How to Periodize a Rehabilitation Program

Everyone knows it’s necessary to problem our sufferers with load through the train development of a rehabilitation plan.

Many individuals prefer to poke enjoyable on the idea of three units of 10 repetitions, in all probability as a result of some abuse it, however there’s a time and place for the whole lot.

On this episode, we focus on set and rep schemes and the way we periodize our workout routines throughout bodily remedy and even the gymnasium.

To view extra episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 345: Find out how to Periodize a Rehabilitation Program

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Present Notes

• Does Periodization of a Program Help Improve Strength?
• Periodization for Strength Training and Rehabilitation

Transcript

Tyler Farr:
So Samantha from Canada says, “I at all times see folks on social media say that three units of 10 reps isn’t purposeful and that we have to have a special set in rep schemes. When in a rehab affected person’s program do you combine up the units and reps and why?”

Mike Reinold:
That’s an ideal query, Samantha, is there nothing higher about social media the place you may simply go browsing anytime you need, 24/7, and really feel shamed and unhealthy about your self at any second in time, anytime you need? You have got the flexibility to try this with social media. So it’s type of loopy what’s on the market. Simply watch out who you comply with, folks. I don’t know.

Each time you see questions like this from folks, you get mad. She feels unhealthy about herself as a result of anyone stated she’s a foul bodily therapist as a result of she gave anyone three units of 10. It’s absurd.

So anyway, all proper off that one. That was my coronary heart fee monitor, Len. I hate seeing these things on social media.

Lenny Macrina:
I agree.

Mike Reinold:
However I believe it is a actually good query as a result of there’s just a few methods we are able to go about this, however I don’t know who needs to begin and speak about, I don’t know, something. I can lead this just a little bit. My first thought on that is, does anyone assume three units of 10 is inherently unhealthy or fallacious? After which why would you modify it, is the query, as a result of there’s standards to alter these set reps and also you’d determine it out. However who needs to begin this one? Dave, you need to bounce in?

Dave Tilley:
Yeah, I’ll simply bounce in. I believe Jonah’s going to speak just a little bit from the efficiency aspect, however three units of 10 when somebody has a reasonably acute concern happening and also you’re making an attempt to load a very good quantity however not push anyone an excessive amount of, I believe you comply with the three to 4 units, eight to 12 for hypertrophy. However generally on the medical aspect, we’re simply making an attempt to load anyone to maneuver basically. It’s not likely about getting tremendous sturdy.

It’s not a couple of energy factor. It’s not about an power system factor. It’s about this individual’s knee hurts they usually had surgical procedure or they haven’t accomplished something shortly and we’re simply looking for quite a lot of workout routines that may assist them simply transfer basically.

So leg raises, knee extensions, hamstring curls, that type of stuff once you’re doing in circuits, three units of 10 is fairly stable to begin as a result of it’s not a loopy quantity of reps. It’s not 5 units, it’s not one set, it’s proper within the center.

So, I believe three units of 10 obtained its place for a cause as a result of lots of people perhaps had acute or subacute accidents that you may’t load them like loopy, however you additionally don’t need to do nothing. You’re looking for quite a lot of stuff to present them in a circuit and it’s a extremely good software. After which in fact it type of leans in or away from that based mostly in your targets and what’s the objective of the particular physiological loading, which I can let Jonah knock out. However yeah, it’s stable for a lot of, many conditions early on within the rehab course of.

Mike Reinold:
All proper, so who needs to say now, how do you progress anyone at three units of 10? So clearly we’re not altering set rep schemes. Can we simply hold loading? What’s your standards to load anyone with three units of 10? What do you assume, Dan? You need to bounce in on that one? On a rehab, how do you load anyone that’s three units of 10? Is it at all times gentle to reasonable? Do you attempt to push the envelope? Do you attempt to get them to failure on the thirtieth rep? What’s your ideas on units and reps?

Dan Pope:
I do know different issues. I’m going to say that it in all probability simply relies upon lots on what you’re making an attempt to get out of the train. I hate to say that, however let’s use a extra particular instance.

