When recovering from an injury, it’s essential to rebuild strength, mobility, and endurance in a way that prevents re-injury while still promoting progress. This is where progressive overload comes into play. Progressive overload is the gradual increase of stress placed on the body to stimulate adaptation.
Understanding Progressive Overload in Rehab
The primary goal is gradual improvement without exacerbating pain or injury. This is achieved by manipulating different exercises.
Variables to progress:
- Resistance/Weight: increasing the weight used
- Volume (Reps & Sets): gradually increasing the number of repetitions or number of sets
- Range of Motion: Gradually moving through a greater ROM as tolerated.
- Tempo (Speed of Movement): increasing or decreasing the speed of the exercise can either increase or decrease the load on the target tissues. This is dependent on the type of exercise as well as the target tissue.
- Exercise selection: progressive overload can be applied with selecting harder exercise variations. E.g progressing from a sit to stand to squat then to a single leg squat
- Frequency: Increasing the number of sessions per week or number of sessions per day
Practical Strategies to Apply Progressive Overload in Rehab
- Progressive overload does not mean increasing a variable every session: Our bodies can only adapt so fast. Different people adapt at different rates and different injuries adapt at different rates. For some people, progressive overload can be applied every session. For others, it may be applied every second week. It all depends on the person and injury at hand.
- Progress one variable at a time: Though not a hard and fast rule, it is generally advised to only progress one variable at a time. This way, it is easier to pinpoint what is contributing to the improvement or worsening in symptoms.
- Monitor Symptoms and Adjust Accordingly: Use a pain scale (0-10) to gauge discomfort. Symptoms should not be worse an hour after or the day after the exercise. If it is then you may need to dial back how much you progressed the exercises.
- Prioritise Quality Over Quantity: Focus on proper movement mechanics before progressing. If form deteriorates, reduce the difficulty and reinforce technique.
- Be Patient and Listen to Your Body: Recovery is not always linear. Expect fluctuations in progress and adjust intensity based on how the body responds.
Conclusion
Applying progressive overload in rehab ensures steady progress while minimising the risk of setbacks. By carefully adjusting load, volume, range of motion, and other key factors, individuals can safely regain strength and function. Remember, patience and consistency are key to a successful recovery. For professional advice on how to progressively overload your rehab exercises reach out to our qualified physiotherapists.
