The 3Rs

The “3Rs” – Release, Restore, Retrain

We all know that an exercise programs should be a cornerstone of an effective care plan. This especially holds true for conditions that are primarily caused by muscle imbalances or dysfunctional movement patterns. Research also shows that exercise is instrumental in preventing and treating chronic pain. But we also know that patients often prefer to avoid exercise during episodes of pain, which sometimes leads to further deconditioning. That’s why it’s our role as Healthcare professionals to help our patients effectively and safely overcome their fear of starting an exercise program, in order to help them reach their long-term goals.

Here are some key points to help make your clients exercise programs more successful:

Don’t ask your patients to work through pain- “No pain No gain” is an old school mindset. Pain alters movement and can therefore lead to more muscular imbalances, dysfunction and pain.

If inhibited muscles are causing dysfunctional movements or pain– only do activation or strengthening exercises after releasing the affected muscles first. This can be achieved through techniques including foam rolling, manual therapy or ISATM performed by the healthcare professional.

If a condition is caused by an altered length-tension relationship of a certain muscle group- incorporate stretching techniques after applying release techniques and before starting motor control or strengthening exercises. We refer to this as the ‘3Rs’: “release, restore, retrain.”

Educate your patients that long term success and pain management– is only possible if muscular balances and function are restored, which will only be achieved through long-term and consistent adherence to exercise programs designed individually for the patient’s needs.

Progress patients according to their stage of recovery and feedback- Performing exercises on unstable surfaces or increasing load will help transitioning patients to the next level.

Help patients understand that they must continue doing their programs even after they are pain-free– to avoid future flare ups. We’re all motivated by our pain, but that motivation has a tendency of dissipating as we forget our pain. They must realize that their condition still exists, even if they don’t consciously perceive the pain or discomfort.

Help your patients overcome obstacles to program adherence– by minimizing needed equipment or time requirements so they can stick to exercise protocols while traveling or under time constrains.


Example protocol for the ‘3R’ methodology applied to the shoulder:

Release Tight and Restricted Musculature

Restore Proper Motion and Motor Control

Retrain Regional Musculature



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