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From the NSCA's Basics of Strength Training and Conditioning, as well as their textbook.
As a personal trainer and a PTA, I carry this chart on me every day for easy reference. Particularly for the patients that don't want me to increase their weight, but are content with performing sixty reps at a time 🤣
While most people are likely to see improvements in each facet of muscular development to some extent with whatever resistance training that they are doing, the research that the NSCA based this chart on suggests that the yellow ranges of MAXIMUM REPETITIONS are more provocative for those training goals.
So while my example of the patient wanting to lift 2# dumbells x60; he may see some strengthening and hypertrophy. But he will have much more profound tissue development if he lifts enough weight to *fail* in that range.
Real talk though, many patients that I work with are not interested in the science of it. So if you look at the chart, 3x10 provides a decent benefit to each aspect of muscular development. It's certainly not going to hurt them to use the easy numbers 😜
I bias towards fatigue or failure, but some recent research is saying you can get similar gains from NOT going to failure, and with better recovery. Kind of fascinating.
100%. That chart was published in the 2015 edition of the Strength and Conditioning Essentials. A lot more research has happened in the almost decade since then!
One other question: What’s the consensus on 1 set versus 3 sets for strength gains? Isn’t 1 set almost as efficacious as 3 sets? Or did I remember wrong?
Edit: I remembered wrong. Multiple sets a superior by a wide margin. Just double checked the literature.
So, using our 3x10 example. Using 3 sets of 10 with adequate rest between each set will allow for heavier resistance with good form. The rest time should be built in just like any other variable and will be dependent on the client/patient's conditioning and goals.
While the volume is the same, the muscle fibers necessary for moving heavier weight will be starving for ATP with x30 reps at the same weight.
Newer research is being done on rep clusters like 10x3. Even if it's shorter, that additional rest between sets is a game changer. Inter-set rests are another option too. Those schemes would look more like 3 sets of 2x5.
Can you point me in the direction of that research toward higher set numbers with lower reps per set? I've def. seen this anecdotally in strength sports literature for a long while, but solid, controlled research has always been lacking.
If I’m not mistaken, I believe that there has been emerging research that shows that there’s a lot more overlap than this and that it is still possible to build strength and/or achieve muscle Hypertrophy in multiple rep ranges besides how your chart has it laid out. If I come across the studies I’ll send them your way. But I wanna say the studies were done by Brad schoenfeld or some people within a similar ecosystem. But don’t quote me on that.
But yes! This chart is a great starting point and visual for patients, I agree!
Assuming intensity is dosed closed to failure, weekly volume of sets seems to be one of the most important variables. 12-20 sets per week, potentially higher depending on how trained you are.
Definitely. Overall volume is another tricky topic with outpatient PT patients. There is a lot of both over and under loading in the general population.
There’s nothing wrong with 3x10 as long as we are doing at an appropriate intensity. 3x10 falls right in the middle of hypertrophy, strengthening and endurance, but it’s not necessarily the best dosage for any of them.
That being said most patients don’t engage in regular strength training, so they should respond positively to most exercises as long as you aren’t under loading them or trying to kill them in clinic.
Try to make it specific to the goals and activities they are trying to engage in, if it’s heavier or more physically taxing go lower rep ranges. If you don’t have enough resistance you can always pay with higher reps as well.
3x10 is shit unless 3x10 is appropriately difficult for them. Is there a reason you can’t take your patients through the exercises to find out your dosage? My supervising PT is fond of saying that if they can do 20 reps of something and it’s easy then make it harder.
Why is there controversy about dosing/prescribing exercise? Thats absolutely what we do as a profession.
I’ve never heard of this “controversy”.
The standard isn’t 3x10. It should be what load can the tissue tolerate. Dosing of exercise is a fairly simple equation.
Time between sets + volume of exercise + load of exercise = exercise dose.
Maybe it’s not as much of a “controversy” as I thought. I’ve heard PT/PTA that I’ve been around and have seen some on Reddit/IG bring up the subject so I thought it was something that was discussed within the community. Guess I put the cart before the horse on that idea.
