Tuesday 24 April 2018

Progressive Overload - Treat Your Rehab Like Training

Progressive overload is the gradual increase in stress placed on the body during exercise. Weight training relies on this concept, as the body requires increased stress, resistance, or challenge in order to adapt and become stronger.

The funny thing, however, is how often this rule is forgotten as soon as we switch from the fitness world to the healthcare one. Oftentimes, I'm witness to individuals in pain who have received prescriptive exercises from a therapist, but have attempting to use that same movement - and same volume - for months or even years!

This is essentially the same as trying to gain bicep size by curling with the same-weighted dumbbell for the same number of sets for a year. How effective do you think this would be for initiating physiological change?

In fact, numerous studies are demonstrating that a progressive increase in the frequency and volume of the load that pain patients are undergoing - essentially, having them partake in rehab that closely reflects a fitness training schedule - resulted in greater improvements in condition. This shouldn't be a surprise to anyone, but what is surprising is how easy it is to neglect this principle in the therapy world.

Perhaps we get stuck in the mindset that injured or pain-afflicted clients should not be taken to realms of discomfort. Fairly enough, even many clients are hesitant to exercise beyond a very mild comfort level. Let's remember, though, that there's a difference between the healthy discomfort of a challenging exercise and the noxious sensation of when it becomes to be too much. (This is part of the reason why I allow my clients to work through a 3/10 pain scale, the other reason being so as to not train their nervous systems to avoid pain.)

Long story short, challenge the tissue and be mindful of the pain, but don't totally avoid discomfort. (Am I starting to sound contradictory? Welcome to healthcare.) All in all, we need to ensure that we're varying the intensity and type of movement. After all, that's life!


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