aspects of the present invention provide an improved system , device , and method of administering electrical stimulation to the muscles of the foot . aspects of the present invention provide a programmable electrical pulse generator for delivering an electrical current of mild and tolerable intensity to the muscles of the foot , which results in a mild contraction of the muscles . in various aspects of the present invention , the contraction may be accomplished by placing surface electrodes on the soles of the feet or at the ankles . when placed on the soles , the active surface electrodes are placed over the larger muscles of the first layer that are closer to the surface of the skin and in an area where callousing of the skin and the fat layer is minimal such as the mid - foot and arch area . the ground electrodes may be placed over or proximal to the heel . by stimulating the foot muscles in this manner , blood pooling in the calf veins is prevented . when placed on the side or top of the ankles , the surface electrodes stimulate the posterior tibial , the anterior tibial , or the sural nerves . by stimulating the peripheral nerves with the arrangement of electrodes around the ankles , pain management and improved wound healing may be achieved . fig4 and fig9 show a device for providing electrical stimulation to the foot , according to aspects of the present invention . the device 400 includes a generator 410 , connecting wires 410 , and electrodes 430 and 435 . the electrodes are connected to the generator via the connecting wires . the generator 410 is a programmable electrical stimulation signal generation device . the electrodes 430 and 435 may be interchangeable and their polarity is determined according to their connection to the generator 410 . the electrodes are self adhesive or otherwise attachable to skin . various aspects of the present invention may be implemented in footwear and accessories to footwear such as shoes , socks , and stockings . they may be carried in a pocket or pouch in an item of footwear , with conductors connecting the stimulus generating portion of the device to electrodes placed on the skin . the electrodes may vary in shape and size and may be self - adhering of the type utilized for tens devices . moreover , if at least one of the electrodes includes a power source , then the electrodes may be wirelessly in communication with the signal generator . in that situation , the signal generator may be located closer to the hands and head of the user , allowing him to more easily adjust the intensity and other parameters of the stimulation . in the case of wireless control , the electrodes must be connected together , outside the body , to create a closed circuit with the passage through the muscles . further , the signal generator may be remotely programmable by a physician monitoring the patient . fig5 shows placement of electrodes on the foot , according to aspects of the present invention . the electrodes 430 and 435 are located on the foot 31 such that one electrode attaches to the heel , and the other is attached to the mid - section or the big arch of the foot . in the arch area , the skin is not calloused , and the fat layer under the skin is minimal . in one aspect , the heel electrode 430 is the ground electrode , and the arch electrode is the active or positive electrode . fig6 a , 6b and 6c show placement of electrodes on the ankles , according to aspects of the present invention . the placement of the ankle electrodes is chosen to optimally stimulate the posterior tibial , anterior tibial , and sural nerves of the leg 50 . this in turn will provide the maximum therapeutic effect for pain management , enhancing wound healing , and preventing muscle atrophy . these electrodes may be located at the area of the peroneal motor nerve , which is also referred to as the anterior tibial nerve . in one aspect , the electrodes would be placed just lateral to the tendon of tibialis anterior and just proximal to the malleoli . fig6 b provides the ankle showing anterior electrode placement ( 435 ) and lateral electrode placement ( 430 ). fig6 c provides a line drawing of the ankle showing anterior electrode placement ( 435 ) and medial electrode placement ( 430 ). fig7 shows a flowchart of a method of increasing circulation , according to aspects of the present invention . the method begins at 701 . at 702 , one electrode , for example the ground electrode , is connected to heel of a foot . at 703 , the other electrode , for example the