December 11, 2023

Load Management Mastery: Empowering Physical Therapists

For your athletes, a balanced recovery and training plan is crucial, given the increased demands and pressures of modern sports. Recent studies surfaced emphasizing the different strategies to enhance athleticism. One strategy that's gaining popularity is load management.

So, what is load management, and how can PTs provide better load management to their patients?

If you want to excel as a PT, an all-rounded, holistic, and science-based approach is needed. Let's find out in this article.

Load Management Meaning In Physical Therapy

Load management is a systematic regulation of exercise and stress response that an individual is exposed to during athletic performance and rehabilitation. In other words, prescribing patients such as athletes the right amount of training intensity, frequency, volume, and rest according to their individual characteristics. Personalizing the training helps strengthen tissues, letting them perform better in the long run. 


Load refers to any type of stress — whether physical, emotional, or mechanical that impacts the body. It can happen at any biological level — cellular, in our organs, or our whole body's system. 

There are 2 types. External load refers to the objective measure of training performed by an athlete, like how much weight the athlete lifted for the week. Meanwhile, internal load is the athlete's physiological and psychological reaction to the training. For instance, how fatigued an athlete feels in the entire week of lifting sessions.

Importance of Load Management in Injury Prevention

Understanding the precise balancing between external load (physical stress) and how the tissue adapts and recovers (tissue capacity) can prevent sports injuries. Load monitoring is one way to make sure that your patient's or athlete's load is aligned with their physical capacities and doesn't train to the point of overexertion. 

That is why the need for individualized load management is key to ensuring they progress at the optimal level of their health.

Monitoring Load and Injury

The significance of monitoring goes beyond visual observations — it's a comprehensive body analysis that goes up to physiological functions. A fully equipped PT practice that can see through physical symptoms can deliver effective treatment plans, decreasing the risk of injuries. 

You can use tools that measure external and internal loads to see the result of an athlete's response to physical training. GPS and accelerometers can be used to measure speed, distance, and activity intensity (external loads).  To monitor physiological stress (internal load), you can use heart rate and rate perceived exertion or RPE.  

You can input these records into EMR+ software like PtEverywhere, which is excellent for monitoring these factors through its many features, such as having easy access to your patient's health records.

Monitoring Measurement Examples

In sports performance, keeping records on different metrics helps PTs ensure that the patients such as athletes are training smart while keeping their health optimized. Making a strategic plan to calibrate the training regimen is a critical function of load management systems. 

Example metrics of external loads:

  • Training or competition frequency
  • Type of training or competition
  • Time-motion analysis
  • Power output, speed, acceleration
  • Neuromuscular function (e.g., muscle activation sprint, balance tests)
  • Exercise repetition counts (e.g., lunges, squats, throws)
  • Distance (e.g., kilometers run, meters swim, miles row)
  • Acute: chronic load ratio

Example metrics of internal loads:

  • Heart rate
  • Rate of Perceived Exertion
  • Sleep
  • Recovery
  • Psychological assessments
  • Hormonal assessments

Key Points to Consider for Load Management


Regarding load management, the same considerations and attention should also be given to bouncing back or recovering from training. It's not about pushing athletes over their limitations, but considering their health status and exercise regimen can prevent them from overuse injuries.  

For example, runners have an 8-10% rule that suggests that they should not increase their weekly mileage by more than 10% over the previous week. This rule gradually progresses athletes, letting their body adapt and preventing overloading injuries. 

Load management, meaning nurturing the whole health of the athlete, not only focusing on competition training but also giving importance to recovery sessions and holistic athlete well-being.

The Truth About Training Load

Training load can significantly affect the athlete's risk for injuries, but it should not be the only factor that can cause it. Additionally, the 10% increased training per week rule should not be a rigid rule but only a guide. It should be adaptable from 5-10% as athletes adapt to training differently. 

Assessing your athletes thoroughly before increasing or decreasing activity gives you a good picture of how they are prone to the risk of injuries and can perform better in their designated sports. 

Lastly, training and injuries are complex. Many factors should be considered, like the athlete's training history, overall health status, training adaptation, and other lifestyle factors such as age, fitness level, and how they manage stress.

The Future of Load Management

There's more to load management, and further research is needed to debunk myths and refine its practices.  Analyzing these loading patterns and tissue responses can help tailor programs to enhance tissue strengthening and decrease stress-related damage. This approach boosts performance and minimizes the risk of injury, ensuring athletes can train and compete safely over the long term.

Using advanced EMR+ software can also help with patient plans. Telehealth, patient portals, messaging, and other useful features can increase patient engagement, responsiveness, and overall practice quality. Not only that, healthy communication between you and your patient can make you provide better load management advice, monitor the patient's progress, and adapt effective treatments seamlessly.

Bottom Line

A holistic training regimen, seeing the athlete as a whole, is vital. At its core, load management is a strategic practice of having regular assessments, maintaining safe training practices, evaluating neuromuscular function movement patterns, and fine-tuning your training plan over time. So, keep an individualized approach to monitor and adjust these metrics to decrease stress-related injuries and hone athletic performance. 

Patients can participate more in their exercises by using PtEverywhere, personalized video exercises, and interactive programs. It also has compliance reports, health trackers, and timely pop-up reminders to organize patients' rehabilitation schedules, promoting consistent load management. This comprehensive solution allows patients to stick to their programs and feel supported, paving the way to greater success in your clinic's rehabilitation process.