Can Exercise Regression Be Progression?

I recently attended an event at medneo UK where the Premier League’s Chief Medical Officer, Mark Gillett, delivered a talk.

One of his opening messages was simple but crucial for effective, lasting rehab outcomes: movement quality should come first, before adding load.

That principle strongly resonates with the populations I work with: people post-stroke, those living with Parkinson’s or MS, older adults, and individuals managing other chronic conditions.

Compensatory movement patterns are common here. When certain muscles are weakened, the body does what it’s designed to do: it adapts. Stronger muscles step in to help accomplish the task.

And in real life, that adaptation has real value.

For example many stroke survivors may not demonstrate a textbook gait cycle, but if their movement allows them to get around safely, maintain independence, and participate in daily life, that’s a meaningful win.

In structured rehab, however, we have an opportunity to be more selective.

Exercise gives us space to rebuild movement quality and strength in underactive muscles so that real-world function can improve over time.

Earlier in my coaching, I sometimes prioritised strengthening before a client had full ownership of a movement. The rationale was to build strength in an accessible range and allow it to carry over.

But in practice, if the intended muscles aren’t doing most of the work, adding load can unintentionally bias the body toward an existing compensation, making balanced development harder to achieve.

More recently, I’ve leaned firmly into a 'movement quality first' approach, even when that means significantly regressing an exercise.

What’s been most interesting is the response. Clients often report that these versions feel harder, more targeted and more purposeful, even though they look simpler on paper.

They can feel the right muscles working, which is where meaningful progress begins.

In many cases, regression becomes progression.

By prioritising quality, control, and awareness first, we build a stronger foundation for load later, when the body is truly ready.

When strength is layered onto good movement, it becomes more durable, more transferable, and far more impactful in everyday life.