Understanding the Different Types of Training in Physical Therapy: Hypertrophy, Endurance, Strength, and Power

Strength training is a crucial component of physical therapy, helping patients regain function, mobility, and prevent future injuries. Depending on your goals, your Physical Therapist may prescribe different types of strength training: hypertrophy, endurance, strength, and power. Each type of training has a unique purpose to help you return to your daily activities without risk of re-injury.

1. Hypertrophy Training: Building Muscle Mass

• Hypertrophy training focuses on increasing the size of the muscle fibers, which is critical for patients recovering from muscle atrophy or needing to build muscle size for joint stability.

  • Sets and Reps:

    • Sets: 3–4

    • Reps: 8–12

    • Intensity: 65–80% of one-rep max (1RM), with a moderate tempo

    • Rest: 30–90 seconds between sets

2. Endurance Training: Enhancing Muscular Stamina

• Endurance training focuses on a muscle’s ability to sustain activity over time an extended amount. This is important for patients who need to improve their capacity for daily activities or specific sports tasks (ie: long distance runners, tennis players)

  • Sets and Reps:

    • Sets: 2–3

    • Reps: 12–20

    • Intensity: 40–60% of 1RM, with a slower tempo

    • Rest: 20–60 seconds between sets

3. Strength Training: Increasing Maximal Force

• Strength training is designed to increase the muscle's ability to utilize maximal force. It is critical for patients recovering from injuries where power and stability are necessary, such as ACL repairs.

  • Sets and Reps:

    • Sets: 3–6

    • Reps: 3–6

    • Intensity: 80–90% of 1RM, with a slow tempo

    • Rest: 2–5 minutes between sets

4. Power Training: Explosive Force Development

• Power training focuses on developing the ability to produce force rapidly, which is important for athletes returning to sports that require quick bursts of speed or explosive movements (ie: football players needing to sprint)

  • Sets and Reps:

    • Sets: 3–5

    • Reps: 3–5

    • Intensity: 30–60% of 1RM, performed explosively

    • Rest: 2–3 minutes between sets

How to Choose the Right Approach

Choosing between hypertrophy, endurance, strength, and power training depends on the patient’s goals and stage in the recovery process. Early in recovery (usually during the first 2-4 weeks), endurance work is often prioritized to build stamina. As the patient progresses, hypertrophy and strength training can be introduced to rebuild muscle mass and improve overall force output. Power training is often used during end stage rehab (ie: 6-9 months after ACL surgery), typically performed with athletes looking to return to a high level sport.

In conclusion, when attending your physical therapy sessions, expect to have some sort of variation of these types of strength training throughout your time. Understand that your Physical Therapist will tailor your program to the goals you discuss during your first visit and will continually change them based on your progress. If you have questions or are curious why your Physical Therapist is choosing a specific type of training, never be afraid to ask! We are usually more than happy to explain the process so that you have a better understanding of your treatment plans.