "

Low to medium intensity on the knee
and caudally to:"
➞ concentrate action on joint elements
for flexibility
➞ prepare manual therapy treatment 
§  Patellar movements
§  Specific minor mouvements
➞ Followed by rehabilitation
exercises
Conclusion "
•  ESTMC TM

is a valuable tool to
empower physiotherapist’s hands

•  Indicated

for many orthopedics and
sports pathology

•  Manual

treatments depend on the
specific training and experience of
operator who stay the central actor of
the therapeutic program
Merci"

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Estmc by human tecar Applications in sports medicine

  • 1. Electromagnetic Stimulator of the Microcirculation  " ESTMC™ Tecnology by Human Tecar " WHTcare Switzerland " Applications in Sports Medicine " © Marc Michnowski - 23 av Niel 75017 Paris - France - marcophysio@yahoo.fr
  • 2. Electromagnetic Stimulator of the Micro Circulation " §  Uses an electromagnetic signal 485 Mhz (intermediate frequency radio wave) produced by a generator §  Applied directly to human tissues without space propagation by two differents types of conducing electrodes §  Mobilizes electrical charges into tissues and creates a deep high or low modification of the temperature and conseguently an increase of the microcirculation §  For different therapeutical effects
  • 3.
  • 4. Using RadioFrequency (RF) in medicine: a bit of history" §  Introduced in 1920: Bovie and Gusting for electro cauterization §  1950: in neuro surgery to create localized lesions of the central nervous system §  1960: in cardiac surgery to remove nodules
  • 5. RF used to treat tumour masses" Leveen et al, 1976" creating hyperthermia in order to destroy central cells (wich have less active metabolism and are less vascularized) Ley et al, 1992" show central necrosis and reduction of peripheral edema of carcinomatous mass suggested possibility to use RF for other tissues
  • 6. Using RF in tissues subject to inflammatory reactions" §  with appropriate proportions of intensity and time §  to not reach temperature who leads to cellular necrosis observed in tumour therapy " §  1953 Lehmann: " 40-45 °C have therapeutic effects in various pathological conditions ➜ NON-INVASIVE Therapeutic RadioFrequency
  • 7. Other uses: dermatology and aesthetic" §  Heat the deep dermis and subcutaneous tissue §  Treat the sagging skin of face and body §  Reduce §  Acne local fat and cellulitis
  • 8. Physical Principles. Electromagnetic wave." §  Product of an electrostatic field and a magnetic field produced by an alternating electrical current. §  Transport energy and is not perceptible by senses All conductive structure subjected to electromagnetic wave will undergo an energy increase as an increase of the ion movements §  §  Temperature increases where the wave condenses
  • 9. The HCR 1001 generator of ESTMC™ Technology " §  Signal is trasmitted to the human body by 2 different electrodes §  High impedance or capacitive (lympho dynamic or thermo dynamic) §  Low impedance or resistive §  A metal conductor sheet closes the circuit
  • 10. Electricity" Capacitor: elementary electrical component constituted of two conductive frames (electrodes) separated by a dielectric polarizable insulator Property: to store opposite electrical charges on their frames by electrostatic effect Capacitive effect
  • 11. High Impedance (Capacitive) effect" Capacitor is made up of: §  one frame - a metal electrode with an insulating layer placed on tissue surface §  one other frame - the metal conductor sheet which closes the circuit with the human tissues as insulator
  • 12. §  Charges tend to condense mainly around the insulated electrode §  Energy tend to increase gradually around it with subconsequence increase the microcirculaton and temperature (if desidered) The energy depends on the voltage applied by the generator (Volts) and the size of the electrode. The movement changes the endothermic response.
  • 13. High impedance electrodes Lympho or Thermo dynamic (Capacitive)" §  The electrodes are constituted by: §  inside different type of conductive metallic material, outside biocompatible insulating material applied with a technique of overlap. §  The geometry : flat or convex §  Two different models: §  Lymphodynamic : allows action to low intensity and causes small temperature variations ➞ lymphatic system; Thermodynamic allows action to high intensity and causes higher temperature variations ➞ other fluidic components
  • 14. Electrical Resistance" Property of a conductive material to slow down the passage of an electrical current Responsible for energy dissipation as heat Certain materials are offering more or less resistance Resistive effect
  • 15. Low impedance electrode (Resistive):" •  Within the structures subjected to the radio frequency signal comprises a movement of ions •  Where the waves condense (bones, ligaments, tendons …) energy increase, temperature and microcirculation too (if desired)
  • 16. §  The RF signal produced by HCR 1001 is administered to the tissues through a manual therapy §  The conductive electrolyte emulsion between electrodes and the skin reduces the skin resistance §  hydrates tissues and facilitates electrode sliding §  Facilitates a deep action
  • 17. Technology’s actions" Action on the tissue’s temperature either superficial or deep on a localized or larger area. HCR 1001 induces an important or very small temperature variation depending on the delivered intensity Objectives: -  to increase the vasodilatation - to increase the blood microcirculation -  to increase the tissue metabolism -  to cause biological reactions - =>to stimulate mechanisms of repair
