Maximizing Strength Training Efficiency with a Minimum Effective Dose
“More isn’t better – it’s just more!” I vividly remember Mike Boyle saying this at a strength and conditioning conference a few years ago. Yet all too often in this industry, we see both practitioners and athletes doing the exact opposite, which is one of the main reasons so many people come to Beth for physical therapy when they’ve broken down. Let’s look at why people tend to go too far when they’re chasing maximum and why a minimal approach is more sustainable.
Despite Boyle’s statement and his decades of experience behind it, many coaches still try to increase their athletes’ total load until they’re just short of a breaking point in the belief that greater volume (and sometimes intensity) is in fact desirable. A lot of athletes mistakenly think that if a little training is good for them, then more must be better. This is tied to the Western work ethic that celebrates long hours and believes it leads to greater productivity.
In a rehab setting, Beth treats a lot of athletes who mistakenly thought that doing more would decrease injury risk or pain, when they were already doing plenty. So they end up getting hurt. They would have been better off zeroing in on the essentials, focusing their efforts on the right things, and doing less overall. This would then have created space for concentrating on beneficial self-care practices, like sleep, recovery, and nutrition.
Hitting the Sweet Spot in the Therapeutic Range
If we think about exercise as a preventative prescription, we need to consider lower and upper limits for what’s helpful, ineffective, or harmful. In healthcare, there’s a therapeutic range in which a medicine might have a beneficial effect on a particular condition, with the minimum effective dose (MED) on one end and the maximum tolerated dose (MTD) on the other. The MED is the least amount that will produce a therapeutic outcome, while the MTD is the upper limit for doing so without causing harm.
“Doses in excess of the MTD are immediately harmful, doses in the vicinity of the MTD may be harmful over time, and doses lower than the MED are ineffective,” veteran strength coach Mark Rippetoe wrote in a blog post. “Obviously, we need to find the sweet spot.”
For me, this sweet spot is MED training repeated consistently. Going back to the medical realm for a moment, the Hippocratic Oath tells clinicians that they must do no harm. We have an incomplete picture of everything a client does in all the other hours of their week when they’re not training, so we need to err on the side of caution and safety. Doing too much repeatedly is an MTD or close to it, which will lead to overuse injuries (the most common kind with strength training), fatigue, and burnout. This would be like taking more medicine than is recommended too often – it wouldn’t make you recover from illness sooner and could actually harm you.
Fitting Strength Training into Your Lifestyle
Whereas getting someone to do just enough to trigger a beneficial training response is a safe MED. Because of this, it is repeatable over time, which is a sound prescription for longevity. When you only have to do the least amount necessary in individual sessions, you can continue to make gains going forward. Fitness should be a way to assist in managing the total load in your life and be additive, not subtractive. It should also provide a general level of preparedness and increase your capacity to do the things you want to focus on.
As a coach, I’d rather you were maximal with your family, career, or hobbies than in the weight room, and the one factor I can manage responsibly in your life is exposing you to just enough stress to see the progress you seek. MED is the least I need to get you one percent better daily, and ensures I never run out of techniques, exercises, and combinations to introduce you to as I might with an MTD method that throws everything against the wall early on.
In addition to enabling busy professionals and parents to fit training into their lifestyles, MED training can be useful for other populations, such as young people just getting started, older folks trying to stay active, and sedentary individuals who are new to strength sessions. It can also empower someone who’s injured to continue working out without aggravating their issue. More advanced athletes can use MED to undo and retrain faulty movement patterns, while in season, they use it to maintain their capabilities and durability. This can mean doing as little as five sets of five reps of one exercise – such as a single-leg squat – in each session.
Doing Just Enough to Progress
Some might assume that to compete in elite sports, athletes need to train for hours a day. But that’s not always so. When legendary strength coach Dan John asked his high school track coach what it would take to earn a D1 scholarship for the discus and shot put, he was told that he’d need to show up to every practice and lift weights two to three times a week. The kicker? For eight years. His coach summarized this advice by saying, “Little and often over the long haul.” John has since applied such minimalism to his coaching, often abbreviating an MED approach as “Put weights overhead. Pick weights off the floor. Carry weights.”
There’s plenty of evidence to back up this sort of MED training. A review of six prior trials published in Sports Medicine concluded that “All identified studies showed that a single set performed minimum 1 time and maximum 3 times per week was sufficient to induce significant 1RM [one-rep maximum] strength gains.” The authors went on to note that this involved just six to 12 repetitions of 70 to 85 percent of the 1RM twice to three times a week for eight to 12 weeks was enough to increase a single maximal effort in bench press and squat.
Achieving Ongoing Gains
The last part of this study’s conclusion speaks to the bit of advice from Dan John’s coach that people often miss: MED training is most effective when done over the long haul. Yes, the acute amount of volume is low, but because it’s done regularly enough, you can build up sufficient chronic load to move the performance needle in a positive direction. Most people are surprised when I tell them that they can get stronger in just a few short sessions per week if they stick with the MED plan.
They will also be able to reap the benefits of steady advancement. Meaningful progressions, such as lasting muscle gain, skill development, neurological adaptations, and improvements in speed, power, and strength, can rarely be fast tracked. MED offers a pathway to such mid- and long-term improvements via a patient, steady approach that is more sustainable over time than quick-fix plans that overpromise, under-deliver, and increase the rate of injury. Plus, a review released via Current Cardiology Reports found that as little as an hour a week of resistance training was enough to improve cardiovascular health and longevity.
Tweaking the Variables
As the Sports Medicine paper indicated, MED training works best with compound exercises that involve multiple joints and large muscle groups. These include ballistic movements, like thrusters, Olympic lifts, kettlebell swings, and plyometrics, and strength exercises, including standing push press, pullups, lunges, carries, squats, and deadlifts. Such exercises lend themselves to greater efficiency, which is at the core of MED.
It's worth noting that while such sessions are usually brief, they shouldn’t be the kind of short workouts that leave you in a sweaty heap on the floor – see Tabata intervals and other all-out efforts. MED isn’t just about keeping volume low, but also managing exercise selection, intensity, and combination effectively. By removing constraints, like maximum reps, time goals, and upper ranges of capacity, we can keep the dose to a minimum.
Chasing a Moving Target
While there are lines of best fit with MED training, it’s not a one-size-fits-all approach. The minimum exposure a novice athlete needs to elicit change might be different to someone with a moderate level of experience, which will vary again with an elite athlete. That’s why we take into account training age, movement competence, injury history, and other factors when considering what is the minimum you need now to make a difference. This comes back to doing a comprehensive intake assessment and continually evaluating your progress from there, using data from wearables alongside simple subjective measurements, like rate of perceived exertion (RPE), mood, sleep quality, and hydration, going into each session.
It’s also important to know that what’s best for you now might not still be the right dosage for next week, month, or year because your baseline will inevitably shift when you build up load tolerance to volume and intensity, become more efficient in the movements, and make neuromuscular adaptations. But the key to continual progression will still be consistency and doing just enough to prompt long-term progression and help you reach your goals without going too far.
After concluding that you should stop doing training to a maximal tolerable dose if it’s interfering with your sport and lifestyle or making you injured, tired, and sore, Rippetoe advised: “Let me tell you again what you should do: find the MED – the Minimum Effective Dose – of squats, benches, presses, and pulls, and do that. For most people, this is a much more practical, productive, satisfying, and effective approach to training.”
-Rick Meldrum M.S. Kinesiology, CSCS
