First and foremost, I want to say that I’m happy to be contributing to this blog again. The past year has been very busy both personally and professionally and I did not feel I had the wherewithal to effectively provide good content that I would be proud of. Call it a new years resolution but I’ve decided to recommit to this goal and jump back in. Enough with the excuses, let’s get to today’s topic.
How do you know if an exercise is “good”? I was recently asked this question by my DPT student and I feel he is not the only clinician or coach often confronted with this puzzle. In the discussion that followed these were main takeaways we came up with:
A good exercise:
- Requires minimal set up time
- Has a fail safe environment
- Allows for progressive overload
- Has a specific adaptation in mind
- Translates directly to achieving a specific KPI
Let’s break each of these down.
- Minimal set up time
This is important in the context of session flow. Increased set up time leads to choppy sessions. Choppy sessions take away from achieving in-session goals and decrease the total volume of care that can be provided.
- Fail safe environment
Creating a fail safe environment has multiple benefits some of which include: increased safety, increased confidence for a specific task, enhanced self-belief and optimism, and allows the patient to experience success. Not only does this protect you as a clinician or coach, but ithas the added effect of a psychological boost for your client that is immeasurable.
- Allows for progressive overload
Progressive overload is massive in achieving targeted adaptations. It has the added effect of increasing confidence and ensuring clients experience some form of success semi-regularly. Progressive overload is dependent on dosage (i.e. sets, reps, total volume, resistance, duration) and it’s gradual increase over time. Another factor to consider is stance or positioning and its effect on challenge and specificity while maintaining the emphasis on overarching goals throughout a program. Too often can we be swayed into providing multiple inputs and challenges within an exercise for the sake of difficulty. I’m not gonna mention any names, but I’m sure we’ve all been bombarded by Instagram heroes and their circus act exercises. I would argue the more input we have for a given exercise (i.e. compliant/variable surfaces, bands, perturbations, and cues) the less we know about the specific output we will gain from that exercise.This makes it more difficult to quantify dosage and identify appropriate progressions or regressions for an exercise. See next point. Increased inputs may also require increased cuing which will contribute to choppy sessions as mentioned in our first point.
- Have a specific adaptation in mind
It is important to have a specific output or adaptation in mind when selecting an exercise. When performing a needs analysis, clinicians should be determining which buckets of need are most lacking. This can help organize a program as well as provide clues as to how long it may take to achieve a given adaptation. Is this exercise meant to increase absolute strength? Stiffness or elasticity? Proprioceptive control? Aerobic or anaerobic capacity/power? Rate of force development? Anti-movement? Each of these provide clues on intensity, dosage, exercise selection, required constraints, and a likely timeline to achieve the adaptation.
- Translates to a specific KPI that directly assists in achieving client goals
Key performance indicators (KPIs) help measure progress and performance over time. They also provide meaningful benchmarks to strive for when determining readiness for a given task. This is important in both the rehabilitation and sports realms. In rehabilitation, KPIs help determine progressions in the context of a criterion based rehabilitation. In the realm of strength and conditioning, they may provide benchmarks to strive for over the course of offseason/preseason to determine whether or not an athlete is performing adequately to effectively contribute in-season. KPIs are most often associated with business practices but also apply well to training. The subject of KPIs in rehabilitation/training deserves its own post but thinking of the coach-client relationship as a “business” elucidates the utility of KPIs.
Wanna read more on KPIs? Check out this quick article.
Tying it all together:
Regarding exercise selection, keep it simple to start. Identify a few low hanging fruits through your needs analysis. Pick out basic activities you know the client can complete independently and will help achieve early success. Frame a session or group of sessions over time by selecting one or two buckets of need that are most lacking. Pick out a few exercises that allow for progressive overload and achieve a specific adaptation. Determine the length of time you feel is necessary to fill those buckets of need, and test your progress at set intervals by using specific KPIs for each bucket.
It’s important to understand that “success” is a moving target. Your programs or plans of care don’t have to be perfect. They just have to get you started on the right line and allow you to adjust as needed.
