I am often asked how many reps to perform for a given exercise. A part of any quality rehab plan of care is intentional programming and repetition and set ranges. While practitioners vary on approach and methodology, I can offer you my suggestions to help you along your road to recovery. One thing to keep in mind is that individual needs vary, and your needs may be different from general recommendations! Additionally, while I have education and certification in strength and conditioning, I am not a full-time strength coach. The nuances of training programs and periodization I leave to those individuals who are working day in and day out with clients. So understand that my recommendations are from the primary viewpoint of a physical therapist with strength training education and experience.
When I am considering rep ranges and overall exercise volume, I typically classify the patient in one of two categories.
The first is the “rehab” category. This category is for individuals coming back from injury who are not regularly lifting weights, exercising at high intensity, or who are still dealing with pain.
The second category is the “strength” category. This is for individuals who are no longer having pain, are performing some strengthening and exercising at high intensities at least some of the time.
Understand that these two categories do overlap and have significant carryover from one to the other. There is no clear delineating factor between the two situations and often this programming exists on a spectrum. This is why it is important to enlist a qualified professional to assist you with you rehab and strength needs!
We will start with the strength category because it is more typically what someone thinks of when they think of getting stronger. This category often involves a pre-programmed schedule of exercise routines that you receive from your coach or therapist. It may vary from 2 days per week all the way up to 6 or 7 days per week. There are a seemingly-infinite number of strength training philosophies and methodologies when it comes to programming – none of which are the concern of this blog post. If you want to dive deeper on methodologies, finding a strength coach is your first step. For our purposes, here, let’s look at the rep ranges for strength goals published by the NSCA.
As you can see, the rep ranges and results all exist on a spectrum! So, you will receive all benefits regardless of which rep range you are participating. This can be confusing for someone new to strength training, so just know that you will not “only” be training for endurance if you are doing 20+ reps per set, or “only” be training for “strength” if you are doing 6 reps per set. There are certainly rep ranges that are ideal for your goals, as you can see in the chart, but it is not nearly as concrete as some people would like to believe.
So, how do you make sense of all of this? Well, the best option for programming is to find a strength coach and get individualized programming. Someone who will talk to you and ask about your goals and interests before programming. Cookie-cutter programs from the internet certainly can be effective, but it may not be optimal for you and your unique situation.
If you are just starting out, a very basic 3 sets of 10 is a safe way to learn your body and how to strengthen. Choose 6-10 exercises per session and perform 3 sets of 10 with 30-60 seconds of rest between your sets. This is the most vanilla and basic of strength programs and I know many strength coaches are rolling in their graves, but we all have to start somewhere right?
When I have individuals who are still firmly in the rehab category, our rep ranges are much more fluid and we are less concerned with overall sets and reps that exist in a standard program. In this phase, I am more concerned with avoiding high levels of pain (greater than a 3 out of 10) and reaching muscular fatigue. Muscular fatigue for this situation means you could do 1-3 more reps if you absolutely had to, but you surely would not enjoy the experience. For example, I may give a runner a single leg deadlift or heel tap exercise and instruct them to alternate legs performing 10 reps per set until they reach their fatigue point. Or for a shoulder pull apart, perhaps I will instruct them to perform 20 – 40 repetitions, or until they hit fatigue.
Why is the fatigue point important? Because muscular fatigue is a quality stimulus for muscular adaptation and hypertrophy. So, if we are trying to make something stronger, we should push it to relative fatigue in order to convince your body that is worthwhile to invest energy to change. Keep in mind that as we get closer to fatigue, pain may start to be present, and we should be cautious to not push past a 3/10 on the pain scale, if possible.
Understand that the typical individual in the rehab category can see wild swings in strength and exercise tolerance, and some days a rep range of 20-25 is easy and other days a rep range of 5-10 is devastatingly hard – both with the same resistance. This is due to recovery and healing and is perfectly fine! Remember that my most important factor for rep determination in this category is fatigue. If you hit fatigue earlier one day, great! It truly doesn’t matter – what matters is the stimulus!
Additionally, the number of exercises and sets are also dependent upon recovery stage. As you get stronger and have less pain, you will be able to keep doing more. As a rule, I start patients off with 3 exercises per session (usually once per day) and will work up to 6-8. If we start getting too far past 8 exercises, I will usually split this into multiple days, so as not to have you performing rehab sessions that are an hour or more.
Hopefully this helped to shed some clarity on a complex and challenging topic. If you have any questions, reach out to me for help!
Thanks for reading,