Let’s say somebody has patellar tendinopathy and also you begin off with units of 10. If somebody’s actually painful, they may not be attending to a real failure simply because what occurs is the ache will get so extreme that they’ll’t actually full a given set. When that’s the case, I believe that plenty of the concepts we have now about program and periodization, they fall out the window just a little bit as a result of we’re not even type of getting near that failure as a result of we’re on the lookout for, I’d say someplace between 4 to 6 reps in reserve to finish failure to truly make a change within the muscle or the power.

If we’re not getting near failure, we’re not likely undertaking that. However you are taking somebody that simply has a lot ache that may’t tolerate doing heavier hundreds, then you definitely work lighter. And I believe what you’re making an attempt to do is construct just a little tissue capability or simply getting the analgesic impact of train. Simply by shifting that individual and doing a little train helps to get the tissue to really feel just a little bit higher.

I believe 10 to 12 is a good place to begin. And I’d additionally say that I really favor just a little bit of a better rep vary early on simply because many of the people we work with are fairly athletic. We need to construct power, we need to construct hypertrophy, we need to push them just a little bit, we need to get that prepare impact, however for those who go decrease together with your rep vary, the load has to go up. The individual’s going to method their true failure.

So, if I prescribe them three units of 15, I do know the hundreds are mechanically going to go down just a little bit if I’m anticipating that athlete to work in the direction of failure. So I believe that’s a giant one.

After which on prime of that, you simply know the fundamentals about set and rep ranges. And I believe that every one begins with an understanding of your affected person’s targets and wishes evaluation. And I don’t need to steal an excessive amount of of Jonah’s thunder, I believe he’s going to enter this, however would you like hypertrophy? Would you like power? Would you like energy? What are you on the lookout for? And then you definitely mainly can go from there.

However I believe from a bodily remedy standpoint, we’re very a lot making an attempt our greatest to not irritate that damage and we’re making an attempt to respect the therapeutic. In order that’s what we do initially. However as soon as we do this, now you may get fancy together with your programming stuff, I believe.

Mike Reinold:
I like that. And I’d say among the errors that I’ve seen on-line, two issues with this… One is that some early profession PTs, they’ll attempt to get fancy with their set rep scheme and go down after which underload folks as a result of the individual doesn’t know intent or they’re not prepared, they haven’t accomplished any heavy load but. So now they drop the six reps, however they’re not utilizing sufficient weight to really go to 6 reps. I imply simply taking place to 5, six reps, it signifies that the load has to go up considerably for that to be worthwhile.

So I’ve seen folks do this after which underload. You marvel why they even do this.

After which generally you see folks do this, after which to Dan’s level, you have got a raging patellar tendinopathy for instance, and also you’re taking place to 5 reps, growing the load, and simply their ache shoots by means of the roof. You may see it from each ends of the spectrum. So you bought to watch out I believe with all these and simply resist that urge.

So I like these “relies upon” solutions as a result of it at all times does.

So Jonah, let’s go to Jonah, proper? Jonah’s in all probability laughing at us there just a little bit right here. So Jonah is our power coach, our Director of Sports activities Science right here at Champion. So that is his world with periodizing and stuff. How does it make you are feeling once you see our sufferers doing three units of 10 on a regular basis? After which what are your ideas on… Do you have got any recommendation for PTs on the entire idea of periodization and what they’ll do higher?

Jonah Mondloch:
Yeah, I believe first off, you guys all lined some actually good issues. Two fast ones from Dan that I believe are actually necessary was the thought of going to failure, the place analysis is displaying that power beneficial properties, no matter rep vary, are superb so long as you’re approaching failure. So I believe when you have got these purchasers or sufferers that may solely deal with lighter hundreds, you’re working with a youthful child the place you simply don’t must put a ton of weight on their again, you may get the identical variations or kind of the identical variations so long as you’re approaching failure. So I believe that could be a tremendous necessary one and three units of 10 is nice for that. And it’s simpler in all probability to simply every week add just a little little bit of load, proceed to push somebody that manner, than attempt to get too sophisticated and altering your set and rep scheme only for the sake of fixing your set and rep scheme.

