How Long Before I See Results from FES Cycling?

It's one of the first questions people ask, and it deserves an honest answer. If you're investing thousands of pounds in an FES Cycling system and committing to regular sessions, you want to know when you'll see results.

The truthful answer is that it varies - between individuals, between outcome measures, and depending on how consistently you use the system. But I can offer some realistic expectations based on research findings and our experience with clients over nearly twenty years.

We are now embarking on a new generation of stimulators that allow our users to enjoy FES cycling, but in addition use muscle stimulation in harmony with many other forms of exercise. We believe that this is revolutionary and creates the opportunity for further enjoyment in exercise for long-term health.

In this article, we map out what you might expect as your use of FES cycling evolves over the weeks and months, and give you a glimpse of the benefits that are really worth seeking.

Defining "Results"

The first challenge is clarifying what we mean by results. FES Cycling can produce various benefits, and they don't all appear on the same timeline and they are very much influenced by the users clinical presentation. We have to generalise to some extent.

Immediate effects (during and just after sessions): You would expect increased circulation in the legs and warmth in muscles that are usually cool. This is because electrical stimulation and the synchronised movement of the legs naturally encourages improved circulation. If oedema is present in the lower legs, then this can reduce. It might recur at first but with consistent use this should improve. If you have troublesome spasms FES Cycling can bring a reduction in spasticity. Occasionally people find that spasms increase at first as the stimulation is introduced. If this happens changes can be made to the settings which will help.

Short-term changes (weeks 2-8): The body will adjust to the stimulation and after a few weeks, an improved muscle response to stimulation will be noted. If you have been relatively sedentary or have had a spinal cord injury, muscle fibre types change and you can become subject to rapid onset of fatigue in the leg muscles. Gradually, this reverses as the muscles adapt to the stimulation, and users can start to notice greater endurance during the sessions. We're always looking to produce a strong contraction so that users are cycling actively using their own leg muscles. At first, it's usual to see muscles fatigue quickly, but sticking at it, you'll find that you then have greater endurance during sessions. Over time, subtle changes in muscle tone will become apparent. You might notice some other changes as well. For example, bowel regularity can improve.

Initial stages involve getting comfortable with routine things such as electrode placements.

In the initial weeks, you're learning to use the system and your muscles are learning to respond. Don't expect dramatic changes yet.

What typically happens:

Week 1-2: You're getting familiar with electrode placement, stimulation settings, and the cycling routine. Sessions may be short (15-20 minutes) as you build tolerance. Your muscles may fatigue quickly, this is normal and expected.

Week 3-4: You should be finding your rhythm. Sessions may be lengthening. Muscle response to stimulation often improves, you may notice stronger contractions at the same intensity settings. Some people report feeling "warmer" in their legs after sessions.

Week 5-8: By now, consistent users typically see improved session endurance. Where you might have managed 15 minutes initially, you may now be doing 30-40 minutes. The muscles are adapting to regular activation.

This early phase is about building the foundation. It's not glamorous, but it's essential. The clients who see the best long-term results are those who persist through these early weeks even when progress feels slow.

It's really important to recognise that the first rule of effective exercise is to find something you can adhere to. In other words, you have to use FES cycling regularly. If it's sitting in the corner unused, then of course it's not going to do you any good.

Medium-term adaptations (months 2-6): With consistent use for a few months you should note a visible increase in muscle bulk. If you chose to measure your thighs, for example, before starting training some months ago, the tape should show you some muscle growth. By now, although you may not find this obvious, there will be measurable improvements in cardiovascular fitness, enhanced circulation as a lasting effect and potential changes in bone density markers.

The First Three Months

This is where things start to become visible.

Muscle bulk. After 8-12 weeks of consistent use (typically 3-5 sessions per week), many people notice their thigh muscles looking fuller. Trousers that were loose may fit differently. This isn't imagination, research confirms measurable increases in muscle cross-sectional area over this timeframe.

Cardiovascular markers. Studies show improvements in VO2 max (a measure of aerobic fitness) after 2-3 months of regular FES Cycling. You may notice you feel less fatigued generally, or that your resting heart rate changes.

Circulation improvements. The legs often look and feel healthier - better colour, reduced swelling, warmer to the touch. These changes reflect improved blood flow that persists beyond individual sessions.

Spasticity changes. Some people report that their background level of spasticity is reduced, not just immediately after sessions but more generally. This doesn't happen for everyone, and the research is mixed, but it's a benefit some experience.

Long-term benefits (6 months and beyond): The greatest payoff from FES cycling for many users lies in expected long-term benefits. These include sustained muscle mass and condition, established cardiovascular fitness, ongoing health maintenance and a potential reduction in secondary complications.

Six Months and Beyond

By six months of consistent use, FES Cycling has typically become part of your routine rather than a new intervention. The benefits you've built are now being maintained, and in some cases, still improving.