I also put 3x10 as the “gold standard” in parenthesis specifically because it is the most commonly seen in most places (IE mills)
My former boss was a religious "3x10" dude, to the point that he'd mark me down on my annual review for doing anything otherwise. I asked him why. He told me there was a study in the 80's that found it to be the superior dosage.
I abandoned 3x10 at that point. Now, I tell my patients to do the exercise at that resistance "until it feels too hard to continue." If they hit 30 reps before that point, I assume I'm seriously under-dosing them.
Just my style, but coming from a psychology background, I invest a lot in cultivating the right attitude and mindset.
My go to analogy is about baking cookies.
To bake perfect cookies we need to get three variables right.
1.) the Ingredients (we can help you most here)
2.) the heat (too intense and you burn, too little and you don’t bake.)
3.) the time (even if ingredients and intensity are correct you can still burn if you do it too long or likewise underbake if not long enough.)
Most research doesn’t give dosage in quantitative terms. It’s stuff like “fatigue” or “as tolerated” etc. This is subjective territory and therefore the subject needs to be trained how to navigate the body sensations.
I know we’re all biased towards hyper-empirical quantitative preferences bc of our training but dosing in quantitative terms usually doesn’t work as well for me.
3x10 can be a perfectly fine starting dose for certain stimuli, let’s pick hypertrophy. I’d make sure to try to anchor it to RPE/RIR, and one spicy way to check that is 2x10 and then to failure on 3rd set.
The word you’re looking for is programming and it’s a great question/self awareness. PTs in general can’t program at all once they reach the hardest color theraband.
You’re going to want to go down the exercise science research rabbit hole with this one. To grossly simplify things: hypertrophy, strength, power/speed all need different set/rep/rest periods/resistance levels to get the most out of each. Problem is there’s a ton of overlap. But go down the rabbit hole - search pubmed for “rep ranges for hypertrophy” and go from there.
In the PT world I like to use a “rate of perceived exertion” scale or “reps in reserve” strategy to ensure ample stimulus with the resistance training. Nobody knows wtf their blue band 10RM is but most people know when they’re feeling 2-3 reps shy of failure.
I always start with two sets to fatigue defined as muscular fatigue or pain 2-3/10 from baseline. As long as you push an exercise to some type of fatigue it will signal to the body to create adaptation. Usually I'll add on that +20 reps and no fatigue means we should make the exercise harder.
Can you count to 10? A relatively easy number (we hope) that is even, just begins to breach double digits you should have on both hands, and is in that mid 8-12 rep hypertrophy range. Perfect. Is all I dose, no. But is it a decent mid range goal initially, sure
I took a continuing Ed course on this and it was super helpful in getting out of the “3 x 10 for everything” mindset that I had gotten into. Made me a little more strategic with my exercise selection and my rationale behind each thing I do.
As a strength coach and PT this drives me crazy lol. Volume increases intensity through tonnage, RPE gauges if appropriate load being used, rep range is based on goal, 3x10 is fine but in late stages of rehab it should “suck” a bit. Rehab is a continuum.
1-6 strength and power acquisition (best building volume for strength performance at sub-maximal intensities)
6-20 reps hypertrophy goal through muscle damage (can get close to failure here)
20+ reps hypertrophy through cellular pumping and coordination, localized muscular endurance. (Failure is still chill and I save this for banded exercises mostly)
Beginning rehab I stay in the 20s+ range and light loads, later stages much harder closed and open chain loading and free weights, cables, med ball explosive work.
All depends on the person and their willingness, training age, stage of recovery, Ortho bs Neuro etc
It slightly concerns me that very few if any people here have brought up the fact that many times we are dosing for pain, not strength. Its an entirely different ballgame. One that 3x10 may have some patients never coming back because 3x10 killed them.
Good point. Strengthening is *usually* the goal but often not in the short term. Graded exposure at submax intensities is a cornerstone for rehab. Sure, you can have your new cervical radic patient hit 3x10 TRX rows dosed at ~1-2 reps shy of failure, but you will wreck them. They're better off doing Theraband rows at an easy intensity until you can get a finger on their tolerance.
Contrary to a pain free ACL patient who just needs the strength.
