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Exercises: Progressive Overload

During your experience at Impact Physiotherapy, you are likely to receive an exercise programme in some form. You will either receive formal exercises specific to regions of your body, or advice and education around managing training load overall like running distances or frequency.

Sometimes from a patient perspective, it can feel daunting to try to manage this despite our efforts to educate and build a plan with you. So, I am writing this blog today with some basics to take home to help manage your exercises.

Now, what do we know about muscle? They adapt to accommodate the stressors or demands put upon them. So, the more you practice the exercises the more the muscles adapt and get stronger. We may start an exercise using 3 sets of 5 reps and over a few weeks aim to progress to 3 sets of 10reps. This is a simple form of progressive overload, by progressing how many reps you do.

Progressive Over-load simply means making something progressively harder to accommodate the increased ability of your muscles or joints. This can apply in all aspects of your rehab and can be a challenging process. When an exercise is prescribed to you, you will likely come across some of the following terms:

Repetition (or Reps): This is how many times you perform an exercise, for example with a straight leg raise, you would lift your leg up off the bed a set number of times. You may be prescribed 5reps, meaning you would perform the exercise five times.

Sets: This is the accumulation of reps. So 5 reps would make one set. Which you may be asked to repeat two or three times. So, three sets of five reps would mean you would perform the exercise five times, have a rest and repeat this process twice more.

Frequency: This Is how often you do the exercise above. So, it may say once a day, twice a day, or maybe three times a week. This would mean doing three sets of five reps three times a week. And the other days you can rest.

Duration: If you are doing static holds or maybe you are planning on returning to running. This would indicate how long you would hold an exercise or long you would run for.

Rest: Rest typically means how long to rest between each set that you do.

Sometimes we as physios want specifics and set all the parameters above, sometimes it is not as important. It really depends on your goals, so you may be prescribed all of the above or only sets and reps.

Example 1) 3x5reps daily

Example 2) 3sets x 5reps, 3sec hold. Every other day, 2minutes rest.

How to Progressively over-load

Reps: Try to do more reps in each set. So, 3 sets of 5reps over the course of a couple of weeks may be built up to 3 sets of 10reps 

Sets:  You may start with 1 set of 5reps and build up to 3 sets of 5 reps

Frequency: You may start with doing the exercises every other day and progress to daily

Duration: You may be able to hold an exercise for 10 seconds and build up to 30 seconds, or run for 5 mins and build to 20mins

Rest: You may start with 2 minutes of rest and reduce to 1 minute to make it harder with less recovery time.

Resistance: You may also consider instead of adding reps and sets, making the exercise harder with an external load, for example, a dumbbell.

Tempo: changing the time of the concentric or eccentric portion of the exercise. For example, 2 seconds up and 2 seconds down, to 2 seconds up 5 seconds down.

Intensity: Considering a percentage of effort or rate of perceived exertion. You may work at 70% max effort or RPE 7/10. This could be subjective or objective by how you feel doing it, or by lifting 70% of the weight of your maximal effort ability.

Your Physiotherapist will likely discuss how they want you to progress, for example, increase the weight used; increase reps done, or advice may include, starting with 3 sets of 8reps. Build to 3 sets of 12reps then bring it back down to 3 sets of 8 reps but add weight next.

These are just the basics that we hope will help you in the management and understanding of how to progress should and when you need to. Of course, when in doubt speak with your physiotherapist.

Written by: Jack Clayton 


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