active electrode , is connected to a mid - section or arch of the foot . at 704 , electrical stimulation is applied to the muscles of the foot through the attached electrodes . at 705 , the method ends . in variations of this method , the electrical stimulation may be periodically or continuously adjusted according to readout of parameters from the patient or according to decision of a physician or the patient himself . fig8 shows a flowchart of a method of pain management , according to aspects of the present invention . the method begins at 801 . at 802 , one electrode , for example the ground electrode , is connected above the ankle of a foot . at 803 , the other electrode , for example the active electrode , is connected to below the ankle of the foot . at 804 , electrical stimulation is applied to the muscles of the foot through the attached electrodes . at 805 , the electrical stimulation is adjusted . at 806 , the method ends . aspects of the present invention provide a wearable device for positioning a first electrode adjacent a heel of the wearer &# 39 ; s foot and a second electrode adjacent an arch of the foot . fig1 shows an exploded perspective view of the wearable device 1000 , according to aspects of the present invention . the wearable device 1000 comprises an outside cover 1002 , an inside cover 1050 , and a circuit 1070 . the inside cover 1050 is configured to contact the wearer &# 39 ; s foot . fig1 and 12 show inside and outside views , respectively , of the wearable device 1000 , according to aspects of the present invention . fig1 shows an inside view of the inside cover 1050 of the wearable device 1000 . fig1 shows an image of the circuit 1070 of the wearable device 1000 , according to aspects of the present invention . referring to fig1 and 12 , the outside cover 1002 comprises a bottom portion 1004 and an ankle portion 1006 . the bottom portion 1004 may be configured to extend along a least a portion of the bottom of the foot , posteriorly from an arch , and around the heel . the ankle portion 1006 may extend upwardly along the back of the wearer &# 39 ; s foot from the heel . at least a portion of the outside cover 1002 is flexible such that it can extend along a least a portion of the bottom of the foot , posteriorly from an arch , around the heel , and / or upwardly along the back of the foot from the heel . the outside cover 1002 may further comprise a foot strap 1008 and an ankle strap 1010 . the foot strap 1008 secures the bottom portion 1004 to the bottom of the wearer &# 39 ; s foot . the foot strap 1008 may extend around the middle of the foot to secure the bottom portion 1004 of the outside cover 1002 to the bottom of the foot . the ankle strap 1010 secures the ankle portion 1006 to the wearer &# 39 ; s ankle . the ankle strap 1010 may extend in one or both directions to surround the ankle to secure the ankle portion 1006 of the outside cover 1002 to the ankle . in the illustrated embodiment , the foot strap 1008 comprises a first wing 1012 and an opposing second wing 1014 for extending around the wearer &# 39 ; s foot . each end of the foot strap wings 1012 , 1014 may have foot strap fasteners 1016 , 1618 to hold the two ends of the foot strap 1008 together . after the wearer places the foot strap 1008 around the middle of the foot , the wearer can use fasteners 1016 , 1618 to hold the two ends of the strap together and keep the foot strap 1008 around the middle of the foot . the fasteners 1016 , 1618 may be complementary structures such as interlocking loop and hook , snaps , buttons , adhesive , buckles , tri - glides , locks , rings , hooks or , sliders . for a foot strap 1008 without fasteners 1016 , 1018 , the wearer may tie a knot with the two ends of the foot strap 1008 , or the foot strap 1008 may be a continuous strap optionally comprising an elastic material . similarly , two opposing wings 1020 , 1022 of the ankle strap 1010 may each have complementary ankle strap fasteners 1024 , 1026 to hold the ends of the ankle strap wings 1020 , 1022 together . after the wearer places the ankle strap 1010 around the ankle , the wearer can use fasteners 1024 , 1026 to hold the two ends of the strap together and keep the ankle strap 1010 around the ankle . the fasteners 1024 , 1026 may be complementary structures such as interlocking loop and hook , snaps , buttons , adhesive , buckles , tri - glides , locks , rings , hooks or , sliders . for an ankle strap 1010 without fasteners 1024 , 1026 , the wearer may tie a knot with the two