Muscle condition. The improvements in muscle bulk often continue to develop over the first year, though the rate of change slows. After that, you're in maintenance mode, your muscles stay conditioned as long as you keep cycling.

Bone density.This is one of the longer-term adaptations. Some studies show improvements in bone mineral density after 6-12 months of FES Cycling, though this varies between individuals and isn't universal. Weight-bearing through the pedals and muscle contractions both contribute to skeletal loading. I personally feel that FES cycling typically doesn't restore bone mineral density but does maintain it at the level it was when you started exercise.

Cardiovascular health. Sustained improvements in heart health require sustained exercise. FES Cycling provides this, but the benefits depend on continued use. Stop cycling, and cardiovascular fitness will gradually decline, just as it would for anyone who stops exercising.

Secondary complication prevention. This is harder to measure but potentially the most valuable benefit. By maintaining muscle bulk, circulation, cardiovascular fitness, and bone density, FES Cycling may help prevent pressure sores, deep vein thrombosis, cardiovascular disease, and osteoporosis. You can't easily quantify problems that didn't happen, but the logic is sound and supported by research. This prolonged exercise supports your metabolic health.

Factors That Affect Your Timeline

Individual results vary considerably. Factors that influence how quickly you see benefits include:

Consistency of use. As I mentioned above, this is the biggest factor. Three to five sessions per week produces results. One session per week is better than nothing but will show slower progress. Daily use may accelerate gains, though rest days have value too. We have some clients who train every day with short sessions, and others that use longer sessions three times a week. Your therapist or other advisor can help you plan and monitor your workouts.

Session duration. Longer sessions (30-60 minutes once you've built up) generally produce more benefit than brief sessions, within reason.

Intensity. Working at appropriate intensities - enough to challenge the muscles - matters more than simply accumulating time. This is something we help you calibrate. Producing strong muscle contractions is usually desirable, but using electrical stimulation we need to avoid irritating the skin. We generally advise a conservative approach with gradual changes to the stimulation settings.

Starting condition. If your muscles are severely atrophied after years of paralysis, rebuilding takes longer than if you start earlier after injury. But rebuilding is still possible, we've seen significant improvements in people who started years post-injury.

Injury level and completeness. If you have a spinal cord injury and your level of injury and its status, in other words, complete or incomplete affects muscle response to stimulation and what outcomes are realistic. Higher level injuries may limit cardiovascular responses; complete injuries mean you're relying entirely on stimulation without voluntary contribution. We always look out for contra-indications and create settings that avoid provoking unwanted responses to stimulation.

Overall health. Nutrition, sleep, general health status, and other factors all influence how your body responds to exercise.

The Stim2Go

The Stim2go offers a very flexible tool to support using muscle stimulation for many forms of exercise. Not just cycling

Until recently, our FES cycling system had a dedicated connection between our model of passive-active bike and the stimulator. With the arrival of the Stim2go product, our clients can enjoy FES cycling but with some additional benefits. The Stim2go doesn't require a direct connection to a passive, active bike, so our users can enjoy FES cycling with any model of bike they choose. But perhaps more important than that is that it opens the door to many more exercise possibilities. The Stim2go contains sensors that detect movement and provide an ability To create stimulation sequences that are limited only by the user's imagination. So now, if you want to exercise using another piece of equipment, this is something that can be accomplished. In the years that come, we will be helping our clients to engage in FES rowing and many other forms of exercise. This is the icing on the cake.

Managing Expectations

Let me be direct about what FES Cycling typically won't do:

It won't restore walking ability. In the vast majority of cases, FES Cycling is about fitness and health maintenance, not functional recovery of walking. There are rare exceptions—some people with incomplete injuries have seen carryover to voluntary function, but this shouldn't be your expectation.

It won't produce overnight transformations. The benefits are real but gradual just as they are with any exercise. If you're expecting visible changes after two sessions, you'll be disappointed. This is a long-term health strategy, not a quick fix.

It won't continue without effort. The benefits require ongoing use. Stop cycling, and the gains gradually fade. This isn't a treatment you complete; it's a practice you maintain.

The Patience Requirement

I'll end with perhaps the most important point: FES Cycling requires patience. As we have discussed, the benefits are real, they've been demonstrated with extensive research over the years. but they're not instant. You need to persist through the early weeks when progress is invisible, trust the process through the months when changes are gradual, and maintain the routine over years to preserve what you've gained.

This is no different from exercise for anyone. Fitness is earned through consistent effort over time, not purchased with a piece of equipment. The equipment enables the exercise; the results come from doing it.

If you're prepared for that commitment, FES Cycling can deliver genuine, meaningful benefits for your long-term health. If you're looking for quick results with minimal effort, you'll likely be disappointed.

For those ready to commit, we're here to support you, with proper setup, ongoing guidance, and realistic expectations about what you can achieve. Contact us to discuss whether FES Cycling is right for you.