Strength & Conditioning in Physical Therapy

24 May 2021Physical Therapy

When you experience an injury, one of the most disappointing aspects can be the inability to perform tasks without pain or as well as you once had.

This is where physical therapy can be your best resource.

A good physical therapy program will not only help you get out of pain, but it will integrate strength and conditioning in order to help you complete the tasks you want to do again. The therapists at F.I.T. Muscle & Joint Clinic work alongside our patients to help them reach their goals whether it’s returning to sport or returning to daily activities through a guided rehab process that appropriately addresses and challenges the injured tissue at each stage of healing. 


When patients arrive for care, we often start with lower level exercises (think 30% of 1-rep maximums) because tissue integrity may have been disrupted due to injury, pain tolerance is low, and fear of re-injury is heightened.  These early exercises are designed to help you begin creating adaptive stress on the affected tissues and building confidence in pain free movement ranges sort of like you’re building your foundation which strength and conditioning can grow on.  We start here as it allows us to help people start moving better, provides an opportunity to modify painful factors, and recover proper function. Although these low level exercises are an integral part of therapy, and you must start with them, research has indicated that low level strength exercises don’t actually create much tissue adaptation, therefore therapy must go beyond this into more significant training and conditioning.  

Strength and conditioning will help take patients further away from that pain threshold as it will build endurance and strength, increase tissue resilience, and improve load tolerance. 

Research indicates you need to work at high levels of resistance (up to 80-85% of 1-reps maximums) to create tissue hypertrophy (growth), therefore a rehab program that moves out of those entry level exercises and into high level exercises is necessary. 


We often get asked why therapy and the progression of strength can seem to take so long.

Here is where a little bit of understanding about the healing process is important. Full tissue recovery can take anywhere from 4-6 weeks up to 14-16 months depending on the severity of the problem, and with the lack of mobility, strength deficits and muscle imbalances that are often a part of injury, full recovery can take a significant amount of time and requires a consistent program that not only gets you out of pain, but increases strength.


Unfortunately, pain is usually the driver or motivating factor of starting therapy, so once pain is gone, often in as little as 4-6 weeks, patients sometimes fall off the wagon in regards to consistency which can potentially lead to a cycle  in and out of pain and in and out of therapy rather than a true recovery.

Without consistent physical therapy that includes a progression of exercises moving from easy to more substantial work when the tissue is ready, the margin of experiencing pain or re-injury is significantly greater. 

If we can condition and strengthen our bodies to be more resilient, learn to move our bodies more effectively and efficiently, we can lead lives with less pain, and physical therapy that incorporates proper strength and conditioning training is a powerful resource to help you accomplish this.