By: Parm Bhullar, Physiotherapist
What is Exercise Prescription?
Exercise prescription is an essential part of treatment in rehabilitation settings. It allows for individualized planning to promote recovery, prevent further injury, and manage various health conditions. It typically involves tailoring parameters such as frequency, intensity, and type of movement to suit an individual’s specific needs and goals.
At Hayer Health, our therapists ensure high-quality treatment by understanding these components when designing and implementing exercise programs. This guide provides an overview of exercise prescription through a rehabilitation lens, with a focus on resistance-based exercise.
Key Components of an Exercise Program (FITT Principle)
Frequency: How Often Should You Train During Rehab?
Frequency refers to the number of training sessions per week. For resistance training, it’s recommended:
Beginners: 2–3 times per week (avoid back-to-back days)
Intermediate/Advanced: 3–4+ sessions, depending on goals (e.g., muscle growth, strength, endurance)
Intensity: How Hard Should You Push?
Intensity refers to the amount of weight or resistance that is used to perform an exercise. This is often based on a percentage of your one-repetition maximum (1RM) or perceived effort.
There are two primary ways to determine your 1RM:
Direct approach: Involves physically testing the maximum weight you can lift for one complete repetition. This method is best suited for experienced individuals or those under professional supervision.
Indirect approach: Uses an estimated 1RM based on the amount of weight lifted for multiple reps. This is more common in clinical or general population settings due to its lower risk.
Depending on the rehabilitation goal, training intensity is generally divided into three categories:
Strength development: 80–100% of 1RM, typically performed for 1–6 repetitions per set. This range focuses on improving force output and neuromuscular adaptation.
Hypertrophy (muscle growth): 65–80% of 1RM, with 6–12 repetitions per set. This moderate-intensity zone promotes muscle mass, which can support joint stability and function.
Muscular endurance: 40–60% of 1RM, with 12–20+ repetitions per set. This range improves the muscle’s ability to sustain repeated contractions and resist fatigue—key in functional recovery.
In rehabilitation settings where 1RM testing isn’t always feasible, subjective effort scales can help regulate training intensity effectively:
Rate of Perceived Exertion (RPE): A self-reported scale from 1 to 10 that reflects how difficult a set feels. For example,
1 = very light effort (rest)
10 = maximum effort (cannot complete another rep)
RPE allows patients and therapists to monitor effort and adjust loads based on daily readiness and recovery.
Reps in Reserve (RIR): Indicates how many more repetitions you could have completed before reaching muscular failure. For instance, completing 10 reps with 2 RIR means you could have done 2 more. This tool helps balance challenge and safety, especially in post-injury training programs.
By tailoring intensity to match an individual’s goals, injury stage, and capacity, physiotherapists can optimize rehabilitation outcomes while minimizing the risk of overtraining or setbacks.
Time: How Much Volume and Rest Do You Need?
In exercise prescription, time refers to two key components within a training session:
Volume – how much total work is performed
Rest periods – how long you recover between sets
Volume
Volume typically refers to the total weight lifted during a workout, calculated as: Sets × Reps × Weight
However, for the purpose of simplicity, we’ll focus on sets only.
Beginners: Start with 2–3 sets per exercise to promote adaptation and minimize fatigue
Intermediate to advanced individuals: Progress to 3–6 sets per exercise, depending on specific rehabilitation goals (e.g., strength, hypertrophy, or endurance)
Rest Periods
Strength: 2–5 minutes between sets
Hypertrophy: 30–90 seconds between sets
Endurance: 15–45 seconds between sets
Type: Choosing the Right Exercises for Recovery
The type of resistance-based exercise depends on your injury and rehab goal.
Options include:
Bodyweight exercises: are completed without any external force or load, like push-ups, planks, etc.
Machine-based: Offers stability, good for early rehab
Free weights (i.e. dumbbells): Engages stabilizers, used when appropriate for function and stability
an Individualized Approach
The SAID principle (Specific Adaptation to Imposed Demand) means your body adapts specifically to the type of training it experiences.
For example, training for strength will lead to stronger muscles and tendons, while endurance training will more likely improve cardiovascular and respiratory function.
In rehabilitation settings, it’s essential to tailor exercise programs to an individual’s specific goals and functional needs. This includes considering their injury history, current concerns, fitness level, and previous training experience. Understanding movement restrictions and pain levels ensures the program is appropriate for their presentation.
The role of the physiotherapist is to assess and guide patients through individualized exercises suitable for each stage of rehabilitation. Physiotherapists and Kinesiologists work closely with patients to ensure proper technique, safety, and appropriate progression.
Common Mistakes to Avoid in Exercise Prescription
Inadequate Recovery
Allowing for 24–72 hours of rest between training sessions for the same muscle group is recommended to support recovery.
A common mistake is doing too much too soon, which can overload muscles and tendons. This increases the risk of re-injury or worsening symptoms.
Pain Levels
Another common mistake is working through high levels of pain and ignoring pain signs or symptoms.
The “no pain, no gain” mentality an individual can adopt may be counterproductive in recovery.
It is recommended to speak with your physiotherapist about pain levels during rehabilitation.
Generally, it is important to monitor pain levels during exercise, later that day and the following morning. This can provide insight into how the body or tissue is responding to activity.
Depending on the injury or presentation, it may be advised to work through tolerable levels of pain or discomfort, however this should be discussed with your physiotherapist.
Lack of Progression
The SAID principle describes how the body adapts to the type of demand placed on it.
Therefore, to avoid plateauing or insufficient load, your exercise program should gradually increase the challenge or stress placed on the tissue. This is known as progressive overload.
This can be achieved by increasing reps, sets, time under tension or decreasing rest periods.
Another strategy is to track progress by logging workouts or using an exercise journal. This can help determine if the exercise program is becoming stagnant or if the body is inadequately recovering based on the previous weeks.
Expecting a Quick Fix
Once an exercise program has started, it is important to stick to it for at least 6-12 weeks before assessing the effectiveness of the program. This will help ensure a realistic timeline and goals for strength adaptations.
Often, a quick fix may be expected, which may ignore the small improvements that are made along the rehabilitation journey. Strength gains often aren’t linear; expect ups and downs.
Build a Smarter Rehab Plan Through Exercise Prescription
This blog explored the key components of exercise prescription through the lens of injury rehabilitation, using the FITT principle as a guide.
By understanding how to adjust frequency, intensity, time, and type (and by avoiding common mistakes) individuals can build safer, more effective rehab programs that support long-term recovery.
At Hayer Health, our team works closely with each person to develop personalized exercise programs based on injury history, movement limitations, and functional goals.
Whether you’re recovering from an injury or looking to prevent one, our physiotherapists are here to guide you every step of the way.
Have questions or want to start your recovery journey?
Contact us today to book an assessment and take the next step toward improved mobility, strength, and confidence.
