Is 3Ă—10 the Best? A Modern Approach to Strength in Rehab
Most rehab programs don’t fail because of a lack of exercises – they fail because of a lack of load.
We underdose intensity. We stop short of meaningful effort. And as a result, we never build the capacity our patients actually need.
In this episode of the Rehab and Performance Lab Podcast, I sit down with Dan Lorenz, DPT, PT, ATC, LAT, CSCS to break down one of the biggest gaps in rehab today – how we prescribe and progress load.
If you’re not getting the strength outcomes you expect, this is where to look.
Are We Teaching Clinicians to Underload?
Underloading doesn’t start in the clinic – it starts in training.
From day one, clinicians are taught to avoid harm. That’s appropriate. But in practice, that often means we’re rewarded for doing too little, not penalized for it.
Students fail for overloading – not underloading.
So what becomes the default?
Start light. Stay conservative. Don’t push too far.
That mindset carries into clinical practice, and it shows up in how we dose every exercise.
The consequence is simple – if we don’t restore strength, we limit function. In cases like ACL reconstruction, that can mean reduced performance, delayed return to sport, and even long-term OA.
If we want better outcomes, we have to change how we think about load from the start.
Why You’re Underloading Your Patients
One question should change how you prescribe exercise:
Why lift in two weeks what you can lift today?
If your patient finishes a set and could do several more reps, the stimulus wasn’t enough to drive adaptation.
Strength doesn’t come from completing reps – it comes from effort.
That doesn’t mean pushing into pain or losing control. It means getting close enough to the patient’s current limit to create change.
For most strength work, that means finishing within one to two reps of failure.
Anything less, and you’re not protecting your patient – you’re underpreparing them.
How to Choose the Right Weight in Rehab
The biggest challenge isn’t understanding effort – it’s applying it consistently.
Most patients don’t know their true max. And even trained individuals underestimate it.
So instead of relying on guesswork, use feedback.
Ask one simple question at the end of a set: how many more reps could you do?
If the answer is more than one or two, the load is too light.
You can also use a simple RPE scale – easy, medium, hard. If it’s easy, increase it. If it’s medium, push it higher. If it’s hard and controlled, you’re where you need to be.
This isn’t about precision – it’s about consistently getting the right stimulus.
When you adjust based on effort, you stop guessing and start dosing load effectively.
Ready to Master Athlete Performance?
If you want better outcomes, you have to rethink how you load.
Effort drives adaptation. Without it, strength doesn’t change – and without strength, function doesn’t hold.
The goal isn’t to do more exercises. It’s to get more out of the ones you’re already using.
When you consistently dose load with intention, you build the capacity your patients need to succeed outside the clinic.
If you’re ready to take that next step, join us inside Coaches Club.
Want to go deeper into these concepts? Listen to the full episode here:
Ep 25: Is 3×10 the Best? A Modern Approach to Strength in Rehab (Live Podcast Recording)
