Last week I posted a question on Twitter, aimed at Physiotherapists / Rehabilitation professionals:

Physios: What’s your biggest ‘want to know’ in S&C?

I was astounded by the response!  So much engagement and so many questions, I couldn’t keep up.  Quite humbled really.  To give this topic and the many questions the attention that they deserve I’ve grouped them into categories (yes, they were that many).  I’ll be creating a DOWNLOAD of how to structure your resistance training with patients to achieve specific goals and I’ll be doing a live WEBINAR to discuss the topic in more depth.  More of that in a second….

In the meantime, I picked a great general question as a starter:

“What are the top 3 principles in S & C”

Thank you @BillingMartin for asking this.

It’s a great one to kick off with.  Why?  Because if you get these fundamental things right it can transform your rehabilitation practice!  The top three things in my opinion are:

  1. SPECIFICITY
  2. OVERLOAD
  3. PROGRESSION

These three things are referred to as the Principles of Training.  I teach this in my Strength & Conditioning Courses for Therapists because these 3 pillars are fundamental to rehabilitation success.  Do you incorporate this strategy into you rehabilitation programming?

principles of training

Specificity

How often do you take the time (or are afforded the time) to ask yourself the question: “what are you trying to improve” with each patient? Whether that be ROM, strength, or cardiovascular fitness, importantly each outcome or goal will require a specific approach – the specificity – to achieve improvements. For example, one exercise will not magically create improvements across all elements of your rehabilitation. Sounds simple, but yet in a time pressured environment it’s easy to overlook.  Maybe your patient needs to improve in fitness, strength and proprioception, in which case you need to plan your programme to optimise improvements in each area.  This requires planning and prioritising over the time that you have.  And if you really haven’t got time to look at everything, it’s better do do one thing well than several things poorly.

Overload

Next, you need to create a load that’s commensurate with what you want to achieve; one that’s greater than the person is accustomed to in order challenge the appropriate system to adapt. For example, asking someone to lift a weight that they can repeat multiple times with ease is not going to improve their muscle strength (the answer to the ‘loading’ question will be covered in the download). Likewise, assigning a gentle walking programme to a person who is able to run for 30 minutes will not improve their cardiovascular fitness.  The overload creates the ‘stress’ to prompt the desired physiologic adaptation.

Progression

If you’ve got the first 2 things right, then your patient will improve. Great! However, if you don’t plan to progress the programme/exercises these improvements will quickly stall.  Think about giving a patient an exercise sheet (Yes, there are so many things we can say about this topic, and I will in future blogs ! but go with me for now) – in which they need to complete say 5 repetitions of shoulder flexion with a theraband. Off they go, remarkably the exercise sheet doesn’t get confined to the kitchen drawer and they do their exercises. Next time you see them, 4 weeks later, they’re delighted because they tell you they can now do 20 reps of the same exercise.  Did you want this to happen…?  Did you want them to be able to to do more and improve muscle endurance, or did you want them to be able to lift/tolerate higher loads and improve muscle strength….?!!  This comes back to the specificity of your intervention – what did you want to achieve and have you planned the progression to maintain that specificity and achievement of your desired outcome?

So, there you have it. My top 3 principles in S&C for rehabilitation. It may sound a little abstract at the moment, but in the meantime as I create some more specific examples and checklists for you, have a think about your current rehabilitation programmes. Do you define the specific goals for your patients (specificity), do you create the appropriate overload to achieve your desired outcome (overload) and do you plan for adaptation and continued improvements (progression)?

If you’d like to be notified directly about the DOWNLOAD that covers how to tailor your resistance training with patients to achieve specific goals and of the WEBINAR for a more in-depth look at this topic please pop your name and email below and I’ll send you notification straight into your inbox.

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