March 27, 2017 4:58 PM EDT
Hi, the short answer is “it depends”. There are many factors that can influence how much we want to push a patient and their musculoskeletal system. Some factors are: initial condition(ing) of the patient prior to starting therapeutic exercise, the goal of the patient with therex (is it recovery from injury or endurance training?), the age of the patient, which muscles are needing the therex, the composition and size (muscle fiber types), breed of patient, skeletal muscle blood flow, oxidative capacity and metabolism, nutrition, hydration, scheduling of therex, and recovery rate and response to therex. If you are trying to condition specific muscles in an althete (i.e. agility dog) you would frequently push them until fasciculations – pushing them beyond a level they are used to for the training to have an effect. If you had an older patient, who was not in very good condition previously and you were exercising a recent injury, they would most likely recover much differently than the athletic dog, and not want to necessarily exercise to the point of fasciculations. Most of my patients fall into the second category and I find if I push too much their recovery takes much longer.