Functional Electrical Stimulation (FES): Electrode and Skin Care
Functional Electrical Stimulation (FES) is a valuable tool used to help restore movement, improve walking, and support muscle strength for individuals with neurological conditions such as stroke, multiple sclerosis, or spinal cord injury.
While FES can make a huge difference to mobility and confidence, one key part of successful long-term use is good skin and electrode care. Proper preparation and maintenance can prevent irritation, ensure comfort, and improve the overall effectiveness of the stimulation.
1. Why Skin and Electrode Care Matters
FES works by delivering small electrical impulses through electrodes placed on the skin. These impulses stimulate muscles to contract, assisting natural movement patterns. Because the stimulation passes through the skin, maintaining healthy skin and clean electrodes is essential to:
- Prevent irritation or redness
- Improve comfort and consistency of stimulation
- Extend the lifespan of electrodes
- Reduce the risk of infection or allergic reaction
2. Preparing the Skin
Before each FES session:
- Clean the skin gently with water (avoid alcohol wipes, which can dry or irritate the skin).
- Ensure the skin is dry before applying electrodes – moisture can increase irritation and affect the contact.
- Remove lotions or creams from the area, as they can interfere with adhesion and electrical conductivity.
- If there is hair where electrodes are applied, trim (don’t shave) to improve contact and prevent discomfort when removing electrodes.
3. Applying Electrodes Correctly
- Check electrode condition before use – replace if edges are dry, worn, or peeling.
- Position electrodes exactly as instructed by your clinician – placement affects muscle activation and walking quality.
- Press evenly to ensure full contact with the skin, avoiding air bubbles which can cause hotspots or tingling.
- Alternate placement sites slightly if you use FES frequently, giving skin a chance to recover.
4. After Each Session
- Remove electrodes gently, pulling back slowly to protect the skin.
- Clean the skin with water and pat dry.
- Check for redness or marks – mild pinkness is common and should fade within 30–60 minutes.
- If redness, blistering, or soreness persists, stop using FES and contact your clinician before resuming.
- Store electrodes properly – most are reusable and should be placed back on their plastic backing and kept in a sealed bag to prevent drying out.
5. Caring for Your Electrodes
- Store in a cool, dry place – avoid leaving them in sunlight or heat.
- Replace electrodes regularly (usually every 20–30 uses, or sooner if they lose stickiness).
- If the gel becomes dry, a few drops of water can help temporarily revive adhesion.
- Always use manufacturer-approved electrodes for your device – this ensures safety and reliability.
6. Managing Sensitive Skin
- Some people have more delicate or reactive skin. To reduce irritation:
- Rotate application sites where possible.
- Use hypoallergenic electrodes if recommended.
- Avoid using FES over areas of broken, infected, or irritated skin.
- Apply a gentle, non-greasy moisturiser after your session (once skin is fully dry) to keep it supple.
7. When to Seek Advice
Contact your FES clinician or orthotics/physiotherapy team if you notice:
- Persistent redness or soreness lasting more than an hour after use
- Burning, itching, or rash
- Electrodes that no longer adhere properly
- Painful or unusual sensations during stimulation
- They can review electrode placement, stimulation settings, or recommend suitable alternatives for your skin type.
In Summary
Regular skin and electrode care is just as important as your FES training itself. Taking a few extra minutes before and after each session will keep your skin healthy, your stimulation comfortable, and your therapy effective.
If you experience any problems or changes in your skin, always let your clinician know — together, you can keep your FES use safe, consistent, and beneficial.
