Physiotherapy Exercises: How Much Is Enough?

The importance of exercise dosage in physiotherapy

Most patients believe that recovery depends on choosing the “right” exercise. In reality, almost any exercise can help — as long as the dose, frequency, and progression are correct. Physiotherapy is based on controlled mechanical stress applied to tissues. Muscles, tendons, joints and cartilage all respond to load.

The mistake people make is thinking that performing a few repetitions is enough. What drives healing is not the choice of movement but the amount of stimulus applied over time. Without sufficient load, tissues don’t adapt. With excessive load, symptoms flare. Physiotherapy is the art of staying in the optimal loading zone where healing happens.

Why doing exercises is not the same as improving

One of the most common reasons patients don’t progress is underdosing. They perform their exercises, but the intensity is too low, the frequency too irregular, or the progression too slow. The body adapts only when the stimulus forces it to reorganise and strengthen.

This explains why generic routines often fail: they are comfortable, but ineffective. To change tissue capacity, the exercises must reach a level of effort that the body recognises as meaningful. The goal is not to “complete the routine,” but to challenge the system enough to promote change.

Understanding how tissues respond to the right level of stress

Muscles adapt faster than any other tissue. They require moderate to high effort repeated consistently. Tendons, on the other hand, adapt slowly and need sustained mechanical loading over weeks. They respond extremely well to heavy slow resistance and controlled isometric work.

Joints and cartilage improve with movement rather than rest. Motion nourishes cartilage, maintains lubrication, and reduces stiffness. When people avoid movement because of fear or outdated advice, the joint becomes more sensitive, not safer.

How much is “enough” for your recovery?

There is no universal dose, but physiotherapy research consistently highlights patterns. Most rehabilitation programs require three to five sessions per week. Early in recovery, daily movement helps modulate pain and restore confidence.

Intensity also matters. Exercises should feel significant — challenging but manageable — not effortless. If you feel absolutely nothing during your exercises, the dose is too low to stimulate adaptation. Pain within a mild zone (0–4/10) is acceptable and often normal, especially in tendon rehabilitation. Avoiding all pain leads to under-loading and delayed progress.

Progression is the key. The body adapts quickly to a constant workload. If exercises remain unchanged for too long, improvement stops. Increasing repetitions, load, range of motion, or complexity every one to two weeks is what transforms exercises into actual treatment.

What a structured physiotherapy plan really includes

A proper plan is not a list of exercises — it is a sequence. It contains mobility work, strengthening, tendon loading, balance training, functional work and a clear strategy to return to activity. Each phase builds on the previous one.

Good physiotherapy offers clarity: what to do, how much to do, and when to increase the difficulty. Instead of guessing, the patient progresses through objective milestones. This structure prevents flare-ups, accelerates improvement, and restores function more predictably.

The essential message

The question is not whether exercises work — they do. The real question is whether the dose is sufficient to stimulate healing. With the right load, frequency and progression, the body responds. Without it, recovery stagnates.

In physiotherapy, exercises are not the “extra” part of treatment. They are the treatment.

I provide structured and evidence-based online physiotherapy for patients worldwide, offering clinical assessment, diagnosis, and personalised rehabilitation.

I also receive patients in person at my physiotherapy clinic in Phnom Penh.

You can begin your online physiotherapy session through the dedicated platform:

https://www.studiohealthon.com/online-physiotherapy

More information on clinical standards and supporting evidence is available here:

https://www.studiohealthon.com/online-physiotherapy-clinical-evidence

Yannick Sarton, MSc Physiotherapist

International Online Physiotherapy & In-Clinic Care, Phnom Penh