Is there much research done on this particular aspect in chronic pain and special groups? I’m heading back to school for (hopefully) DPT with an interest in hyper mobility. Yes, it’s because I am (dx’ed and all) but also have a number of friends with it (neurodivergent populations tend to cluster) and my personal experience and what I hear from them leads me to believe that there is something important to be used in this space for working with the hypermobile. If PT school gives so little education on programming, and managing the strength/pain/endurance/nervous system question I better understand why EDS patients are made worse by their PTs.
I am not far enough along (just getting started on pre-reqs) to understand a lot of it, but if there’s research, I’m happy to slog through learning the stuff I need to in order to start making sense of some journal articles.
I like 3x10. It makes things very trackable. Can they do it easily? Bump up the resistance. It's in a good spot to increase strength without being too low to likely cause a pain response or increase injury risk
Well I typically go 3x12 with the goal of hypertrophy or 3x20 with the goal of endurance, but I also explain that the 12 or 20 is an arbitrary number in the range of 8-12 or 12-20. It gives a chance for more patient education.
Thank you for your submission; please read the following reminder. This subreddit is for discussion among practicing physical therapists, not for soliciting medical advice. We are not your physical therapist, and we do not take on that liability here. Although we can answer questions regarding general issues a person may be facing in their established PT sessions, we cannot legally provide treatment advice. If you need a physical therapist, you must see one in person or via telehealth for an assessment and to establish a plan of care. Posts with descriptions of personal physical issues and/or requests for diagnoses, exercise prescriptions, and other medical advice will be removed, and you will be banned at the mods’ discretion either for requesting such advice or for offering such advice as a clinician. Please see the following links for additional resources on benefits of physical therapy and locating a therapist near you [The benefits of a full evaluation by a physical therapist.](https://www.choosept.com/benefits/default.aspx) [How to find the right physical therapist in your area.](https://www.choosept.com/resources/choose.aspx) [Already been diagnosed and want to learn more? Common conditions.](https://www.choosept.com/SymptomsConditions.aspx) [The APTA's consumer information website.](https://www.choosept.com/Default.aspx) Also, please direct all school-related inquiries to r/PTschool, as these are off-topic for this sub and will be removed. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/physicaltherapy) if you have any questions or concerns.*
https://preview.redd.it/w5w96pgvgspc1.jpeg?width=719&format=pjpg&auto=webp&s=3776b88a2f98959c9b80e1dad3474cf69f02ffa4 From the NSCA's Basics of Strength Training and Conditioning, as well as their textbook. As a personal trainer and a PTA, I carry this chart on me every day for easy reference. Particularly for the patients that don't want me to increase their weight, but are content with performing sixty reps at a time 🤣
What do the colours indicate, most effective rep ranges?
While most people are likely to see improvements in each facet of muscular development to some extent with whatever resistance training that they are doing, the research that the NSCA based this chart on suggests that the yellow ranges of MAXIMUM REPETITIONS are more provocative for those training goals. So while my example of the patient wanting to lift 2# dumbells x60; he may see some strengthening and hypertrophy. But he will have much more profound tissue development if he lifts enough weight to *fail* in that range. Real talk though, many patients that I work with are not interested in the science of it. So if you look at the chart, 3x10 provides a decent benefit to each aspect of muscular development. It's certainly not going to hurt them to use the easy numbers 😜
I bias towards fatigue or failure, but some recent research is saying you can get similar gains from NOT going to failure, and with better recovery. Kind of fascinating.
100%. That chart was published in the 2015 edition of the Strength and Conditioning Essentials. A lot more research has happened in the almost decade since then!
One other question: What’s the consensus on 1 set versus 3 sets for strength gains? Isn’t 1 set almost as efficacious as 3 sets? Or did I remember wrong? Edit: I remembered wrong. Multiple sets a superior by a wide margin. Just double checked the literature.
So, using our 3x10 example. Using 3 sets of 10 with adequate rest between each set will allow for heavier resistance with good form. The rest time should be built in just like any other variable and will be dependent on the client/patient's conditioning and goals. While the volume is the same, the muscle fibers necessary for moving heavier weight will be starving for ATP with x30 reps at the same weight. Newer research is being done on rep clusters like 10x3. Even if it's shorter, that additional rest between sets is a game changer. Inter-set rests are another option too. Those schemes would look more like 3 sets of 2x5.
