It depends on what setting we are talking about and what the context is within that setting. It depends on all of the details within that context.
Is this in a clinical setting? Is this in a high-performance strength and conditioning setting?
Is the person injured or are they 100% healthy?
What are their goals?
What is the goal behind the exercise that is being prescribed? Is it to increase strength? Is it to decrease fear around movement? Is it to increase power? Is it to increase confidence?
With what intensity and frequency are the 3 sets of 10 reps (volume) being prescribed at?
Without knowing all of this information, and more, it would be incredibly presumptuous to answer the question, “what is wrong with 3 sets of 10 reps?”
Strength and Conditioning (S&C) seems to be a hot topic in the MSK therapy world. It feels like there is a movement by clinicians to use it more in practice. I am glad because I like to use a lot of exercise and movement prescription in practice as it has a lot of secondary benefits1-3 that some other modalities cannot boast of.
For some reason though, there is a fair amount of negativity being directed towards some musculoskeletal (MSK) clinicians who prescribe their patients 3 sets of 10 reps of blank exercise. The negativity coming from other professionals who maybe have a little more training in the exercise prescription/S&C realm is a head scratcher.
Do they know the setting, context and details of the situation that the 3 sets of 10 reps were prescribed in/for? Do they know the intensity and frequency that were prescribed with the volume?
In most instances 3 sets of 10 reps is a great prescription. In my opinion, the quality of the prescription lies in the multitude of contextual factors that are involved in the person’s case who has been given the prescription.
What might be most important is what the goal of having the person perform the exercise is.
If the goal of the prescribed exercise is to increase confidence or decrease fear then the person really just needs to perform the exercise without any large aggravation in their symptoms. In this case, you may not want the intensity or volume to be too high. Frequency might be the prescription detail that might deserve the most attention.
To reinforce that they are safe to perform the exercise, you may want to have them perform it many times over the course of a day. So in this instance, the volume and intensity are not as important compared to a situation where tissue adaptation was the goal.
If the goal is to cause an adaptation in the tissue then you would want to make sure that the person is reaching failure or near failure during their bout of exercise. In this particular discussion, that would be at the end of each set.
This would satisfy the overload principle which states that cells, tissues, organs and systems adapt to loads that exceed what they are normally required to do.4
The sets and reps are important here but intensity is equally if not more important.
You would also want to prescribe enough frequency over a week to promote adaptation of the tissue. Once per week probably will not stimulate much of a change but 2-3 times a week would be a great stimulus for tissue adaptation.
What you begin to see is that sets and reps (volume) are but one component of exercise and movement prescription. All three variables, volume, intensity and frequency are important and need to be considered and adjusted to match each particular situation.
If you are going to question the sets and reps of someone’s prescription (poor volume is taking all the flak), you should really question the person’s prescription of frequency and intensity as well.
But are you in a position to do that? Do you know all the contextual factors around the prescription that was given?
Sure there may be more optimal exercise prescription details that promote particular facets of a human’s physiology but in most clinical settings this is rarely needed.
On the other hand, if you are dealing with an Olympic athlete then you would want to prescribe rehabilitative exercise as optimally as possible.
Your goal would be to prescribe optimal loading strategies to promote tissue adaptations that would help to build the specific capacity needed for them to perform the demands of their sport at the highest levels of human potential.
Yeah the specifics of volume, frequency and intensity would be very important in this case.
I think it is fantastic that MSK clinicians are looking to increase the utilization of exercise prescription in their practices. It has so many secondary benefits that you just don’t get with other modalities.
I feel it is important for those who are a little more knowledgeable in the area to not create an air of superiority which may keep other health care professionals from trying to incorporate it into their practice in fear of being criticized? In my opinion, the last thing we need to do is create more barriers to health care professionals utilizing the prescription of exercise to help people.
Most of the time 3 sets of 10 reps are appropriate but it depends.
At least 3 sets of 10 gets people moving and is that not a major goal of what we are all trying to do?
I suppose it depends.
Supplement: For specific resistance training loading recommendations for strength, hypertrophy and local endurance this open access literature review by Schoenfeld et al. (2021) is a fabulous summary.
1 Bricca, A., Harris, L., Jäger, M., et al. (2021) Infographic. Benefits and harms of exercise therapy in people with multimorbidity. British Journal of Sports Medicine. Published Online First: 09 June 2021. doi: 10.1136/bjsports-2021-104367
2 Warburton, D.E.R, Nicol, C.W., & Bredin, S.S.D. (2006). Health benefits of physical activity: the evidence. Canadian Medical Association Journal, 174(6), 801-809. DOI: https://doi.org/10.1503/cmaj.051351
3 Zhao, M., Veeranki, S., Magnussen, C., Xi, B. (2020). Recommended physical activity and all cause and cause specific mortality in US adults: Prospective cohort study. BMJ, 370:m2031. https://doi.org/10.1136/bmj.m2031
4 Wenger, H.A., McFayden, P.F., & McFayden, R.A. 1996. Physiological principles of conditioning. In J.E. Zachazewski, D.J. Magee, & W.E. Quillen (Eds.), Athletic injuries in rehabilitation (pp. 189-205). Philadelphia: W.B. Saunders.