Demystifying Program Design

Program design can be tricky but it doesn’t have to be.  To get a measurable amount of actual strength gain you need to hit between 10-30 sets a week.  Yes, 30 is a lot.  You likely won’t run into that range unless you’re in exceptionally good shape, have very specific workout goals, and have a lot of free time.  So lets assume 10 sets is the target for most people.  Three sets of an exercise that hits a muscle group 3 days a week gives you 9 total sets…so one of those days toss in an extra set and you’re good to go.  Example, if you want to target your quads you can try to isolate them with a split squat movement or a leg extension.  Even if you set it up to be 3 sets of 10 (which is a traditional beginner series) you’d see notable strength gains if you would not have been able to complete an 11th or 12th rep during each of those sets. 

One thing you have to take into account is that number 10 comes from a high RPE (rating of perceived exertion) challenge.  You won’t get the strength effect if you’re leaving a lot of reps in the tank each set.  If you complete a set of 10 but you could have done 15, your quad isn’t going to get stronger.  You have to be stressing your system for all 10 sets.  Otherwise you’ll need to add more sets or change your set structure to more reps or pick a different exercise where you can exert yourself more forcefully.  Given the high strain of these required 10 sets make sure you’re warmed up property before you start counting towards the 10.   

The huge number of variables to consider when making a fully program can be intimidating but keep this one at the top of your list and you’ll start to see clear progress in 4-6 weeks.   So, give it a shot!  Shoot me a message if you get stuck along the way.

When is dry needling appropriate?

Stim current about to be applied to a needle in the left lumbar multifidi

Answer:  For a huge number of conditions.  Maybe a better question would be when is dry needling NOT appropriate.   

When thinking about if dry needling could be useful for you it’s necessary to know what it’s often used for. The goal of dry needling is to create a very controlled local trauma to an area not getting good blood flow.  These areas often manifest as muscle knots, trigger points, or other pain generators.  The currency of healing is blood flow…there is no second currency.   You have many important biochemicals in your body relating to the exact science of how tissue is healed but none of them can get to the damaged tissue without blood flow!  Surgeons can’t perform surgery if they can’t get to the hospital!  All exercises, modalities, prayers, seances, (whatever you’ve got going on) are considered to be physically successful if they bring blood flow effectively to an area.   

So, if you have an acute injury, surgery, post intensive lift, or any condition where the body already has a natural high flow of blood to an area you are unlikely to benefit from this aspect of dry needling.   In a similar vein if you’re already successful getting blood flow to an area with massage, hot pack, etc. you likely won’t see an appreciable benefit from dry needling for this specific function.    

Enter the second major benefit; turning on/retraining a malfunctioning/nonfunctioning muscle.  This is maybe the best tool physical therapists have in their toolbox for this specific problem.  It’s the only modality that gets below the skin (electrical current the exception, but even this is not specific).  There are some extraordinary therapists out there who can use their hands to do some amazing things.  But they are limited by having to push through the skin, fascial layers and any superficial muscles before they can impact any deeper muscle tissue.  Often times simply getting the needle into the right area is all you need before the muscle ‘wakes up’ and starts responding to targeted exercise.  

Once you have the muscle turned on and well supplied with blood put it to work!   All good dry needling sessions are followed by use of the muscle in question.  Doesn’t have to be heavy lifting, but you’ve now got blood flow and a very awake muscle primed for movement.