Practical Guide to Hip and Knee Strengthening

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Introduction[edit | edit source]

Progressive Overload for Strength Development[edit | edit source]

General principles to consider with progressive overload:

  • Remember TWO things when dealing with a patient who requires strengthening[1]:
    • Establish the level of load they can currently cope with
    • Keep reassessing the situation as patient progresses
  • Progressively expose an individual to load at a tissue and system level[2]
  • Maximum tolerated loads are necessary to generate supraphysiological stress and low level of micro failure to create adaptation[3]
  • Allow sufficient recovery time to enable adaptation
  • Application of the appropriate load to drive the required adaptation
  • Specific Adaptation to Imposed Demand (SAID) principle
    • Adaptations produced by training are highly specific to the nature of the stimulus or overload applied[4]
    • Adaptations are specific to strength, power, endurance, functional activity, joint angle, sequence of muscle activations, energy systems and virtually all other variables present
    • SAID principle is impacted by:
      • Position or length of the muscle (length-tension relationship)
      • Speed of contraction (force - velocity relationship)
      • Muscle contraction type (isometric, concentric, eccentric)
      • Percentage (%) repetition maximum
        • Training as a percentage of repetition maximum (RM)
          • e.g. 80% 1RM
        • Repetitions to failure
          • e.g. 80% 1RM = 7 - 10 repetitions to failure

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Resources[edit | edit source]

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References[edit | edit source]

  1. Herrington, L. Practical Guide to Hip and Knee Strengthening. Course. Plus. 2024
  2. Taberner M, Allen T, Cohen DD. Progressing rehabilitation after injury: consider the ‘control-chaos continuum’. British journal of sports medicine. 2019 Sep 1;53(18):1132-6.
  3. Herrington, L. General Principles of Exercise Rehabilitation Course. Plus. 2022.
  4. Schoenfeld BJ, Grgic J, Van Every DW, Plotkin DL. Loading recommendations for muscle strength, hypertrophy, and local endurance: a re-examination of the repetition continuum. Sports. 2021 Feb 22;9(2):32.