  • 18. In combination with a manual therapy and in rehabilitation programs" §  Increase extensibility of collagen tissue by the modification of viscosity §  Reduce pain and release endorphins §  Reduce muscle spasms and contractures §  Help the reduction of edema and hemorrhagic collections
  • 20.
  • 21.
  • 22. Healing" §  “Good orthopeadic health” is a state of balance of our systems §  Under various aggression effects (intrinsec or extrinsec) trauma, over uses, sport training, ageing, fatigue, stress… §  Balance changes ➞system adaptations to new balance until a decompensation ➞ pathology ➞ inflammation ➞ healing process ➞ same or new system balance
  • 24. Inflammation = usefull for healing Physiological response to aggression, Necessary to lead to tissue reconstruction and healing 2 phases" §  Vascular : vasodilatation and vascular permeability increase release of molecules, activation of proteines, secretion of chemical mediators §  Cellular : local vasodilatation to increase blood flow to: # evacuate dead cells and toxins # # bring necessary elements for reconstruction §  Clinic : vasodilatation ➞ redness and heat aqueous fluid from blood plasma by osmosis to tissues ➞ edema edema ➞ nerves compression ➞pain
  • 25. Synergistic Healthcare Methodology" §  Use of this technique since 10 years in high level sports (football, tennis, motorsports, athletics….) has helped us to develop a method of treatment called SHM §  Athletes need fast recovery, precision and security from physiotherapy to treat and prevent imbalances §  SHM helps us to accelerate bio repairing processes, control pain without inhibiting inflammation often necessary
  • 26. SHM combines the action of : technologies products with functional ingredients special manual techniques Rehabilitation programs To assist therapist’s and give their hands power to help tissues to : §  regain a new balance initially lost" " §  create other balance if it permanently lost (rheumatology)" " §  restore a balance before pathology occurring (prevention)"
  • 28. Trauma " •  London 2012 , women pault vault qualification •  Athlete felt acute pain on heel during impulse •  Clinical exam : pain on manual pressure of posterior and lateral heel area pain on plantar fascias stretching / contraction walking difficulties Athlete wants to try to compete the olympic final 36 hours later
  • 29. US (3h) : fat lesion with sub cutaneous edema " no visible strain on plantar fascias"
  • 30. Treatment with ESTMC" •  Low Impedance electrode application with high intensity on calf and popliteal area to :! -  Create important temperature variation up the heel ! -  Stimulate blood flow increase, relax calf muscles and help drainage! •  High Impedance electrode application with really low intensity on heel area to : ! Analgesie and drain edema! Others : Ice applications / compressive bandage! 30 minutes treatment 3 times a day!
  • 31. US after 36 hours : edema resorbtion"
  • 32. conclusion" •  Clinical exam : Pressure pain was less No pain during stretching / contraction / walking Running 60 % result : Treatment with SHM help for analgesic and edema resorbtion No enough time for healing
  • 33. Acute pathology : Achille’s tenosynovitis" " "
  • 34. Acute occuring during running or jumping Pain and oedema US ➞ oedema in sheath / fibre thickening or strains Fonctionnal disability: fast walking / stairs / foot impulse
  • 35. Clinical examination" •  Tendon palpation to evaluate where is the most painfull area ( lateral, medial side, depth or superficial …) and oedema tonicity •  Calf palpation to research muscle spasm : soleus +++ •  Evaluate the ankle, subtalar and foot join motions •  Evaluate the stretch range before onset of pain
  • 36. Preparation" Mild application of lymphoarticular oil on popliteal area, on achilles tendon and on ankle and foot joins application of thermoactivante oil on the calf muscles ➞ lymphatic stimulation and reduce resistances application of dermopurifiante solution to cleansing the skin
  • 38. 1/ Thermodynamic High Impedance Electrode" High intensity, cranially, on calf muscles and poplitéal area : ➞ Creating signifiant temperature difference between 2 areas ➞ Improving lymphatic drainage ➞ Increasing blood circulation in muscles to relief tensions and relax ➞ Application associated with massage and slow and soft stretching if possible
  • 39. 2/ Low Impedance Electrode " Low intensity on tendon, paratenon, ankle, foot joints : ➞ Inducing a small increase in temperature ➞ Associated with massage (Cyriax) stretching or eccentric techniques ➞ Manual therapy for joint loss of mobility
  • 40. 3/ Convex Lymphodynamic High Impedance Electrode" Low intensity" ➞ inducing a minimal temperature variation to activate lymphatic drainage ➞ mild massage to reduce space between tendon and sheath
  • 42. Clinical examination" §  Cartilage and meniscus degeneration of patellofemoral and/or tibiofemoral joint(s) §  Beside inflammatory phase where pain can be severe if sub chondral achievement §  Fibrosis synovial / flexum / ligament stifness §  Thigh muscular stiffening §  Muscle atrophy / loss of strengh and elasticity
  • 43. Treatment " Thermodynamic High Impedance" Electrode" " High intensity on the thigh muscles for increasing blood flow to ➞ Reduce spasms ➞ Prepare to strecthing and strenghtening
  • 44. Low Impedance Electrode " Low to medium intensity on the knee and caudally to:" ➞ concentrate action on joint elements for flexibility ➞ prepare manual therapy treatment §  Patellar movements §  Specific minor mouvements ➞ Followed by rehabilitation exercises
  • 45. Conclusion " •  ESTMC TM is a valuable tool to empower physiotherapist’s hands •  Indicated for many orthopedics and sports pathology •  Manual treatments depend on the specific training and experience of operator who stay the central actor of the therapeutic program