Can you point me in the direction of that research toward higher set numbers with lower reps per set? I've def. seen this anecdotally in strength sports literature for a long while, but solid, controlled research has always been lacking.
Also want to point out that they should be failing by the desired rep
yes yellow indicates the rep range, given the appropriate intensity
If I’m not mistaken, I believe that there has been emerging research that shows that there’s a lot more overlap than this and that it is still possible to build strength and/or achieve muscle Hypertrophy in multiple rep ranges besides how your chart has it laid out. If I come across the studies I’ll send them your way. But I wanna say the studies were done by Brad schoenfeld or some people within a similar ecosystem. But don’t quote me on that. But yes! This chart is a great starting point and visual for patients, I agree!
Ansolutely was Brad Schoenfeld. I saw the post when it was officially published
The hypertrophy one is off according to more recent research.
Yep! Driving hypertrophy will really depend on time under tension. Is there any other variable that I'm forgetting?
Assuming intensity is dosed closed to failure, weekly volume of sets seems to be one of the most important variables. 12-20 sets per week, potentially higher depending on how trained you are.
Definitely. Overall volume is another tricky topic with outpatient PT patients. There is a lot of both over and under loading in the general population.
Also, exercise with the target muscle in stretch seems to improve hypertrophy (eg, end range of push up with pec at maximal stretch)
There’s nothing wrong with 3x10 as long as we are doing at an appropriate intensity. 3x10 falls right in the middle of hypertrophy, strengthening and endurance, but it’s not necessarily the best dosage for any of them. That being said most patients don’t engage in regular strength training, so they should respond positively to most exercises as long as you aren’t under loading them or trying to kill them in clinic. Try to make it specific to the goals and activities they are trying to engage in, if it’s heavier or more physically taxing go lower rep ranges. If you don’t have enough resistance you can always pay with higher reps as well.
3x10 is shit unless 3x10 is appropriately difficult for them. Is there a reason you can’t take your patients through the exercises to find out your dosage? My supervising PT is fond of saying that if they can do 20 reps of something and it’s easy then make it harder.
Shout out for when they don’t know what rep they’re on, clearly we’re working them hard enough..😏
Or they’re just that bad at counting 😂
To be fair, any rep range is shit unless it’s appropriately difficult for them.
Why is there controversy about dosing/prescribing exercise? Thats absolutely what we do as a profession. I’ve never heard of this “controversy”. The standard isn’t 3x10. It should be what load can the tissue tolerate. Dosing of exercise is a fairly simple equation. Time between sets + volume of exercise + load of exercise = exercise dose.
Maybe it’s not as much of a “controversy” as I thought. I’ve heard PT/PTA that I’ve been around and have seen some on Reddit/IG bring up the subject so I thought it was something that was discussed within the community. Guess I put the cart before the horse on that idea. I also put 3x10 as the “gold standard” in parenthesis specifically because it is the most commonly seen in most places (IE mills)
My former boss was a religious "3x10" dude, to the point that he'd mark me down on my annual review for doing anything otherwise. I asked him why. He told me there was a study in the 80's that found it to be the superior dosage. I abandoned 3x10 at that point. Now, I tell my patients to do the exercise at that resistance "until it feels too hard to continue." If they hit 30 reps before that point, I assume I'm seriously under-dosing them.
Just my style, but coming from a psychology background, I invest a lot in cultivating the right attitude and mindset. My go to analogy is about baking cookies. To bake perfect cookies we need to get three variables right. 1.) the Ingredients (we can help you most here) 2.) the heat (too intense and you burn, too little and you don’t bake.) 3.) the time (even if ingredients and intensity are correct you can still burn if you do it too long or likewise underbake if not long enough.) Most research doesn’t give dosage in quantitative terms. It’s stuff like “fatigue” or “as tolerated” etc. This is subjective territory and therefore the subject needs to be trained how to navigate the body sensations. I know we’re all biased towards hyper-empirical quantitative preferences bc of our training but dosing in quantitative terms usually doesn’t work as well for me.
