Progressions And Pregressions – An Under-Rated Tool In The PT Toolbox

Rob Zand

What you’re in for:

  • ~1700 words
  • 3-10 minutes reading time

Sorry to start on a negative, but one of my absolute pet HATES is seeing a PT taking on a new client, and immediately introducing them to a barbell back squat.

Stop doing that.

Please – stop.

As a PT, it’s vital to understand not only the progress that carefully chosen pregressions and progressions can bring to our clients, but also the value that they can bring to our coach/client relationship.

Every individual is going to have different levels of strength, flexibility, mobility, coordination and stability when it comes to performing different movement patterns especially those who are new to exercise.

Therefore we need to know the various progressions and pregressions for different movements to ensure they’re suitable for each individual at any given time.

What Are Progressions and Pregressions?

Progressions allow us to make adjustments to movements from the least to the most challenging in order to develop certain abilities in each individual.

On the flip side, pregressions are ways to deconstruct movements that are challenging into easier patterns to develop different qualities.

Pregressions are useful in that we’re able to tailor a particular movement pattern to a client’s ability level, therefore giving us the ability to develop the different parts of movement pattern such as:

  • Ranges of motion
  • Joint angles
  • Type of tension

Why ‘Pregressions’, And Not ‘Regressions’?

To regress can be defined as to “return to a former or less developed state”. People are going to associate the word regression with going backwards, so straight away there are negative connotations. You don’t want to make clients feel incompetent – feelings of competence are vital to successful behaviour change (learn more here)

Let’s say you’re working with an individual who is a relatively new to exercise, they’ve made great efforts to seek out your help which in itself was very difficult for them. They’re well and truly outside their comfort zone.

When you’re making your initial assessments regarding their current level of ability to perform different exercises and movements the absolute last thing both you and the client wants is to start off on a negative.

Despite having the best intentions of course, saying to your client that we need to “regress” this exercise isn’t going to make them feel particularly good about themselves. In fact it’ll in most cases do the opposite and knock their already fragile confidence further.

Whether you’re working with a beginner, intermediate or advanced trainee, no one wants to feel like they’re going backwards!

Part of our role as a coach is to try to make people we work with feel empowered, to feel more confident in themselves – this will ultimately make happier, more motivated and more likely to sustain the changes you’re trying to implement.

Communication is huge – a.k.a how we get our points across. The language, words and tone we use when delivering information to our clients is key.

Putting a positive spin on situations that could easily be perceived as negative is only going to be a good thing for the client and you as a coach.

Factors In Progression

We start with simple and easy movements before transitioning onto the more complex ones. By doing so this allows us to build a base from which we can develop on over time.

So when we are developing foundational movements we are looking at a number of things:

  • Form and technique
  • Movement Patterns
  • Building Confidence
  • Motor Patterns

Focusing on the client’s form and technique should be the initial primary focus as this allows them to keep progressing as well as preventing injury. On the flip side, if improper technique is encouraged then this will result in improper technique being ingrained from the outset.

The exercises we use are built around the different movement patterns such as horizontal push & pull, adduction, vertical pull, shoulder extension etc. The pregressions and progressions are built around developing these movement patterns.

During the first few months of training is when your clients are most likely to see the largest increases in strength gains therefore use this to build their confidence with positive reinforcement. By the same token, even when their rate of gains may slow, always encourage their progress positively.

Motor control is also an aspect we want to develop, however this will be more targeted towards a beginner. The aim is to make their movements more fluid and controlled.
For example when someone is performing a dumbbell shoulder press for the first time their execution tends to be very unstable, whereas someone who is no longer a beginner will be able to perform the same movement with more control.

Unilateral vs Bilateral Progression

When it comes to upper body movements, focus on developing the clients unilateral movements first. This allows them to learn to control the weight and really focus on how they’re performing the exercise. Upper body movements tend to only involve the movement of 2 joints (the shoulder and elbow), and the stabilisation of the wrist.

