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The criticism directed at prescribing 3 sets of 10 repetitions for exercises has gained traction in the recent past, but it remains simple and does develop strength and hypertrophy provided the load is heavy enough. Strength training can now be done effectively with multiple forms of repetition. It’s likely that rather than the numbers, it’s the effort and consistency that counts.
This brings me to a very important point: the reason behind three sets of ten exercises still being relevant is its ease of use. Patients are more likely to follow through with their rehab when it’s straightforward. If a patient does not have the right amount of guidance, then they are simply not going to attempt it. These patients will be able to do and remember 3 sets of 10.
When a study showed that under 30% of runners complied with their recommended exercises, I believe this emphasizes the need for patient-centered care models that they can easily understand and follow.
My biggest concern regarding the 3 x 10 model is when it allows the patient to do many more than 10 reps without breaking a sweat. This won’t challenge them and it won’t change them! 3 sets of 10 close to or at maximum (or near to) is a different ball game. That would indeed pose a challenge, and increase the chances of augmenting strength and muscular development.
For a good number of our patients, they might not have a background in strength training or know what the phrase ‘rep max’ entails. Hence, I prefer a more straightforward strategy and propose the exercises should aim to be “tough at 10”. If it’s tough at 10 reps great. Otherwise, make it tougher! That way, patients can independently progress by adding load or increasing range of motion.
3 sets of 10 offer value, but they are not guaranteed to optimize everything. See the graphic below for three relevant conditions.
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