Periodization: current review and suggested implementation for athletic rehabilitation

Abstract

Background: Clinicians are constantly faced with the challenge of designing training programs for injured and noninjured athletes that maximize healing and optimize performance. Periodization is a concept of systematic progression-that is, resistance training programs that follow predictable patterns of change in training variables. The strength training literature is abundant with studies comparing periodization schemes on uninjured, trained, and untrained athletes. The rehabilitation literature, however, is scarce with information about how to optimally design resistance training programs based on periodization principles for injured athletes. The purpose of this review is to discuss relevant training variables and methods of periodization, as well as periodization program outcomes. A secondary purpose is to provide an anecdotal framework regarding implementation of periodization principles into rehabilitation programs.

Evidence acquisition: A Medline search from 1979 to 2009 was implemented with the keywords periodization, strength training, rehabilitation, endurance, power, hypertrophy, and resistance training with the Boolean term AND in all possible combinations in the English language. Each author also undertook independent hand searching of article references used in this review.

Results: Based on the studies researched, periodized strength training regimens demonstrate improved outcomes as compared to nonperiodized programs.

Conclusions: Despite the evidence in the strength training literature supporting periodization programs, there is a considerable lack of data in the rehabilitation literature about program design and successful implementation of periodization into rehabilitation programs.

Keywords: linear periodization; nonlinear periodization; periodization; undulating periodization.

Figure 1.

The Holten curve. Percentage of 1-repetition maximum (1 RM) on the left side of the curve with estimated repetitions at that intensity on the right. Used with permission from Oostdam N et al. Design of FitFor2 study: the effects of an exercise program on insulin sensitivity and plasma glucose levels in pregnant women at high risk for gestational diabetes. BMC Pregnancy and Childbirth. 2009;9:1.

Figure 2.

Periodization of strength training with associated terminology used in European and American literature. Note the inverse relationship of intensity and volume. Used with permission from Gearhart RF Jr et al.