Exercise Progressions: Why, When and How?

One of the targets of a rehabilitation program is the strengthening of muscles that are inactive or weak and thus create muscle imbalances.

In order to strengthen a muscle it must be overloaded, which creates stress and adaptation, which will then lead to muscle growth. Once you can master the prescribed sets and reps of a given exercise, it needs to be progressed to the next level to challenge the muscle and further stimulate adaptation.

Basic principles for safely progressing an exercise:

  • Don’t progress to the next level if you still feel challenged performing the prescribed reps and sets of an exercise.
  • An exercise can be progressed by adding intensity, load, duration or complexity (i.e., including additional movements).
  • The general guideline for progressing patients is called the “10% rule”, where total training (intensity, frequency, duration or complexity) is not increased more than a 10% per week.
  • It is safer to change one component at a time (e.g., increasing exercise volume, but not exercise intensity).
  • If you experience pain or a flare-up the exercise must be regressed to the previous level.
  • Intensity can be increased by either changing resistance or changing stability. See the example below:

#1 Bird Dog with Toe Touch

# 2: The Bird Dog can be progressed by lifting the feet to decrease stability.

#3 The Bird Dog can be progressed by adding resistance.

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