If we use the example of the dumbbell shoulder press again, when performed by a beginner the movements is very unstable therefore we focusing on teaching the unilateral exercise as it can make it easier for them to learn.

Note – by this, I don’t necessarily mean a single arm dumbbell shoulder press. Using dumbbells ensures that both sides are working independently of one another, as opposed to with a barbell or a machine in which one side can often “take over”. If you have a client performing a dumbbell shoulder press, and you see that one side is lagging severely, then you can switch to a single arm movement to help develop more control on one side.

In contrast, with lower body movements it’s generally better to focus on developing bilateral movements first. One of the reasons being that unilateral lower body movements have a buge balance component which is going to be a limiting factor before added load for beginners in particular.

For example, the single leg squat is going to be too difficult for some people to perform due to the balance aspect. Therefore we’d focus on developing the bilateral squat first.

Lower body movements typically involve three dynamic joint actions – there’s generally movement at the hip, knee and ankle.

Another for why you might teach unilateral upper body exercises first, and bilateral lower body exercises first is one of loading. In comparison to the lower body, there are very few ways in which you can alter the loading of a specific upper body exercise. Changing the way you load a lower body movement pattern (front vs back squats, RDLs vs good mornings, etc) can drastically alter the way the movement looks or even your client’s ability to perform the movement full stop. In contrast the vast majority of upper body exercises have very few possible modifications without totally changing the movement.

Example Progressions And Pregressions

Upper Body – Bench Press

Going back to our order of progressions, when working with a beginner on the incline bench press we’d start with using a dumbbell variation as opposed to a barbell.

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Similarly with the dumbbell shoulder press example I briefly touched on earlier, a beginner is typically going to be very unstable when practicing the bench press for the first time.
Therefore by starting with dumbbells we can focus on practicing performing the exercise unilaterally.

There are a few coaching cues that I like to use with this exercise:
– Once you lie back on to the bench, Ensure that your feet are firmly planted on the floor and don’t allow your hips to rise up off the bench throughout
– With the dumbbells now at shoulder level and to the sides of your chest, simultaneously press them upwards towards each other until your arms are nearly at full extension

– As you bring the dumbbells together at the top of the movement squeeze your chest and then return the dumbbells back to the start position in a controlled manner

Another benefit of starting with the dumbbell bench press is that it allows you bring your hands together at the top of the rep, therefore it can make it easier to contract the chest and have your clients develop a better ‘mind-muscle’ connection. There is a difference between just moving a weight from A to B, and actually contracting the muscles you are targeting. Read more about there here.

Once your client is comfortably able to perform the dumbbell bench press in a more fluid and controlled manner then you can look to transition on to teaching them the barbell bench press.

Lower Body – Romanian Deadlift (RDL)

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Unlike with the upper body example, when working with a beginner on a lower body movement we are going to use a bilateral variation.

Trying to teach a beginner the single leg Romanian deadlift, whose lack of balance is going to be a major stumbling block, is going to be very difficult.

Therefore we need to focus on teaching the client the correct technique of the bilateral Romanian Deadlift first and foremost.

When is comes to teaching this exercise, the coaching cues I like to use are:

– Place and keep your feet shoulder-width apart

– Keep your shoulders back and maintain a neutral spine throughout the movement

– Gripping the bar with a neutral overhand grip, push your hips back and lower the bar towards the floor whilst having a slight bend in your knees

– Keep lowering the bar to the point in which you feel the stretch in your hamstrings and as far as you can go without your lower back rounding

– Once you’ve reached this point, lift the bar back up over your knee’s and thighs back to the start position and aim to keep the bar as close to your body as possible

This goes without saying, but it’s important to ensure that the weight the client starts with isn’t too heavy that it compromises correct form.

With beginners especially, making regular increases in strength is going to be very likely due to it being a new stimulus, however it is key that the movements that they’re taught and perform are of solid technique.

Once the client has become proficient at performing the bilateral Romanian Deadlift with good form and has increased their strength and stability, then you can look at transitioning them onto the single leg Romanian Deadlift.