From Bands to Bars: Transitioning from therapy to the gym
People come to physical therapy for many reasons and are treated with evidence-based interventions that help strengthen the systems in your body that require attention. These interventions, through strengthening, provide relief from the symptoms a patient is experiencing and hopefully encourage people to lead more active, healthy and pain free lives. Physical therapy can help many people with these interventions but what happens after you finish physical therapy? After physical therapy, patients are encouraged to continue their exercises to maintain what they have strengthened to help prevent the symptoms from returning.
When nearing the end of physical therapy patients are then reminded to continue these exercises to maintain the strength they have gained in therapy, which can help reduce the likelihood of their pain returning. They then have many questions about what to do afterwards regarding their pain. Question like “what exercises am I allowed to do?” or “How do I know I am doing too much?” or “How do I know if what I am doing is benefitting me?”. Unfortunately, if these questions are left unanswered, this state of not knowing what to do after therapy can become a barrier to achieving the healthy pain free lifestyle they seek after therapy. These questions likely are coming from a place of low exercise self-efficacy. Exercise self-efficacy is a person’s belief in their capacity to exercise. To address low exercise self-efficacy, we want to reduce the anxiety of exercise after therapy by providing guidelines to help take out the guess work of commonly asked questions.
How do I know I am not hurting myself?
- When performing your exercises, pain should subside after stopping the exercise.
- If pain lingers reduce resistance.
- Stay within a pain range of 0 - 3/10.
- If pain is higher than usual, go back to exercises used in therapy that reduces your pain
Soreness can last for up to 2 days after exercise, if it persists past 2 days it is likely that you need to reduce the intensity of your workout in the next session and prioritize rest to recuperate.
How do I know I’m doing enough?:
- Assuming there is no pain, remain at a 5-7/10
rate of perceived exertion (RPE)
- If the exercise you chose starts to feel easy and
goes below RPE 5, increase your RPE
- If the exercise you chose is too hard and goes
above RPE 7, reduce your RPE
Ways to increase RPE
- Increase resistance
- Increase repetitions
- Decrease rest time
- Increase how long each repetition is performed
- Increase number of sets
Ways to decrease RPE
- Decrease resistance
- Decrease repetitions
- Increase rest time
- Decrease how long each repetition is performed
- Decrease number of sets
WHEN INCREASING RPE PLEASE ONLY DO ONE OF THE OPTIONS
AT A TIME, IMPLEMENTING MORE THAN ONE AT A TIME MAY
INCREASE RPE EXCESSIVELY
Exercise selection tips
Machines vs. free weights
- Machines are more stable than free weights
- Free weights require more control and stability from your body
-Warm up on a bike or treadmill for about 5-10 minutes
- Usually start with free weights first then machines
- Go from compound movements to isolated movements
- Compound movements require movement from more than one joint
- Overhead press
- Push ups
- Isolated movements require only one joint
- Bicep curls
- Leg extensions
- Lateral raise
- Tricep extensions
Trying a new exercise
- Start with a resistance you can do 15 repetitions at RPE 5 and warm up with the movement until you feel comfortable
- Slowly increase the resistance until you reach a weight you can do 8-12 repetitions at RPE 5-7
Reps and sets
- Generally, 3 sets of 10 is a good start for new exercises
- 8-12 rep range for 2-4 sets
- If you can only achieve reps less than 8 it may be too heavy
- If you can achieve rep ranges above 12 it may be too light.
THIS IS NOT TO SAY BEING OUTSIDE OF THESE RANGES WILL BE BAD, THEY JUST BECOME MORE SPECIFIC FOR DIFFERENT GOALS, THESE RANGES ARE A MID RANGE THAT DIPS INTO BOTH STRENGTH AND ENDURANCE.
Below is an example chart where you can choose an exercise from the exercises in the bank to the left and create your own workout by putting an exercise into the blank spaces in the table.
Timothy Young, SPT
Arcadia University Class of 2022
Outside of pursuing a career physical therapy, Tim has been a certified person trainer since 2017. He is an avid weightlifter and is passionate about people moving pain free.