The Importance of Including Power Exercises in Physical Therapy

The ultimate goal of physical therapy is to return clients to the field, court, or wherever else they want to go. It is important to have an understanding of what is required to perform in an individual's sport. Usually, there is a power component to an athletic performance, and we as physical therapists do a terrible job of addressing it!

Before we get too far into it, let's look at what power means.

Power = Force X Velocity

So, to increase power, you need to do something with more force or do it faster. From a physical therapy lens, we can look at the demands of power and see where the system might break down. For example, if I asked you to lift a 100 pound weight as fast as you could, you would need two components: you need the strength to lift the weight and the ability to do so quickly. If you were not strong enough to lift the weight, then you could hurt yourself trying to lift it. Similarly, if you lift the weight faster than you can handle, then you might injure yourself as well!

I often point out that we underload clients in physical therapy. We are typically content with band exercises that do nothing to replicate real world weights or demands of sport or other activities. However, let's just say that you have a great physical therapist who actually takes the time to get you stronger and ready to go back on the field. Let's use a basketball player who strained his quad as an example. His physical therapist takes him through a bunch of strengthening exercises and he is squatting, lunging, and his leg is even stronger than it was before. That is a great start, but it is neglecting his sport needs.

This PT did a great job of addressing the force production in the power equation, but he neglected velocity. If the athlete goes back to basketball, he may be able to squat down and feel stronger in that position, but what if he tries to jump. He may not be able to jump as high as before, because even though he gained strength, he lost velocity. Also, he may subject himself to an injury because he is doing a rapid movement for which he is unprepared.

To better understand this concept, take a look at the force velocity curve:

Source: brandonsmitley.com

If we are using a squat as an example exercise, think about how fast you can squat 10 pounds vs 100. Now, if you are trying to get as strong as possible, squatting 100 pounds is much more effective, as that is biased towards the strength side of the curve. However, if you want to move as fast as possible, then 10 pounds will let you move much faster.

This is where knowing the specific demands of the client's sport is crucial. In basketball, players need to jump and sprint quickly to rebound, defend, etc. Strength is important to allow that to occur, but if the athlete is unable to jump high enough or quickly enough to get a rebound, then it does not matter if he can squat 400 pounds. A good physical therapist should understand this and progress training towards power once adequate strength is gained.

A great physical therapist should be able to assess the athlete and determine their individual needs. Imagine you have a basketball player like Kevin Durant walk into your clinic. He is notoriously thin, but clearly has excellent velocity because he is an incredible athlete. He may need to focus more on the strength side for rehabilitation purposes, but his success is predicated on power. Packing 20 pounds of muscle onto him may be a change that his body is unable to handle and may end up actually costing him on the court.

It is easier to look at a great player and determine his strengths and weaknesses, but what if a 12 year old, averaged-sized basketball player comes into your clinic? You could do the reasonable treatment and develop strength and then power and send him on his way. Or, you could figure out a way to assess him and determine his individual traits to allow an exercise prescription that is dialed into his unique needs.

Throughout this post, I have been using basketball as an example because it is easy to visualize running and jumping and because I talk about baseball a lot. Unfortunately, I do not know about specific tests to determine force compared to velocity for basketball, but I do know those geared towards baseball!

OnBase University and Titleist Performance Institute (TPI) have used a battery of tests for golfers over the years to determine their ratios and measurements. They have re-interpreted the numbers based on baseball players and I was fortunate enough to take the course that outlined their testing protocols.

Basically, I look at how a baseball player performs several tests of power for upper body, core, and lower body and I examine if their results are appropriate based on the different areas of the body. This is helpful because it tells me if your overall training is too biased towards your upper body, core, or lower body. Then, I can perform other tests to see if you are demonstrating appropriate force for your results. If your force is higher than expected, you are probably missing out on some velocity improvements. If your force is lower than expected, then you are probably neglecting strength training and relying on velocity. We can then tailor your training to augment your weaknesses while also enhancing your strengths.

Well informed physical therapists and strength coaches will perform a variety of strength and power exercises to allow for the development of both. However, the next frontier is using data accumulated from thousands of athletes to determine what your individual needs are, and how we can best address them.

Interested in figuring out how you can improve your performance on the field? If you are near our office in Sterling, VA I would love to help you out. Reach out to me at danny@eclipsewellnessnova.com and let's make a plan for you to recover from injury and come back even stronger! Even if you don't have an injury, we can perform the same tests and fine tune your training to give you maximal results! What are you waiting for?