At some point in our careers, we have all given the exercise prescription of 3 sets of 10.
But why do we always default to this brainless, no good evidence, an arbitrary number of sets and reps? Simple, because we are lazy and its a simple enough number to remember. Some people will argue that it is a valid training load for certain clients and situations, which it is, but how often is that truly an appropriate dose. And others will argue that sometimes giving someone something to do, anything to do is better than nothing.
I just want my patient to move, I don’t care how much or how often. But after that the training load needs to be more specific for each individual. I am not advocating that we tell clients I want 4 reps for this exercise, 12 for that one, and 7 for this one, but rather we can’t be giving everyone the same exercise prescription. Because face it none of our clients are same EVER.
Above pictures will clearly tell you what I mean to say.
If our goal is to strengthen a tissue, is pulling red thera-band 3×10 really going to achieve that effect? If the goal is neuro-muscular adaptation and we need the client to go through the range with a low load, then sure the 3×10 is fine. There is no two injuries are the same, nor are no two shoulders for instance, why do we always give the same exercises? when we discussed a case with our colleague “this exercise works best for this condition” and that is why they always give that particular exercise. But is it really that exercise helpful, or is it a multitude of other factors involved, such as healing time, client perception, manual therapy, adherence to treatment, which is the cause for improvement in the condition.
There are many practitioners get stuck in the way they prescribe exercise in protocols. For example, nowadays ACL reconstruction and Total knee replacements are booming in our field. so everyone asks for the protocol and trat patient accordingly. when that protocol doesn’t work then they move on another. Every protocol is tailored made, which don’t fit into every patient. people say, you have to do these type of exercises in supraspinatus impingement? is the patient condition same ?With this some practitioners become exercise snobs, if it is not done “their way” its the wrong way. Or they try to come up with a novel exercise .
Same goes for the same treatment plans who have established through years of clinical experience. Again if it works it works, but if its not working that’s when we need to take a step back and examine what we are doing and why we are doing it. Or better yet, before implementing a treatment plan step back and ask “is this patient who will respond well to the way I always treat an ACL or other conditions or do we need to mix things up a bit because that approach may not be as effective”.
my advice is when next time you are working with a patient for rehabilitation, don’t just spit out 3 set of 10 or stick to one protocol. Think about what you are trying to achieve and what load is most appropriate for that scenario. Don’t be afraid to incorporate high training loads in fear of re-injury, and also don’t be afraid of giving low-level movement based activity in fear of the patient being bored or not buying-in.
At the end of the day with any type exercises, we are trying to optimize the load a tissue . Thera-band exercise with 3 sets of 10 can only do so much in load training.