Exercise Modifications: Mastering Progressions & Regressions

1.0   Introduction

This article provides a brief overview of progressions and regressions, which are central to any safe and effective exercise programme.

As fitness, strength levels, and movement competencies vary between individuals, it is important that exercise professionals are able to modify exercises through progressions and regressions. Consequently, exercise modification is a crucial skill for exercise professionals to learn and, hopefully, master.

2.0   Why is Exercise Modification Important?

Each client who trains with you will react differently to the same exercises, for a variety of reasons, including:

• Connective tissue;
• Differing mobility;
• Differing flexibility;
• Exercise history; and
• Injury history.

In practical terms:

• Person A has a hypermobile, flexible, ectomorph body.
• Person B has a mesomorph, less flexible body.

If an exercise professional gave these two the same exercise, their bodies would not respond in the same way, and certain exercises would put both of them at risk.

3.0   What is the Purpose of Exercise Modification?

In simple terms, progression is about moving towards a goal or achieving more. Thus, the purpose of a progression is to make an exercise more intense, demanding more stability, endurance, strength, power or mobility, depending on the training goal.

Progression can also involve advancing towards a more functional movement pattern demanding:

• More proprioception;
• Neural connections; and
• Greater relevance to day-to-day life.

There should be a transition from a simple, basic, isolated movement into a more complicated, functional type of movement.

In contrast, the purpose of a regression is to enable an individual to perform an exercise safely, at their current ability level. Another perspective it to think about regression as a consolidation of the work the individual has done to prepare them for the work they are about to do.

Therefore, exercise modification can help bridge the gap between where the individual currently is and where they need to be, in turn ensuring they can achieve their goal and perform it not just once, but consistently and safely.

4.0   Progressing at the Right Pace

Selecting exercises which keep an individual mentally engaged, challenged and deliver physical adaptations yet, at the same time, do not exceed their movement competency, can be a fine balance.

The perils of progressing to quickly can include:

• Exposing individuals to unnecessary stress and, if they are overloaded, it can lead to overtraining. Overtraining can lead to neurological, psychological and physiological deficits to performance.
• Increasing the likelihood of injury or trigger underlying injury risk factors that perhaps were not identified in the pre-screening process.
• Affecting an individual’s skill acquisition, meaning they may not be ready for the next element of the training programme.

In contrast, the perils of progressing too slowly can include:

• Demotivation;
• Reduced fitness gains;
• Training stagnation; and/or
• Reduced training adaptations.

As well as conducting an initial movement screen with a new client to establish what they are capable of, it can be helpful to repeat this screening every on a regular basis (for example six monthly), to reveal how far the client has advanced in their movement competency.

This will provide exercise professionals, and the client, with an objective measure of progress and from there a decision can be made on whether to make the movement pattern harder.

5.0   Identifying when it is Time to Progress or Regress

Knowing when an individual can, or should, be progressed to a more challenging version of a movement pattern, or conversely, when they may need to be given a regressed or simplified version, requires good observational skills. Some signs to consider include:

• Watch your client closely:
• Constantly observing your client and how they move will tell you whether they are tolerating an exercise or not, and when they are fatiguing.
• Signs such as shaking, holding breath and hitching shoulders can all be indicators that maybe the exercise is too difficult.
• Look for compensatory patterns:
• These can include a client hitching their hips or shoulders, using momentum and not controlling or using their back to move before lifting their arms.
• Observe their attitude:
• A client’s emotional state can indicate how well they are handling an exercise and/or training load.
• For example, you may notice a drop in their motivation or an increase in irritability.
• Understand the limitation:
• If you observe a deficiency in how a client moves, consider the underlying reason.
• For example:
• Is it a physical (e.g. muscular, skeletal, or neurological) limitation in their movement competency; or
• A cognitive one, where maybe they have misjudged or misunderstood the movement pattern.
• Ensure consistent good form:
• As a general rule, if the client is able to perform 20-30 repetitions or two to three sets of 10 repetitions with good form and no fatigue or discomfort, they are ready for the next progression.
• In contrast, if a client is struggling with an exercise, for example, by losing stability through their core and shoulder muscles when performing a bodyweight press-up on their toes, the exercise should be regressed to allow them to master core and shoulder stability at their level (e.g. wall press-up, bench press-up or knee press-up).
• Listen to your client:
• Ask a client where they are feeling a particular exercise in their body, which should correlate with the target muscle(s) of that exercise.
• The client may be feeling the exercise in places where they should not or using the wrong muscles to try and do the exercise.
• Test their understanding:
• If a client can tell you what the movement should feel like, what muscles are involved or even demonstrate it to you themselves, it indicates they have reached a good understanding of the exercise and can handle a next level progression.

