Joint Recovery

Joint Recovery

Joint Recovery and Pain Relief


Joint pain prevents millions of people from being active and living a full life. This has a negative impact on quality of life. Common pain areas include the tibiofemoral (knee) joint, acetabulofemoral (hip) joint, glenohumeral (shoulder) and acromioclavicular (AC) joints, as well as the sacroiliac (SI) joint (which is a common joint associated with low back pain). Joint pain relief and recovery does not seem to be in sight as it’s estimated that 50 million Americans suffer from chronic pain, equating to approximately 20% of the adult population [1]. Out of the 50 million, 20 million of these individuals have pain severe enough that it frequently limits common activities of daily living which may ultimately lead to surgery with only the hopes of repairing functional mobility [1]. 


There are several mechanisms at the root of joint pain. One common cause may be related to physical injury to the joint caused by either contact and/or non-contact mechanisms [2]. Joint pain may also stem from physiological alterations as dysregulation of cytokines (proteins that mediate inflammation and immunity), adipokines (cytokines secreted from fat tissue), and hormones negatively impact joint health [3]. Lastly, joint pain may result from poor body mechanics and improper joint alignment. This would result in a mechanopathology or an injury as a result of poor movement mechanics [4]. Whether physical, physiological, or mechanical, joint recovery from joint pain or injury is of paramount importance.


PowerDot technology is the first step to natural joint pain relief helping people move well, move often, and move pain free. PowerDot harnesses the technology of both Neuromuscular Electrical Stimulation (NMES) and Transcutaneous Electrical Stimulation (TENS) all in one device operated by using an app and bluetooth connectivity on a smartphone. Stronger muscles that surround a joint have demonstrated the ability to decrease pain in that joint making muscle strengthening exercises a key component to joint pain relief. Stronger muscles may also help provide a mechanical solution by aligning the joints of the body, thus decreasing pain caused by improper joint alignment and movement [5]. NMES enhances muscular strength improvements by increasing muscle fiber recruitment and causing muscle hypertrophy (growth) by upregulating a key anabolic signaling pathway [6]. However, it is hard and painful to move, let alone exercise, with joint pain. TENS has been shown to significantly reduce pain more so than exercise [7]. Taking advantage of the NMES and TENS technology, offered wirelessly by PowerDot, enables the human body to experience joint pain relief and pain free movement. 

Masking Pain with Opioids

With the rise in pain continuing to skyrocket, the global community is in search for an answer. As opposed to using natural analgesic (pain relieving) solutions, people are turning towards injections and opioids. The joint pain injection industry is projected to grow and reach approximately 5.7 billion dollars over the coming years while the global opioids marketplace was just recently valued at 25.4 billion dollars and these numbers are expected to continue climbing. To be clear, the use of opioids does not help joint recovery, rather it masks the joint pain increasing one’s dependence on opioids for pain, which may result in addiction. The use of opioids for pain has resulted in approximately 2.4 million people (just in America) suffering from opioid use disorder [8]. 

Though there is a rise in more natural remedies for joint pain relief, PowerDot technology is backed by science. Specifically, TENS has been studied as a nonpharmacological and non-invasive intervention to reduce opioid utilization. This has been displayed by a reduction in fentanyl use after surgery when TENS therapy was used [9]. TENS releases endorphins and/or blocks pain signals sent to the central nervous system reducing the pain sensation. TENS has also been found to naturally interact with opioid receptors to produce pain relieving effects [10]. This was tested by examining the analgesic (pain relieving) effects of TENS under three conditions where participants were given a saline solution, a low dose of naloxone, and a high dose of naloxone [10]. Naloxone is a medication that binds to opioid receptors and reverses or blocks the effects of other opioids, meaning it would block the effects of TENS. However, TENS maintained it’s analgesic properties under the saline and low dose conditions. On the contrary, TENS analgesia was blocked under the high dose condition [10]. With limited or no pain as a result of TENS therapy, patients will not need or require opioids, lowering the costs to patients for the treatment of pain [11,12]. Though, beyond just the reduction in pain, TENS therapy may also improve activity levels, function, and quality of life. 