After which that being stated, as Dan talked about, when you begin desirous to have totally different variations, that’s when it does begin to develop into necessary to alter this stuff. And the way in which I type of take a look at the rehab or return to sport facet is sort of a condensed model of your long-term athlete growth, the place fairly than in your case making an attempt to get wonderful at each single high quality, it’s good to begin to simply just remember to’ve uncovered your athletes to numerous qualities.

So say you’re working with any type of decrease physique damage, even one thing similar to an ankle sprain, we have to ensure that we’re getting again into high-speed working. That’s one thing that you simply’re not going to perform for those who’re making an attempt to do 15 second lengthy length tempo runs. You want to actually dash after which energy goes to be one thing that’s necessary to get into.

Identical factor, you don’t need to do three units of 10 on field jumps. You need to choose an train that you are able to do at a extremely, actually excessive intent, and perhaps do 4 or 5 reps at a time.

Fee of drive growth I do know is one other large one which we had a podcast on not too way back, so you may return and take heed to that. However identical thought. If we all know that anyone’s maximal power ranges are fairly good, however their fee of drive growth isn’t nice but, once more, we’re going to need to reduce on the variety of reps we’re doing, perhaps enhance the variety of units we’re doing and that manner each single rep they do by means of it, each set could be carried out at a extremely excessive intent so that you simply really are engaged on the speed of drive growth.

So, I believe the massive image with all of it’s altering when it’s a new adaptation that you simply need to work on, not altering simply because it’s good to change and hold your shopper or affected person entertained.

Mike Reinold:
I like that. And also you do generally see that, that folks simply combine issues as much as combine issues up for the fallacious cause. So humorous.

However Anthony, I don’t know, any ideas from you, a youthful PT on the decision at present with the power and conditioning background. You’re an athlete your self, or former athlete. I imply you’re at all times an athlete. As soon as an athlete, at all times an athlete, proper?

Anthony Videtto:
All the time, at all times. Yep.

Mike Reinold:
However I don’t know, I do know that is the type of factor that you simply see on social media and I do know you’re directed by this. Any ideas that you simply need to add or something you’ve discovered simply from being round us at Champion?

Anthony Videtto:
Yeah, I believe it’s very easy to get caught up in making an attempt to alter issues an excessive amount of, particularly as an early clinician. I positively discovered myself saying, “Okay, we’re going to begin with three units of 10 right here.” After which I’d say, “Okay, we did that. Now I want to modify it up as a result of I must get fancy and present these those that I do know what I’m doing.” So I’ll go to eight reps after which go to 6 reps. After which I believe I discovered myself, such as you guys stated, underloading after I ought to have simply caught with that linear development to begin, go three units of 10, load them as a lot as they’ll for these 10 reps. After which as soon as they attain that time of, “okay, I can’t really add any extra weight on the bar for 10 reps,” then perhaps lowering the reps from there. So we’re stepping into some extra power stuff if they’ll deal with it at the moment.

However such as you stated, I believe it’s simply not getting too fancy early on and actually simply type of pushing that linear development. I believe that’s an effective way to go about it for the primary part of rehab there.

Mike Reinold:
It at all times blows my thoughts at how lengthy you may hold the set rep schemes the identical in linear load. It’s manner longer than folks give it credit score. We have a tendency to combine it up manner prior to we in all probability must for many rehab folks and even some folks with a low coaching age within the gymnasium, proper? You have got a 12, 14, no matter 12 months previous child, you may linear load for a very long time earlier than you drop down to 5 units of 5. That child has plenty of room to develop into his load scheme. So nice stuff.

Samantha, hopefully that helped. That was some actually good solutions from the PT aspect, however I believe having Jonah’s ideas was actually invaluable there. So thanks Jonah for that. Actually nice stuff.

When you’ve got extra questions like Samantha, ask away. Head to mikereinold.com, click on on that podcast hyperlink and please, please, please subscribe so that you get our future episodes on Apple Podcasts and Spotify and we’ll see on the subsequent episode. Thanks a lot.