How often should I do therapy exercises, how many reps, and how many sets?

Reps, sets & frequency, oh my! How often should I do therapy exercises, how many reps, how many sets?

I get asked this a lot, and the answer is not as simple as it seems. Hopefully these general guidelines will help.

Before we start, though, here are some terms you will hear when referring to exercise. First is frequency, this is how often the exercises should be performed. Next is repetitions or reps, this refers to how many of each stretch or exercise you should do at one time. Finally, there is sets, this is the group of reps you do at one time. So if you see 3 sets of 15 reps, you would do the exercise 15 times, take a break and do that a total of 3 times in one session (you might also see it written as 3 x 15).

There are many formulas given by The American College of Sports Medicine. The most common ones you will see is 4-6 reps for heavy weights to increase muscle size (hypertrophy), 8-12 for general strengthening, and 10-15 reps for muscular endurance. But here’s the thing, this is for general strengthening when you DON’T have an injury. So again, it’s not an easy answer.

Therapeutic exercises and stretches or therapy are not meant to bulk up muscles, it’s meant to help retrain your muscles and get them working how they are supposed to again. Then you can work on building muscles once you are healed.

You should always work closely with your own Physical Therapist or healthcare professional when coming up with a plan for therapeutic exercises. This way, the exercise plan can be designed specifically for your current abilities, the exact injury you have, and how quickly (or slowly) your recovery is progressing. The following are guidelines only, and may not be appropriate for your specific injury.

Since therapeutic exercises are not as stressful on the muscles/joints, they can usually be done more often. General guidelines suggest that for frequency, therapeutic exercises should be done every day, 1-3 times a day. I personally like breaking up routines to 2-3 times a day with shorter time (5-10 minutes each), and you can break up the exercises, so you are doing different ones each time. This makes it more “doable” for many people. One of the biggest reasons I hear for not doing a home exercise program is someone just doesn’t have 30-40 minutes a day to dedicate to their exercises. Making the time shorter allows you to do some exercises in between other activities or throughout your workday.

As far as reps and sets, therapeutic exercises are very dependent on several things including:

How long have you had the injury (is it acute or chronic)?
What is your specific injury (a sprain, strain, tendonitis, etc.)?
Are you on any precautions?
How is your body responding to the treatment (does it hurt while or after doing them)?

Sometimes reps, sets, and frequency will change from day to day depending on how your body is reacting, like increased soreness, increased pain, no pain or soreness, swelling, etc.

Here are some general guidelines that can help you figure out what may work best for you.

Exercises should be between 10-20 reps. If you can do 20-25 without difficulty, you need to increase your resistance.
If you are doing an exercise and can no longer use correct form (compensating to get the rep), you need to stop. Never sacrifice quality for quantity. That’s a quick way to injure yourself further.
Sets can be anywhere from 1-3 depending on how many you are able to do at a time. The more reps you can do, the less sets you need.
A good general rule for reps is to do as many as you can until you feel burning or fatigue, then try to do 2 more as long as you don’t sacrifice technique and form.
Stretches should always be held for at least 30 seconds. This allows the muscles to fully relax and get the most benefit of the stretch. The gold standard is holding for 30 seconds and doing 3 sets (3 x 30 sec). However, if you don’t have time to do a full stretching routine, my personal opinion is to still hold the stretch for 30 seconds but do less sets.
Give yourself a break in between each set. Even if it’s just 15-20 seconds, allow your muscles to rest and recover.

It might seem a little confusing when reading all this information, but when you truly listen to your body, it will let you know what you should and shouldn’t be doing. And when you are first starting out, make sure you go see a physical therapist in person, even if it’s just for an evaluation. They can help guide you and build an exercise program specifically for you.