Pain Relief: Hips and Knees

The hips and knees are common joint pain areas in which relief is needed. The hips and knees are connected as a kinetic chain by which movement at these joints affect one another. There are countless causes of hip and knee joint pain. Physically, more active individuals may suffer from things like runner’s knee, which may include iliotibial band syndrome or patellofemoral pain syndrome [13]Mechanically, retroversion at the hip (this points the toes out as people stand or walk) caused by tightness in the posterior chain muscles (think hamstrings and glutes) may result in hip pain [14]. Physiologically, degeneration of articular cartilage and bone (ie. arthritis) results in bone on bone contact and pain which is why total knee replacements and total hip replacements are expected to grow 171% and 189%, respectively. Whether an active or aging population, joint pain relief for lower extremity injuries and damage is needed now and in the future.

Whether it’s activity related pain, arthritis, or recovery from surgery, the key to joint pain relief of the hips and knees is to strengthen the surrounding muscles and to get moving [6,13,15,16]. For instance, runners with weak quadriceps, hip flexors, and hip abductors have displayed an increased risk of lower extremity pain and overuse injuries [13,15,16]. Enhancing strength after joint replacement surgery restores and improves physical function post-operatively more quickly [17]. However, painful joints can be debilitating, making movement and exercise undesirable. This is where the PowerDot TENS and NMES technology comes in. 

As previously mentioned, TENS technology has the capability to mitigate pain symptoms allowing for immediate pain relief. By also incorporating NMES training, not only does muscular size and strength improve, but NMES contributes to reductions in pain, stiffness, and functional limitations associated with joint pain [18]. Researchers have explored how adding NMES 3 days per week for 6-weeks improves quadriceps strength. By stimulating one leg with NMES during training and using the other leg as a control, meaning one leg received NMES and the other leg did not, the leg that received NMES increased in strength by 24% and the control leg by only 10% [19]. This is further supported in those who have had joint replacement surgery where adding NMES may speed-up recovery and functional movement performance [6]. PowerDot technology can be utilized to combat lower extremity joint pain by offering immediate and long-term joint pain relief. 

Pain Relief: Shoulder Girdle

The shoulder is a synovial (freely moving) joint in which the head of the humerus articulates with the scapula (shoulder blade). So, when examining pain and movement at the shoulder, it’s imperative to consider the entire shoulder girdle of both the humerus and scapula. The shoulder is a very open joint and the muscles (rotator cuff, deltoid, rhomboids, trapezius) and ligaments around the shoulder girdle all contribute to making sure the head of the humerus aligns in the right position to avoid pain and potential injury.

Glenohumeral and AC joint pain (essentially… shoulder pain) may be caused by several different mechanisms. Pain may be due to a physical injury such as an AC joint sprain (which is very common in contact sports), mechanically by improper movement and posture, and/or physiologically by arthritis and degeneration of the joint which narrows the joint space [20]. Deficits in muscle strength and neuromuscular control are common after joint injury and that joint injury may lead to long-term muscle weakness as well as dysfunction in motor planning and movement [21]. The end goal is to strengthen the muscles of the shoulder girdle to allow for proper alignment of the humeral head in the shoulder joint and reduce instability [22]. Though traditional physical therapy may work, PowerDot TENS and NMES technology may further aid in the recovery after a sprain. When used in conjunction with one another, TENS and NMES technology have been demonstrated to restore motoneuron activation and increase the strength of muscles around previously injured ligaments enhancing the quality of the joint movement and reducing pain [21,23,24]. 

Pain Relief: Low Back and SI Joint

It’s been estimated that 75-85% of individuals will experience back pain at some point in their lives [25]. Low back pain may stem from several different causes, one of which is SI joint pain. This pain may be due to physical stress from axial loading (ie. running), mechanically by improper body mechanics during everyday movements, and/or physiologically due to hormone and inflammation alterations [26]. 

The SI joint pain that emanates as low back pain is a result of hypermobility/instability of the joint (too much movement) or hypomobility/fixation of the joint (too little movement) at the joint. As mentioned with all joint pain, exercise and strengthening are major contributors to pain relief. Though when referring to the SI joint cause of low back pain, strengthening should focus around stability. 

Those with chronic low back pain demonstrate a less efficient muscle control control system and inability to provide necessary spinal stability for everyday movements. In order to enhance the stability, strengthening of pelvic floor muscles, low back muscles, and the glutes is essential [27,28,29]. In just 10 visits focused on glute strengthening, patients with SI joint dysfunction decreased their pain and improved their function [27]. Adding PowerDot Smart TENS and NMES technology to therapy and strengthening may further reduce pain by up to 20% by optimized improvements in muscle strength, balance, and lumbar and pelvic stability [29,30].  

