Training Strength First With Repetition Maximum Dosing

Repetition maximum, the number of repetitions possible with a load before failure, is used to explain dosing. Strength gains are greatest at 3 to 5 RM, while 12 RM works more as muscular endurance. Evidence from trials in older adults, including people with osteoporosis, supports heavy loading. A 2020 paper by Okubo found similar muscle growth at 3 to 5 RM and 8 to 12 RM when volume was matched. Prescribing by RM lets patients progress on their own by adding weight once they reach a set number of repetitions. The speaker argues for putting strength first because power and other qualities build on it, using the example of an older person who trips and needs enough force to recover their balance. A common knee osteoarthritis prescription, a theraband knee extension for 10 to 12 repetitions, is used as an exercise. It fails as strength training because intensity is not anchored, the load is too light even if taken to failure, and the same dose is given to very different patients.