ends of the ankle strap 1010 , or the ankle strap 1010 may be a continuous strap optionally comprising an elastic material . the outside cover 1002 may further comprise an extender strap 1028 . the extender strap 1028 may be attached to the foot strap 1008 or the ankle strap 1010 of the outside cover 1002 . the extender strap 1028 extends the length of the foot strap 1008 or the ankle strap 1010 such that the foot strap 1008 or the ankle strap 1010 extends around the full circumference of the middle of the foot or the ankle , respectively . the extender strap 1028 may comprise a fastener 1034 configured such that its first end 1030 is fastened to a first end of the wings 1012 , 1014 of the foot strap 1008 or the wings 1020 , 1022 of the ankle strap 1010 . the fastener 1034 may be configured to hold together its second , opposing end 1032 and the second , opposing end of the wings 1012 , 1014 of the foot strap 1008 or the wings 1020 , 1022 of the ankle strap 1010 . the inside cover 1050 is attached to the inside of the outside cover 1002 . the outside surface of the inside cover 1050 is configured to abut the inside surface of the outside cover 1002 and may be secured by stitching , adhesives , heat bonding or other techniques . the inside surface of the inside cover 1050 is configured to touch the skin of the wearer &# 39 ; s foot . referring to fig1 , the inside cover 1050 comprises a bottom portion 1054 and an optional ankle portion 1056 . the bottom portion 1054 of the inside cover 1050 is attached to the bottom portion 1004 of the outside cover 1002 . the bottom portion 1054 of the inside cover 1050 has two apertures 1060 , 1062 on or near the central longitudinal axis of the inside cover 1050 . referring to fig1 , electrically conductive pads 1064 , 1066 may be removably placed in contact with the electrodes 1074 , 1076 and exposed through the two apertures of the inside cover 1050 . the electrically conductive pads 1064 , 1066 are positioned over the foot muscles and may be electrically and / or mechanically connected to the electrodes 1074 , 1076 of the circuit 1070 . the first aperture 1060 ( arch aperture ) is located near an arch of the wearer &# 39 ; s foot , and the first electrically conductive pad 1064 ( arch pad ) may be placed in the arch aperture 1020 . the second aperture 1062 ( heel aperture ) is located near a heel of the foot , and the second electrically conductive pad 1066 ( heel pad ) may be placed in the heel aperture 1022 . when attached to the electrodes 1074 , 1076 of the circuit 1070 , the electrically conductive pads 1064 , 1066 are electrically connected to the electrodes 1074 , 1076 . when touching the skin of the foot , the pads 1064 , 1066 electrically connected to the wearer &# 39 ; s foot . the pads 1064 , 1066 comprise a support layer and may further comprise a protective film on each side of the pads . the pads 1064 , 1066 may further comprise electrically conductive gel to enhance their electrical conductivity . the outside surfaces of the pads 1064 , 1066 may be covered by adhesive so that the pads 1064 , 1066 are removably attached to the electrodes . the inside surfaces of the electrically conductive pads 1064 , 1066 touch the skin of the wearer &# 39 ; s foot when the wearable device 1000 is worn . electrical stimulation conducts from the electrodes 1074 , 1076 to the wearer &# 39 ; s foot via the pads 1064 , 1066 . for a wearable device 1000 without pads 1064 , 1066 , electrical stimulation may directly conduct from the electrodes 1074 , 1076 to the foot . the ankle portion 1056 of the inside cover 1050 is attached to the ankle portion 1006 of the outside cover 1002 . the circuit 1070 ( fig1 ) is positioned between the outside cover 1002 and the inside cover 1050 and conducts electricity from a control , which generates electrical stimulation , to the wearer &# 39 ; s foot . the circuit 1070 comprises first and second connectors 1072 , arch electrode 1074 , heel electrode 1076 , and conductors 1078 such as wired or conductive traces . optionally , the electrically conductive pads 1064 , 1066 are electrically connected to the control via the circuit 1070 . the connectors 1072 electrically connect the control with the circuit 1070 . the circuit 1070 is made out of electrically conductive materials . the connectors 1072 may be located on the outside surface of the outside cover 1002 or the inside surface of the inside cover 1050 . the connectors 1072 may electrically or both electrically and mechanically connect the control