In the July Physio Talk, I described how I believe the best stretching is individualized, done by what the person feels. This is because everyone is different, a cliché, but true. Well, the same can be said for exercise to become stronger.
The best exercise to become stronger in any muscle is done at a level that makes the muscle tired. Actually, since any movement is the result of many muscles working together, it is better to say the movement became too difficult because all the muscles responsible became too tired. The exercise principle being applied here is overload. Work the muscles until they have a difficult time doing any more exercise. I suspect this principle is one of the main reasons so few people exercise on a regular basis. The sensation of fatigue is not nice, and if the person does not get there, the muscles do not get stronger. So, many people end up doing some exercise, stop before they reach fatigue (because they don’t like the sensation) and no fatigue, no increase in strength, so they quit.
Fatigue can be reached by placing a large load on the muscles responsible so they do only a few movements before fatigue, or by placing a smaller load on the muscles and asking them to repeat the effort until fatigue. In rehabilitation, the second way is much safer because the body is recovering from injury and may not be able to handle a very large load.
So, when the physio is recommending an exercise to help you recover strength after injury, if he/she does not tell you how much exercise to do, just do it until you are too tired to do more. Your number of repetitions will likely be different than another person simply because your situation will likely be different from his/hers.
One consequence of exercising to fatigue will likely be post exercise soreness, which you should expect. The soreness should be different from the original pain or discomfort you experienced, will peak the second day after starting the exercise, and decrease over the next several sessions, assuming you do your exercises. Post exercise soreness is recovery soreness, and not reinjury soreness. If you are not sure which it is, ask your physio.
These comments are general in nature. Be sure to check with your physio or doctor if you are not sure whether they apply to your situation.
Dave Rohe is a recently retired physio having practiced in New Zealand since 2004. He originally qualified in the USA, subsequently practicing in Malawi, Egypt and Cambodia prior to emigrating to New Zealand in 2003. He has enjoyed management positions in pediatric and adult outpatient facilities as well as taught physiotherapy for 15 years at the University of Georgia. He is currently living in Parakai with his wife, Sharon Robinson, a local midwife, near his adult children who are working, and one of whom is studying to qualify as a physio through the programme at the University of Otago. His articles previously appeared in local newspapers in Taranaki and on the blog site sponsored by NZSPT.