Strength Training in Physiotherapy: Why and How to Incorporate It
Strength training is no longer just for competitive athletes. On the contrary – properly guided strength training is one of the most effective tools in modern physiotherapy. It aids not only in recovery after an injury but also serves as the most effective prevention against future injuries.
What Strength Training Looks Like
The foundation lies in sufficient exercise intensity to trigger tissue adaptation. We generally prefer multi-joint compound movements, such as:
Squats
Deadlifts (including single-leg variations)
Presses (e.g., bench press or push-ups)
Pulls (e.g., pull-ups or rowing)
Complex movements like the Turkish get-up
These movements can be adapted for anyone – from absolute beginners to athletes.
The Core Principle: Strength Training (3–5 Repetitions)
Developing maximum strength requires:
3–5 repetitions
3–5 sets
High load (approx. 80–90% of your 1-repetition maximum)
Key Rule: The weight should be heavy enough that you are physically unable to perform more than 5 repetitions.
How to Find Your Correct Weight
If you can manage 6 repetitions → increase the weight next time.
If you manage exactly 3–5 repetitions → it is ideal.
If you manage fewer than 3 repetitions → the weight is too heavy.
Structure of the Training Session
Warm-up Sets: Approx. 50% of your working weight.
Working Sets: 3–5 sets of 3–5 repetitions.
Rest Periods: 3–5 minutes (or even more for very heavy weights).
Note: Longer rest periods are crucial. They allow the central nervous system to recover and maintain peak performance by replenishing the creatine phosphate metabolism system.
How Often Should You Train?
While recovery after strength training sufficiently occurs within 24 hours, we prefer a rest day between sessions. This means a maximum of 3 times a week, though incorporating strength training even minimally—just once a week—is enough to see results.
Why Strength Training is So Important
1. Neuromuscular Adaptation (Fast: 6–12 weeks)
During the first 6–12 weeks, you will experience improvements in:
Coordination
Muscle recruitment
Overall strength
The body is essentially learning how to move efficiently.
2. Tendon and Ligament Adaptation (3–6 months)
Unlike muscles, tendons require a high mechanical load approximately 80% of your maximum) to adapt. This is absolutely critical for conditions such as:
Achilles tendinopathy
Plantar fasciitis
Note: Light exercise does not provide a sufficient stimulus for tendon remodeling.
3. Cartilage and Intervertebral Disc Adaptation (6–9 months)
Strength training supports the health, resilience, and structural integrity of joint cartilage, menisci, labrums, and spinal discs.
4. Bone Tissue (9–12 months)
Long-term strength training:
Increases bone mineral density
Decreases the risk of osteoporosis
Studies demonstrate that even older individuals can significantly improve bone tissue quality through regular, progressive strength training.
How Strong Should You Be? (Baseline Benchmarks)
General Population:
Deadlift: 1x body weight
Squat: 1x body weight
Bench Press: 1x body weight
Athletes:
Approx. 1.5x body weight or more, depending on the specific sport.
Unilateral & Complex Movements:
Single-leg Romanian Deadlift: 0.5 body weight
Turkish Get-up:
Men: 40 kg
Women: 32 kg
Safety: Is Strength Training Risky?
Quite the opposite. Properly executed strength training is actually:
Safer than training with high repetition ranges (8–15+ reps).
Safer than most recreational sports.
The Reason: Fewer repetitions mean less cumulative fatigue, which directly leads to fewer technical errors and structural breakdowns.
Next Steps: Muscle Endurance
Once a solid foundation of maximum strength is developed, you can incorporate endurance blocks:
10–20+ repetitions
Utilizing 2 Repetitions in Reserve (RIR 2)
Note: RIR 2 means stopping the set two repetitions short of absolute muscular failure. This approach results in better fitness, hypertrophy (muscle growth), and cardiovascular support.
Explosive Strength (Advanced Phase)
The subsequent step focuses on the rate of force development (RFY), which is vital for athletic performance and reactive injury prevention. This typically includes:
Olympic weightlifting variations
Dynamic, ballistic movements
Summary for Clients
Strength training in physiotherapy:
✔ Improves overall bodily function.
✔ Treats active injuries and prevents new ones.
✔ Strengthens tendons, bones, and joints.
✔ Is completely safe under professional supervision.
The core formula is simple: Heavy weight + low repetitions + adequate rest.
Are you looking to safely build a resilient body, recover from chronic pain, or supplement your current sport with structured strength work? Book your initial session. Our 90-minute comprehensive diagnostic assessment will identify your baseline physical capacities and map out a safe, progressive training plan tailored to your goals.
Fyzioterapie Chalupa – your English-speaking physiotherapist in Brno.
