How Many, How Heavy, How Often

You have just recovered from a shoulder, knee or other joint-strain or sprain. There is an important question to ask yourself periodically when easing back into an exercise regimen or advancing your prescribed therapeutic exercises. How do you know when it is time to make an exercise harder? The answer can sometimes be complex and requiring some assistance from a trainer, physical therapist or even your medical doctor. However, here is a simplified strategy that you may find helpful: When you can perform three sets of twenty or more repetitions of an appropriate strength exercise (eliciting none of the wrong kind of joint-aches and pains) it may be time to increase resistance. At this point of twenty or more repetitions, the skill being worked-on is muscle endurance and no longer muscle strength. One approach is to change the weight or perhaps even the exercise so that you experience targeted strength building muscle fatigue between two and three sets of twelve to fifteen repetitions. It is typically safe to take two to four weeks to consistently work-up to performing three sets of twenty repetitions two to four times per week before you advance again. The overall periods are loose because you want take your time establishing an amount, an intensity and frequency that build strength but do not ignite or reignite a joint irritation. You may find that when you begin to increase the difficulty of your exercises, that before you reach the desired muscle fatigue, you begin to experience soreness or hints of your past injury. It is safest not to push past these types of sensations. If you are practicing good form, it can sometimes be helpful to consistently work-up to a point just before a joint ache occurs but again, it is not all right to push through discomfort to finish a set. Physical therapists are problem solvers. We assist individuals who need help in designing specific therapeutic and/or strength building exercise plans that promote optimal recovery from difficult musculoskeletal injuries.

Anna Kotula, DPT