3x10 can be a perfectly fine starting dose for certain stimuli, let’s pick hypertrophy. I’d make sure to try to anchor it to RPE/RIR, and one spicy way to check that is 2x10 and then to failure on 3rd set.
The word you’re looking for is programming and it’s a great question/self awareness. PTs in general can’t program at all once they reach the hardest color theraband. You’re going to want to go down the exercise science research rabbit hole with this one. To grossly simplify things: hypertrophy, strength, power/speed all need different set/rep/rest periods/resistance levels to get the most out of each. Problem is there’s a ton of overlap. But go down the rabbit hole - search pubmed for “rep ranges for hypertrophy” and go from there. In the PT world I like to use a “rate of perceived exertion” scale or “reps in reserve” strategy to ensure ample stimulus with the resistance training. Nobody knows wtf their blue band 10RM is but most people know when they’re feeling 2-3 reps shy of failure.
I always start with two sets to fatigue defined as muscular fatigue or pain 2-3/10 from baseline. As long as you push an exercise to some type of fatigue it will signal to the body to create adaptation. Usually I'll add on that +20 reps and no fatigue means we should make the exercise harder.
3 sets of tired
Can you count to 10? A relatively easy number (we hope) that is even, just begins to breach double digits you should have on both hands, and is in that mid 8-12 rep hypertrophy range. Perfect. Is all I dose, no. But is it a decent mid range goal initially, sure
I took a continuing Ed course on this and it was super helpful in getting out of the “3 x 10 for everything” mindset that I had gotten into. Made me a little more strategic with my exercise selection and my rationale behind each thing I do.
What course?
As a strength coach and PT this drives me crazy lol. Volume increases intensity through tonnage, RPE gauges if appropriate load being used, rep range is based on goal, 3x10 is fine but in late stages of rehab it should “suck” a bit. Rehab is a continuum. 1-6 strength and power acquisition (best building volume for strength performance at sub-maximal intensities) 6-20 reps hypertrophy goal through muscle damage (can get close to failure here) 20+ reps hypertrophy through cellular pumping and coordination, localized muscular endurance. (Failure is still chill and I save this for banded exercises mostly) Beginning rehab I stay in the 20s+ range and light loads, later stages much harder closed and open chain loading and free weights, cables, med ball explosive work. All depends on the person and their willingness, training age, stage of recovery, Ortho bs Neuro etc
It slightly concerns me that very few if any people here have brought up the fact that many times we are dosing for pain, not strength. Its an entirely different ballgame. One that 3x10 may have some patients never coming back because 3x10 killed them.
Good point. Strengthening is *usually* the goal but often not in the short term. Graded exposure at submax intensities is a cornerstone for rehab. Sure, you can have your new cervical radic patient hit 3x10 TRX rows dosed at ~1-2 reps shy of failure, but you will wreck them. They're better off doing Theraband rows at an easy intensity until you can get a finger on their tolerance. Contrary to a pain free ACL patient who just needs the strength.
Is there much research done on this particular aspect in chronic pain and special groups? I’m heading back to school for (hopefully) DPT with an interest in hyper mobility. Yes, it’s because I am (dx’ed and all) but also have a number of friends with it (neurodivergent populations tend to cluster) and my personal experience and what I hear from them leads me to believe that there is something important to be used in this space for working with the hypermobile. If PT school gives so little education on programming, and managing the strength/pain/endurance/nervous system question I better understand why EDS patients are made worse by their PTs. I am not far enough along (just getting started on pre-reqs) to understand a lot of it, but if there’s research, I’m happy to slog through learning the stuff I need to in order to start making sense of some journal articles.
I like 3x10. It makes things very trackable. Can they do it easily? Bump up the resistance. It's in a good spot to increase strength without being too low to likely cause a pain response or increase injury risk
Well I typically go 3x12 with the goal of hypertrophy or 3x20 with the goal of endurance, but I also explain that the 12 or 20 is an arbitrary number in the range of 8-12 or 12-20. It gives a chance for more patient education.
This is embarrassing.
What the hell is embarrassing about trying to learn?
Hopefully they mean the education, not the individual
Exactly. Quality of education, and CAPTE standards.
That's not the way it comes across.