Should you always be using 3 sets of 10?

Author: Noah Kaminsky, PT, DPT, SCS, CSCS

Three sets of ten is the most common repetition and set scheme you may hear in physical therapy.  Is it wrong? No. Can it be more individualized and specific? Yes.  It can be used as a starting point.  There is a lot to consider when prescribing exercise to a patient.  Some include healing timeline, repetitions, sets, and load.

Repetitions are the number of times you perform a specific exercise and a set is the number of cycles of repetitions that you complete.  Loading describes the amount of weight lifted or resistance used.  This includes dumbbells, barbells, and resistance bands.  Different loads are specific for certain goals such as strength, hypertrophy, and endurance.  The same goes for repetitions and sets.  Healing time includes time from injury and exercise progression is different for each tissue (tendon, ligament, muscle, etc.).

Below are two charts with specific ranges based on goals of the exercise.

American College of Sports Medicine (ACSM)

Strength

                        Novice/intermediate: 60-70% 1RM, 1-3 sets, 8-12 reps

                        Advanced: 80-100% 1RM, 2-6 sets, 1-8 reps

Hypertrophy

                        Novice/intermediate: 70-85% 1RM, 1-3 sets, 8-12 reps

                        Advanced: 70-100% 1RM, 3-6 sets, 1-12 reps

Endurance

                        Novice/intermediate/Advanced: <70% 1RM, 2-4 sets, 10-25 reps

National Strength and Conditioning Association (NSCA)

            Strength: > 85% 1RM, 1-6 reps, 2-6 sets

            Hypertrophy: 65-85% 1RM, 6-12 reps, 3-6 sets

            Endurance: < 65% 1RM, >12 reps, 2-3 sets

In rehabilitation, the limitation is usually tissue capacity which is why higher loads are typically not used early in the rehab process.  However, intensity of exercise is still important.  When higher loads can’t be used, autoregulation can be used to determine intensity. These include rating of perceived exertion (RPE), reps in reserve (RIR), and velocity-based training (VBT).  RPE is a subjective scale from 1-10 where 10 is max effort. RIR is an estimate of how many more reps you can perform until you hit failure.

Three sets of ten for someone who can do 100 reps won’t get the strength benefit as another person whose 8, 9, and 10 repetitions are very hard.  Three sets of ten can’t be done forever.  Progressive overload is required in order to get tissue adaptation.