Physical therapy allows for patients recovering from injury to regain muscular strength, muscular endurance, and flexibility which are beneficial for improving overall physical health. Physical therapy is a process that requires patience, effort, and creativity. Exercises are performed and muscles are functioning again. However, performing the same exercises over and over again without any change results in plateaus and no further progress in treatment. To avoid the plateaus and improve the treatment, there needs to be a change whether it would be an increase in weight, an additional set, more repetitions, or an advanced exercise. Implementing the increased intensity is a concept called progressive overload.
Progressive overload refers to the increases in intensity for the muscles to adapt to a heavier workload.
It has been argued by many trainers, exercise physiologists, and other scientists that progressive overload is the most important factor for the development of our muscles. Although the word “overload” sounds intimidating, let’s take this one step at a time! Here is a simple example of implementing progressive overload in physical therapy for an injury such as a torn rotator cuff as shown in the pictures:
A front shoulder raise exercise, also called shoulder flexion, is being performed here with no weight.
For progressive overload after several prior visits, a one-pound weight is used to complete the exercise.
After more visits, two-pound weights can be used.
And so on…
The key thing to note when using progressive overload is not to be drastic.
If you can do 15 reps of an exercise and that you were previously doing 10-12 reps you should up your weight.
Doing things as simple as adding one pound to the exercise or an additional set of an exercise are simple ways to use progressive overload. The options are endless when trying to use progressive overload, but there are a few things to consider:
- Make sure that you are 100% confident in performing the exercises with proper form before increasing intensity.
- Monitor the pain, if any, on the areas of concern. Progressive overload should not be used if you have pain. “No pain, no gain” is a phrase often heard, but in physical therapy, we want to gain, but limit pain as much as possible!
- Choose either an increase in weight OR adding an additional set for progressive overload. Try NOT to increase weight AND adding sets at the same time. That would be too drastic of an increase and could lead to increased muscle soreness in the weaker areas.
This post was written by Zack Schneider, an intern at Peak Performance Physical Therapy. He graduated from Michigan State University in May 2016 with a Bachelor’s of Science in Kinesiology. Zack will be attending physical therapy school starting in June 2016 at Stony Brook University in Long Island, New York.