Rehab & Recovery Zone!

When to Progress, When to Regress

By Sheri Walters, PT, DPT, SCS, ATC/L, CSCS,
Director of Performance Physical Therapy, EXOS

In physical therapy and performance training, success is all about progression and improvement. That's why it's so important and why I often get asked about how to know when it's time to progress an athlete to the next level – and, conversely, how to know when it's time to pull back and regress training.

Establish a Baseline

Before you can even think about progressing a client, you first need to establish a baseline. Every coach should have a system in place for completing a starting evaluation. This evaluation should give you a comprehensive idea of what your athlete is capable of and what his or her limitations are.

Of course, you'll want to modify your baseline evaluation according to your athlete's goals and situation. For instance, a 25-year-old male athlete is going to be in a very different place than a 45-year-old businessman who hasn't worked out in years.

And if you're assisting an athlete coming back from injury, you'll want to focus on the area that needs rehabilitation and will need to ratchet down the baseline evaluation to an appropriate level.

All About Quality

When you observe that an exercise is starting to become easy for an athlete, it's time to progress him or her to the next level. But that doesn't mean the same thing to everyone. In the case of the businessman who hasn't worked out in years, you may want to increase the number of reps performed, and then the number of sets, before increasing the amount of weight being pushed. For athletes who train regularly, you can increase the weight sooner.

But as in most training, it's about quality – not quantity. If an athlete isn't able to perform a quality movement, regress him or her down to a movement pattern that can be done properly. Strategic regression is safer and produces better results than simply piling on additional weight.

For athletes returning from injury, neurologic inhibition is often a cause of improper movement. Before regressing an athlete, try providing cuing and stabilization assistance to see if this allows them to properly execute a movement. For instance, let's say an athlete returning from ACL injury is still having trouble performing a squat after going through all their progressions. If their core stabilizers have shut down due to injury, you can assist with stabilization – in the case of the squat, by using mini bands to help activate the glutes and core. But if cuing and modifications don't work, then you know it's time to regress the movement.

Modify, Modify, Modify

Just about every movement can be modified to suit an athlete's ability. For example, we're working with an NFL defensive player who's just coming back from shoulder surgery. His entire job is to push offensive linemen.

We started him off just having him lie on his back pushing a stick in the air. We want to first establish the neurological pattern before we load the movement. We eventually will add little dumbbells. Then we'll progress him to wall push-ups, bench push-ups and, finally, full floor push-ups. If at any time he is unable to properly perform the movement, we'll regress him back to the previous step.

It's not just elite athletes who benefit from strategic training adjustments. Thoughtful, frequent, and customized changes can fine-tune any program, reducing injury risk and helping athletes move more efficiently and effectively.

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(November 2014)