Progressive Overload – what this should look like in rehab

Progressive overload is a fundamental principle of exercise training and especially rehab. It is when you progressively increase the load, frequency, intensity or volume of the exercise. Unfortunately in some rehab plans though it’s not used effectively. 

Let’s take an example, you have recently injured your shoulder at gym training for an upcoming event. You know you’re going to need to meet your PB strength to compete in the event. You see a physio who just does some basic testing and gives you an exercise band to do some strength work and says keep doing it until you’re stronger. The colour of the band might go up or a few more reps over the weeks but the reality of this is that it’s likely to actually give you much strength. 

At Inspire we handle this much differently. On assessment we use accurate tests to determine your strength – so now we know you’re 20% weaker. Your event is in 6weeks meaning you need to be improving about 3% per week. We can much more closely track this progress to decide if you’ll be safe to compete. For your rehab as well if you could lift say 4kg, and we know that your good side is 10kg, you have to be increasing by 1kg per week to keep on that goal. 

A more relaxed example – you are self pay, live out of town and have limited direct access to good physio. You rolled your ankle on a run and your goal is to just get back to 10km when you are safe enough. Testing reveals you can do 30 calf raises on your good side, but only 12 on the injured. Your home work is then to continue with calf raises until you can do at least 25 on that injured side and that is when you come back in for progression. We then take you into dynamic hopping and a run/walk program providing no pain. 

Progressive overload is the essential component of your rehab and needs to be agreed, tested and tracked to keep making informed decisions. The rehab plan and the level of overload you’ll need to do should be outlined within the first one or two sessions depending on complexity. If this concept or the above pathway isn’t anything like what you have experienced with your physio, reach out to us and see how we can help.