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  • Writer's picturePawel Krotki–Borowicki

Return Under the Bar

This text is addressed to patients and individuals seeking healthy recommendations for strength training preparation and returning to sports after a prolonged period of physical inactivity or recovery from illness.

However, it should not be considered medical advice. Physical activity is part of the prevention of many conditions, which in many occasions should be consulted with a doctor and based on regular clinical diagnosis. Unless there are restrictive indications for supervised rehabilitation, which may be the case in post-surgical conditions or advanced stages of disease, the desire to move or 'get back under the barbell' is a calling that simply should not be suppressed.

In this article, I provide an exercise plan in interactive PDF form with videos to facilitate this. I dedicate it to people who face barriers to taking up activity, but wish to train in accordance with health-promoting recommendations. In addition, I address it to patients without contraindications to independent exercise recreation, who have little experience at the gym and for many personal reasons cannot afford to work with a trainer or simply want to get stronger and feel more confident first.

I also recommend it to my colleagues in physiotherapy and sports who are looking for basic information on therapeutic exercise and programming, or who may want to share a link to this site with their patients or clients. If the thought behind the practices presented here convinces you, feel free to do so. This protocol is a collection of the best among the practices that I know of, which define the procedures that can become the first step toward fitness and health in the lives of people in need.

General Recommendations

Physical activity is a pharmacological agent that can't be bought at the drugstore.

This is not an empty slogan, because the idea of treating movement as medicine, offering a cascade of health-promoting and psychoactive benefits, is in line with current medical knowledge. It affects not only how efficiently we move, but also how efficiently we think, remember and regulate emotions. Exercise, however, cannot be swallowed like a pill while sitting in front of the TV. They have to be done, and preferably in a challenging way, not always enjoyable, but enabling the transformation of weakness into strengths.

Training—like medicine—requires (among many things that probably only specialists know) proper dosage, repeatability, specificity and progression. The World Health Organisation (WHO) recommends 150-300 minutes of moderate and 75-150 minutes of intense aerobic exercise per week. These instructions are intended to reduce the scale of immobility, including sitting for hours, which are one of those circumstances in which ... death can occur prematurely.

A common indication is also a 60-minute strengthening workout, which is recommended to be performed at least twice a week. The preventive nature of such treatments can be based on bodyweight work, lifting weights methods or resistance training on machines, and can be expanded to include cross-sectional fitness efforts. If the exerciser is accompanied by periodic fatigue with shortness of breath, such training further improves metabolic profile and stimulates the immune system.

It is also important to choose exercises that guarantee progress in learning motor skills and preventing fear of movement, falls and injury. The presence of movement challenges that develop a range of skills and improve a variety of abilities, i.e. walking, lifting, reaching, landing and jumping will definitely fit more into the context of the life. Balance exercises, cognitive challenges and elements of sports games can be an interesting addition to strict exercise protocols (at the gym), which will give the activity a fun dimension. The important thing is that training should be engaging regardless of age – entertainment, after all, has no expiration date!

Training programme

I present a program designed to get you started moving according to the above recommendations and prepare you for more intense forms of exercise in the near future. In it I offer intensified exercises, performed mainly using the body with a small but demanding load of many foundational positions. I have selected their variants so that they do not require specialised instruction, making them safe to perform without the supervision of a trainer.

Demonstration of the exercises involves playing a video. Clicking on the name of the exercise opens a window with the video, which just have to be imitated. Equipment, include only two dumbbells of 5 kg each, a small step, which can be replaced by a chair, a small piece of a wall and a body. Before starting, it's worth finding a moment and click through the sheet to familiarise with the names, videos and progression patterns of the exercises.

A link to download a PDF of the interactive videos can be found here.

It will take about 45-60 minutes to complete one session. The appropriate frequency is 2-3x workouts per week. The table includes simple exercises, repeated with identical set–reps, and main exercises, the dosage of which changes from session–to–session within the vertical columns labeled with numbers I-VIII (8 workouts in total). Exercise series are denoted by S, and repetitions by x. Intensity refers to a subjective feeling scale, described by the numbers 1–10. The last variable is rest time (time rest, tr), which is sometimes strictly defined or in selected methods is self–regulated (SR).

The pace of exercise is slow. It allows for gradual habituation to the positions and in many cases is dominated by a safe method that involves holding final positions, such as for few seconds (HOLD). This fixation is additionally performed without holding the breath, which fascilitates the work of the chest and the muscles responsible for posture and breathing.

It will take about 3-4 weeks to complete the entire schedule. The effects will be measured in terms of ease of movement, increase in physical strength and habituation (adaptation) to what has been worked through. This may also manifest itself in a 'hunger' for new challenges and a further need for progression. Perhaps also a conviction to buy a gym pass, enroll in a favourite group class or return to sports.

In the future, I will publish a continuation of the current plan in a similar format of a clear PDF sheet with videos, where the beneficiary of the program will learn the basics of resistance training and weightlifting for overall health.

Possible risks.

The above program is 'ready-made', which by definition means that it will not be suitable for everyone. In addition, the exercise suggestions I have chosen may be too difficult for people with impaired coordination and low kinesthetic sense to perform it correctly. They may also be unsuitable for elderly patients and seniors, and anyone at risk of losing stability and falling.

Read more.

Bull FC et al. World Health Organization 2020 Guidelines on Physical Activity and Sedentary Behaviour. British Journal of Sports Medicine (2020) FREE ACCESS.

Anderson E et al. Physical Activity, Exercise and Chronic Diseases: A Brief Review. Sports Medicine and Health Science (2019) FREE ACCESS.

Jurdana M. Physical Activity and Cancer Risk. Actual Knowledge and Possible Biological Mechanisms. Radiology and Oncology (2021) FREE ACCESS.

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