with the circuit 1070 . the control may removably attach to the connectors 1072 . the connectors 1072 may be one or more snaps , clips , slides , pins , or others known in the art . in addition to first and second connectors 1072 , one or two or more additional connectors 1073 maybe provided for additional electrical and or mechanical connection to a control . in the illustrated embodiment , first and second connectors 1072 are configured to both electrically and mechanically removably connect to the housing of the control . additional mechanical integrity is provided by the third connector 1073 which mechanically releasably connects to the housing of the control . see also fig1 . referring to fig1 , each of the arch electrode 1074 and the heel electrode 1076 may comprise a flexible , conductive foil . the conductive foil may comprise silver . the arch electrode 1074 is placed adjacent to the first aperture 1060 of the inside cover 1050 near an arch of the foot . the heel electrode 1076 is placed adjacent to the second aperture 1062 of the inside cover 1050 near a heel of the wearer &# 39 ; s foot . the electrically conductive pads 1064 , 1066 may be removably attached to the arch electrode 1074 and the heel electrode 1076 . the wires 1078 electrically connect the connectors 1072 with the arch electrode 1074 and the heel electrode 1076 . the wire 1078 may comprise a conductive foil . insulator 1080 is placed around the wires 1078 and electrically insulates the wires to prevent unwanted electrical leak from the wires 1078 . it is desirable that electricity is conducted from the control to the circuit 1070 only via the connectors 1072 , and electricity is conducted from the circuit 1070 to the skin of the foot only via the arch electrode 1074 and the heel electrode 1076 . protector 1082 is placed around the wires 1078 near the connectors 1072 and protects the wires 1078 from load , tension , stress , physical fatigue , or failure . the protector 1082 may be composed of materials whose stiffness is higher than that of the wires 1078 . the protector 1082 may also be composed of insulating materials . the protector 1082 may be composed of the same materials as the insulator 1080 . fig1 shows a control 1500 for controlling administration of electrical stimulation . the control 1500 generates electrical stimulation signal , which is conducted to the wearer &# 39 ; s foot via the connectors 1072 , the wires 1078 , the electrodes 1074 , 1076 , and , optionally , the removable pads 1064 , 1066 . the control 1500 may produce an intermittent signal pattern such as a square wave pattern of variable frequency , duration , intensity , ramp time , and stimulation on - off cycle . the control 1500 is programmed in a manner to stimulate the target muscles to reduce pooling of the blood in the soleal veins of the calf . while wearing the wearable device 1000 , the wearer may modulate one or more characteristics of electrical impulses applied to the wearer , including the frequency , duration , intensity , ramp time , and on - off cycle of the electrical stimulation by operating the control 1500 . alternatively , the control 1500 may be preprogrammed or programmed once during an initial setup process . in one aspect of the present invention , the control 1500 may comprise a power controller 1502 and a stimulation adjuster 1504 . the power controller 1502 turns the control 1500 on and off . the power controller 1502 may be one or more buttons , keypads , switches , dials , slides , or levers . the stimulation adjuster 1504 controls one or more the characteristics of the electrical stimulation , including the frequency , duration , intensity , ramp time , and on - off cycle . the stimulation adjuster 1504 may be one or more buttons , keypads , switches , dials , slides , or levers . the control 1500 may further comprise a display screen 1506 , which shows the characteristics of the electrical stimulation as the stimulation is adjusted by the stimulation adjuster 1504 . the display screen 1506 may go to sleep after a certain period of inactivity . in another aspect of the present invention , the control 1500 may further comprise a power indicator 1508 and a stimulation indicator 1510 . the power indicator 1508 indicates whether the power of the control 1500 is on or off . the power indicator 1508 may be a speaker , a light bulb , a led , a display , a vibrator , or a motor . the stimulation indicator 1510 indicates whether the control 1500 is generating electrical stimulation . the stimulation