6.0   Methods for Exercise Modification

In general, when it comes to progressions and regressions, modifying repetitions, sets, and weights are probably the first things to that come to mind. However, there are numerous other techniques an exercise professional can draw on.

Many techniques tend to work along a continuum and can often be scaled up or down according to individual capacity. For example, an exercise professional could:

• Start with supported and/or more isolated exercises to help the client get the feeling of how a muscle should be activating.
• Once achieved, the client can then increase the range of movement (ROM), the levers and/or the speed of movement.
• Start a client with body weight exercises and progress to resistance exercises or exercises using weight. This, in turn, can lead to a large range of strength training variables, including:
• Time under tension to power sets;
• Super sets; and
• The flushing method.
• Utilise bilateral and unilateral training (e.g. double and single arm/leg exercises respectively).
• For example, single leg exercises can be a good way to progress an exercise without having to increase the load.
• Base exercises on duration (e.g. blocks of time).
• For example, if the exercise professional is targeting strength endurance, then suing time can be beneficial.
• In contrast, when used for strength training it can rush technique (This can be ameliorated by ensuring the client is consistently performing the exercise at the correct speed).
• Utilise equipment to assist with exercise modification.
• For example, medicine balls and dead balls can be useful, especially the latter due to the lack of a reactive component.
• Power bands can be used to apply load differently to a cable machine or free weights.
• Fat bars or trap bars attached to a bar to make a different grip.
• Change a client’s position:
• As well as grip (overhand, underhand, wide, narrow), a client’s hand, foot and body position can also be altered.
• For example, performing a high step-up with the torso upright stresses the thighs and knees, whereas the torso forwards and bent at the hips stresses the glutes and hamstrings.
• Change the surface area:
• For example, with a Swiss ball, depending on the training goals.
• It could improve balance and co-ordination.
• However, there is research that suggests this can make an individual weaker, because the rate of force development is a lot less.

7.0   Modifying Exercises in a Group Fitness Setting

Developing and mastering exercise modifications for group fitness can be a challenge, where the personalised attention possible in one-on-one training is reduced. The following can help to achieve this:

• Select accessible movement patterns:
• Group fitness classes are an opportunity to perform movement patterns that are not too technically demanding.
• Movements selected should be easy to perform and repeatable.
• Demonstrate multiple variations:
• In group settings, exercises can be demonstrated with multiple variations on offer, enabling clients to practice the variation that suits them the best.
• For example, squats can range from arm assisted sit-to-stands (most regressed), progressing to a no arms sit-to-stand, then on to chair squats, fit ball wall squats, free standing squats and then barbell squats (more advanced).
• Be proactive with feedback:
• Clients should be allowed to self-select the variation they feel capable of, with exercise professionals intervening when necessary.
• If the exercise professional sees that a client has selected an inappropriate version for their ability level, they should instruct them to perform a different variation, checking technique and ensuring the exercise is safe and effective.
• Keep feedback constructive, positive and if possible aimed at the class to avoid client embarrassment.
• Advise clients with an injury history to start slow:
• Group fitness classes should be seen as an end goal for clients rehabilitating from injury.