Joint Recovery For All

In conclusion, joint pain is preventing people from living life and living life to the fullest. TENS and NMES from PowerDot was created to provide affordable science-based technology to the global community to optimize pain free movement and enhance everyone’s quality of life. PowerDot Smart NMES and TENS therapy complement one another by providing joint pain relief utilizing bluetooth technology. The power to decrease pain, enhance recovery, and improve performance is now in the palm of your hands on an app on your phone.  Since the majority of people suffer from some type of pain, everyone should have access to both the NMES and TENS technology of PowerDot in their pocket. Pain should not be a limiting factor in life. Grab the new PowerDot 2.0, risk free, and don’t let pain limit your life. 



  1. Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., ... & Helmick, C. (2018). Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. Morbidity and Mortality Weekly Report67(36), 1001.[Link]
  2. Hibberd, E. E., Kerr, Z. Y., Roos, K. G., Djoko, A., & Dompier, T. P. (2016). Epidemiology of acromioclavicular joint sprains in 25 National Collegiate Athletic Association sports: 2009-2010 to 2014-2015 academic years. The American Journal of Sports Medicine44(10), 2667-2674. [Link]
  3. Bay-Jensen, A. C., Slagboom, E., Chen-An, P., Alexandersen, P., Qvist, P., Christiansen, C., ... & Karsdal, M. A. (2013). Role of hormones in cartilage and joint metabolism: understanding an unhealthy metabolic phenotype in osteoarthritis. Menopause20(5), 578-586. [Link]
  4. Hosseini, S. M., Wilson, W., Ito, K., & Van Donkelaar, C. C. (2014). A numerical model to study mechanically induced initiation and progression of damage in articular cartilage. Osteoarthritis and Cartilage22(1), 95-103. [Link]
  5. Hollman, J. H., Ginos, B. E., Kozuchowski, J., Vaughn, A. S., Krause, D. A., & Youdas, J. W. (2009). Relationships between knee valgus, hip-muscle strength, and hip-muscle recruitment during a single-limb step-down. Journal of Sport Rehabilitation18(1), 104-117. [Link]
  6. Burgess, L. C., Swain, I. D., Taylor, P., & Wainwright, T. W. (2019). Strengthening Quadriceps Muscles with Neuromuscular Electrical Stimulation Following Total Hip Replacement: a Review. Current Physical Medicine and Rehabilitation Reports7(3), 275-283. [Link]
  7. Cheing, G. L., Hui-Chan, C. W., & Chan, K. M. (2002). Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain?. Clinical Rehabilitation16(7), 749-760. [Link]
  8. Itzoe, M., & Guarnieri, M. (2017). New developments in managing opioid addiction: impact of a subdermal buprenorphine implant. Drug Design, Development and Therapy11, 1429. [Link]
  9. Lan, F., Ma, Y. H., Xue, J. X., Wang, T. L., & Ma, D. Q. (2012). Transcutaneous electrical nerve stimulation on acupoints reduces fentanyl requirement for postoperative pain relief after total hip arthroplasty in elderly patients. Minerva Anestesiologica78(8), 887-895. [Link]
  10. Leonard, G., Goffaux, P., & Marchand, S. (2010). Deciphering the role of endogenous opioids in high-frequency TENS using low and high doses of naloxone. Pain151(1), 215-219. [Link]
  11. Pivec, R. O. B. E. R. T., Minshall, M. E., Mistry, J. B., Chughtai, M., Elmallah, R. K., & Mont, M. A. (2015). Decreased opioid utilization and cost at one year in chronic low back pain patients treated with transcutaneous electric nerve stimulation (TENS). Surg Technol Int27, 268-74. [Link]
  12. Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain Management4(3), 197-209. [Link]
  13. Dixit, S., Difiori, J. P., Burton, M., & Mines, B. (2007). Management of patellofemoral pain syndrome. American Family Physician75(2), 194-202. [Link]
  14. Reynolds, D., Lucas, J., & Klaue, K. (1999). Retroversion of the acetabulum: a cause of hip pain. The Journal of bone and joint surgery. British Volume81(2), 281-288. [Link]