indicator 1508 may be a speaker , a light bulb , a led , a display , a vibrator , or a motor . in one aspect of the present invention , the maximum or peak stimulation intensity may be between about 20 ma and about 40 ma and in one implementation is about 30 ma . the maximum frequency of the electrical stimulation may be between about 40 hz and about 60 hz and in one implementation is about 50 hz . the maximum or peak voltage may be about 133v dc , and the maximum impedance may be about 5 kω . one example of stimulation signal pattern type may be a constant current , biphasic pulse . constant current means that as the impedance of the control 1500 increases , the voltage of the control 1500 increases in order to maintain the set current . this only happens as long as the voltage is less than the maximum voltage . the output electrical stimulation is determined according to the following equation : v = iz , where v is the voltage , i is the current , and z is the impedance of the control 1500 . in one aspect of the present invention , the duration of each cycle of the electrical stimulation may be about 300 microseconds ( or about 150 microseconds per phase ). the positive and negative phases of the electrical stimulation may be symmetrical to each other . if there is any asymmetry between the phases , such asymmetry is preferably less than 10 % difference in area . the electrical asymmetry between the phases may result in electrical charge accumulation on one of the electrically conductive pads 1064 , 1066 or the electrodes 1074 , 1076 after each cycle of the electrical stimulation ( or each pair of stimulation phases ). fig1 a , 16b , and 16c show exemplary waveforms of electrical stimulation generated from the control 1500 . referring to fig1 a , the waveform output generated from the control 1500 is biphasic with 12 seconds of 50 hz stimulation followed by 48 seconds of rest . the intensity of the electrical stimulation may change according to the one - minute cycle that includes 2 seconds of ramping up , 8 seconds of constant set intensity , 2 seconds of ramping down , and 48 seconds of rest . if the intensity of the electrical stimulation is increased , the change in the output waveform will be as shown in fig1 b . if the intensity of the stimulation is decreased , the change in the output waveform will be as shown in fig1 c . before wearing the wearable device 1000 , the wearer may clean the area of the foot where the pads 1064 , 1066 or the electrodes 1074 , 1076 will be placed in order to allow good contact and to help prevent skin irritation . the wearer may use a mild soap and water to wash the skin of the foot before placing the pads 1064 , 1066 or the electrodes 1074 , 1076 on the skin to improve adhesion . it is preferred that the wearer applies the pads 1064 , 1066 or the electrodes 1074 , 1076 to clean , unbroken skin . fig1 a , 17b , and 17c show a procedure of attaching the releasable electrically conductive heel pad 1066 ( second electrically conductive pad ) to the wearable device 1000 . referring to fig1 a , the wearer may peel the heel pad 1066 from the protective film on one side of the pad 1066 . the wearer may alternatively peel the protective film from one side of the heel pad 1066 . referring to fig1 b , the wearer may then place the heel pad 1066 in the heel aperture 1022 ( second aperture ) of the inside cover 1050 . referring to fig1 c , the wearer may then peel the protective film from the foot contacting side of the heel pad 1066 . the wearer may place the arch pad 1064 ( first electrically conductive pad ) to the wearable device 1000 in a similar fashion as described above . fig1 a , 18b , 18c , 18d , 18e , and 18f show a procedure of mounting the wearable device 1000 and the control 1500 on the wearer &# 39 ; s foot . this procedure may occur after applying the electrically conductive pads 1064 , 1066 to the wearable device 1000 . referring to fig1 a and 18b , the wearer may step on the wearable device 1000 or place the wearable device 1000 on the wearer &# 39 ; s foot . the wearer may place the arch pad 1064 attached to the wearable device 1000 near the arch of the wearer &# 39 ; s foot and then place the heel pad 1066 attached to the wearable device 1000 near the heel of the wearer &# 39 ; s foot . the wearer may alternatively place the heel pad 1066 near the heel of the wearer &# 39 ; s foot and then place the arch pad 1064 near the arch of the wearer &# 39 ; s foot . fig1 c shows where the arch pad 1064 and the heel pad 1066 