Is more always better? Is there a dose response effect of exercise for musculoskeletal pain? Should exercise be just like a medication, where the dose has to be sufficient in order for it to elicit a therapeutic effect?

These are the questions we contend with on this episode of The Shoulder Physio Podcast.

Key resources

Lawford BJ, Hinman RS, Spiers L, Kimp AJ, Dell'Isola A, Harmer AR, Van der Esch M, Hall M, Bennell KL. Does Higher Compliance With American College of Sports Medicine Exercise Prescription Guidelines Influence Exercise Outcomes in Knee Osteoarthritis? A Systematic Review With Meta-Analysis. Arthritis Care & Research. 2024.

Liang X, et al. The Best Exercise Modality and Dose for Reducing Pain in Adults With Low Back Pain: A Systematic Review With Model-Based Bayesian Network Meta-analysis. JOSPT. 2024.

Malliaras P, Johnston R, Street G, Littlewood C, Bennell K, Haines T, Buchbinder R. The efficacy of higher versus lower dose exercise in rotator cuff tendinopathy: A systematic review of randomised controlled trials. Archives of Physical Medicine and Rehabilitation. 2020.

Powell JK, Lewis J, Schram B, Hing W. Is exercise therapy the right treatment for rotator cuff-related shoulder pain? Uncertainties, theory, and practice. Musculoskeletal Care. 2024.

Powell JK, Lewis JS. It is not all about strength: rethinking mechanistic assumptions in exercise-based rehabilitation. British Journal of Sports Medicine. 2025.

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#59: Exercise, sets, reps and the pharmacology problem

The Shoulder Physio Podcast

#59: Exercise, sets, reps and the pharmacology problem