  15. Niemuth, P. E., Johnson, R. J., Myers, M. J., & Thieman, T. J. (2005). Hip muscle weakness and overuse injuries in recreational runners. Clinical Journal of Sport Medicine15(1), 14-21. [Link]
  16. Fredericson, M., Cookingham, C. L., Chaudhari, A. M., Dowdell, B. C., Oestreicher, N., & Sahrmann, S. A. (2000). Hip abductor weakness in distance runners with iliotibial band syndrome. Clinical Journal of Sport Medicine10(3), 169-175. [Link]
  17. Jan, M. H., Hung, J. Y., Lin, J. C. H., Wang, S. F., Liu, T. K., & Tang, P. F. (2004). Effects of a home program on strength, walking speed, and function after total hip replacement. Archives of Physical Medicine and Rehabilitation85(12), 1943-1951. [Link]
  18. Vaz, M. A., Baroni, B. M., Geremia, J. M., Lanferdini, F. J., Mayer, A., Arampatzis, A., & Herzog, W. (2013). Neuromuscular electrical stimulation (NMES) reduces structural and functional losses of quadriceps muscle and improves health status in patients with knee osteoarthritis. Journal of Orthopaedic Research31(4), 511-516. [Link]
  19. Balogun, J. A., Onilari, O. O., Akeju, O. A., & Marzouk, D. K. (1993). High voltage electrical stimulation in the augmentation of muscle strength: effects of pulse frequency. Archives of Physical Medicine and Rehabilitation74(9), 910-916. [Link]
  20. Hibberd, E. E., Kerr, Z. Y., Roos, K. G., Djoko, A., & Dompier, T. P. (2016). Epidemiology of acromioclavicular joint sprains in 25 National Collegiate Athletic Association sports: 2009-2010 to 2014-2015 academic years. The American Journal of Sports Medicine44(10), 2667-2674. [Link]
  21. Konishi, Y., McNair, P. J., & Rice, D. A. (2017). TENS Alleviates muscle weakness attributable to attenuation of ia afferents. International Journal of Sports Medicine38(03), 253-257. [Link]
  22. Martetschläger, F., Kraus, N., Scheibel, M., Streich, J., Venjakob, A., & Maier, D. (2019). The diagnosis and treatment of acute dislocation of the acromioclavicular joint. Deutsches Ärzteblatt International116(6), 89. [Link]
  23. Kim, K. M., Croy, T., Hertel, J., & Saliba, S. (2010). Effects of neuromuscular electrical stimulation after anterior cruciate ligament reconstruction on quadriceps strength, function, and patient-oriented outcomes: a systematic review. Journal of Orthopaedic & Sports Physical Therapy40(7), 383-391. [Link]
  24. Hauger, A. V., Reiman, M. P., Bjordal, J. M., Sheets, C., Ledbetter, L., & Goode, A. P. (2018). Neuromuscular electrical stimulation is effective in strengthening the quadriceps muscle after anterior cruciate ligament surgery. Knee Surgery, Sports Traumatology, Arthroscopy26(2), 399-410. [Link]
  25. Andersson, G. B. (1998). Epidemiology of low back pain. Acta Orthopaedica Scandinavica69(sup281), 28-31. [Link]
  26. Cohen, S. P. (2005). Sacroiliac joint pain: a comprehensive review of anatomy, diagnosis, and treatment. Anesthesia & Analgesia101(5), 1440-1453. [Link]
  27. Added, M. A. N., de Freitas, D. G., Kasawara, K. T., Martin, R. L., & Fukuda, T. Y. (2018). Strengthening the gluteus maximus in subjects with sacroiliac dysfunction. International Journal of Sports Physical Therapy13(1), 114. [Link]
  28. Pel, J. J. M., Spoor, C. W., Pool-Goudzwaard, A. L., van Dijke, G. H., & Snijders, C. J. (2008). Biomechanical analysis of reducing sacroiliac joint shear load by optimization of pelvic muscle and ligament forces. Annals of Biomedical Engineering36(3), 415-424. [Link]
  29. Krstev, T. (2015). Comparison of two treatment modalities for chronic pain syndrome due to sacroiliac joint dysfunction. International scientific Journal of Kinesiology “Sport Science”8(2), 55-58. [Link]
  30. Moore, S. R., & Shurman, J. (1997). Combined neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation for treatment of chronic back pain: a double-blind, repeated measures comparison. Archives of physical medicine and rehabilitation78(1), 55-60. [Link]

Ready to take the next step? Explore more below