may be placed on the wearer &# 39 ; s foot . referring to fig1 d , the wearer may wrap the foot strap wings 1012 , 1014 of the foot strap 1008 of the wearable device 1000 around the wearer &# 39 ; s foot . the wearer may optionally use the foot strap fasteners 1016 , 1618 to hold the two ends of the foot strap 1008 together . referring to fig1 e , the wearer may attach the control 1500 to the wearable device 1000 using the connectors 1072 and optionally the additional connectors 1073 . the wearer may attach the control 1500 to the wearable device 1000 before or after placing the electrically conductive pads 1064 , 1066 to the wearable device 1000 . the wearer may attach the control 1500 to the wearable device 1000 before , during , or after wearing the device 1000 on the foot . referring to fig1 f , the wearer may wrap the ankle strap wings 1020 , 1022 of the ankle strap 1010 of the wearable device 1000 around the wearer &# 39 ; s ankle . the wearer may optionally use the ankle strap fasteners 1024 , 1026 to hold the two ends of the ankle strap 1010 together . the wearer may consult with a medical practitioner to set up the wearable device 1000 and the control 1500 . once the wearable device 1000 and the control 1500 are placed on the wearer &# 39 ; s foot , the wearer may turn on the control 1500 by operating the power controller 1502 . the control 1500 may indicate via the display screen 1506 , the power indicator 1508 , and / or the stimulation indicator 1510 if the control 1500 is not connected to the wearable device 1000 when the control 1500 is turned on . after turning on the power of the control 1500 , the wearer may increase the intensity of the electrical stimulation by operating the stimulation adjuster 1504 . the wearer may feel an electrical sensation as the intensity of the electrical stimulation increases . the wearer may experience a visible curl of the wearer &# 39 ; s toes as the intensity of the stimulation increases . the level of stimulation may vary from individual to individual . the wearer may decrease the intensity of the electrical stimulation by operating the stimulation adjuster 1504 . the wearer may decrease the intensity of the stimulation through the stimulation adjuster 1504 when the wearer feels discomfort . before removing the control 1500 from the wearable device 1000 , the wearer may reduce the intensity of the electrical stimulation to zero by operating the stimulation adjuster 1504 or turn the control 1500 off by operating the power controller 1502 . the control is safe to remove from the wearable device 1000 when the intensity of the stimulation is zero or the control is turned off . the control 1500 may further comprise a safety module that locks the control 1500 to the wearable device 1000 when the control 1500 is turned on , and intensity of the electrical stimulation is not zero . in one aspect of the present invention , the wearable device 1000 and the control 1500 may be ideally operated at temperature from 5 ° c . to 38 ° c ., relative humidity from 15 % to 93 %, atmospheric pressure from 700 hpa to 1060 hpa , and altitude up to 3000 m above sea level . the present invention has been described in relation to particular examples , which are intended to be illustrative rather than restrictive , with the scope and spirit of the invention being indicated by the following claims and their equivalents .
system , device and method for providing neuromuscular electrical stimulation to muscles of foot . the device includes an electrical signal generator for producing a wave pattern of variable frequency , duration , intensity , ramp time and on - off cycle . the device further includes surface electrodes for being positioned over the foot muscles or around ankles and attached to the signal generator . the device includes a wearable device for positioning a first electrode adjacent a heel of the wearer &# 39 ; s foot and a second electrode adjacent an arch of the foot . the signal generator is programmed to stimulate the foot muscles and nerves . location of the electrodes and the programming are adjusted to reduce pooling of the blood in the soleal veins of the calf and enhance venous blood flow to prevent deep vein thrombosis ; to enhance venous blood flow for the post - thrombotic syndrome patient ; to expedite wound healing ; to reduce neuropathic pain of the foot and ankle , chronic musculoskeletal pain of the ankle and foot , and acute post - operative foot and ankle pain ; and to prevent muscular atrophy of the foot muscles .