by Mike Klobucher, DPT, FAFS
This might be one of the most common questions we hear on a daily basis as physical therapists, and it is undoubtedly an important question to answer. It is important because we most effectively make lasting changes in our bodies through repeated movement. The body responding to this cumulative stimulus is what allows us to get stronger, become less sensitive (i.e. painful), improve flexibility, and refine our movement patterns. It would be lovely if a therapist could lay their hands on you and produce these same outcomes, but unfortunately, that simply isn’t the truth. Now, manual therapy (i.e. hands-on treatment) certainly has a large role in most of our treatment strategies at i’move, but it is typically in an effort to help the patient be more successful with what they ultimately do to change their situation…that being exercise. So, if exercise or movement training is important, how much do you we have to do to reach our goals? Three sets of ten reps sound familiar? How about three sets of nine or eleven reps? Why not eight sets of five or one set of fifty? The most honest answer to this conundrum is: we don’t know for sure. Now that you have ultimate confidence in us, let’s explore a few things surrounding this issue.
First, we can’t know for sure at the outset because it depends what the goal is. If it’s increased power or strength, you’re probably looking at lower reps and higher loads. If it’s increased endurance, you’re probably looking at higher reps and lower loads. If it’s more mobility you’re after, it’s probably going to take even more repetition. And if it’s changing, refining, or improving a certain movement pattern, research would suggest it’s probably going to take thousands, if not tens or hundreds of thousands of reps.
Second, there is plenty of evidence now that no two people will respond exactly the same to any particular exercise regimen. Therefore, the individual and all that makes them unique is going to play a role in determining the right amount of exercise including their personal schedule, pain sensitivity, current fitness level, and past experiences. We prioritize the individual, not a protocol.
Finally, we are usually seeing people in pain, and this needs to be taken into account as well when determining what the right amount of exercise is. It is important to “poke the bear,” so to speak, but crucial not to make it too angry. For example, we don’t consider it effective if someone recovering from an injury grits their teeth to finish their arbitrary three sets of ten but cannot walk normally for the rest of day due to increased pain. Is that effective exercise?
In the end, at i’move we use the general principles that have been researched regarding exercise volume but then really aim to come alongside the individual to test and experiment to find unique strategies that help you reach your functional goals without entering the pain cave. We are patient and committed to taking this journey with you because your goals are our goals, and no one, including us, can honestly say they know the right amount of exercise for you without investing in you and experimenting to find success. We abide in one-on-one individualized care because we believe that only by making this effort can one really discover their movement potential.