What the largest prescription review found
A 2023 British Journal of Sports Medicine network meta-analysis compared different combinations of load, sets and weekly frequency. The strength network included 178 studies and 5,097 participants; the hypertrophy network included 119 studies and 3,364 participants. Every resistance-training prescription in the analysis improved strength and muscle growth compared with no training.
Higher-load training—above 80% of one-repetition maximum—ranked best for strength. For hypertrophy, prescriptions were broadly comparable, although higher-load multiset training performed twice weekly ranked highly. Rankings help compare the available data; they do not prove that one exact prescription is uniquely best for everyone.
Practice heavier work
If the goal is lifting more weight, include technically sound sets with heavier loads and longer rest.
Use challenging sets
A range of loads can work when sets are hard enough and the target muscle is doing the work.
Use more than one set
Multiset training gives a practical way to accumulate enough weekly stimulus.
Make the week repeatable
Training a muscle around twice weekly is a useful setup, not a biological law.
Do sets need to reach failure?
A Sports Medicine systematic review found no evidence that reaching momentary muscular failure is superior to stopping earlier for hypertrophy. Getting reasonably close to failure can help ensure a challenging stimulus—especially with lighter loads—but grinding every set can add fatigue and reduce the quality of later work.
A practical default is to finish most working sets with roughly one to three good repetitions left. Novices may need time to learn what that feels like. Isolation exercises are often easier to take close to failure safely than technically demanding compound lifts.
A simple evidence-aligned template
- Train two or three days.Use full-body sessions or another split that reaches the main muscles regularly.
- Cover the main patterns.Squat or split squat, hinge, push, pull and carry or trunk work.
- Do two to four working sets.Use a load that makes the planned rep range genuinely challenging.
- Keep most sets shy of failure.Finish with about one to three technically sound reps available.
- Progress one variable.Add a repetition, a little load, a set or better range of motion when earned.
Priorities before optimization
- Regular attendance and stable exercise technique.
- Enough hard weekly sets to create a repeatable stimulus.
- Progressive overload across weeks and months.
- Adequate total protein and energy for the goal.
- Recovery that lets performance move forward.
Protein supports the training—it does not replace it
A separate BJSM meta-analysis found that protein supplementation modestly improved resistance-training gains, with little additional average benefit beyond total daily intake of roughly 1.6 g/kg/day in healthy adults. That figure is a useful planning reference, not a mandatory target for every person or medical circumstance.
Research used in this guide
- British Journal of Sports Medicine (2023): network meta-analysis of resistance-training prescriptions.
- Sports Medicine (2023): systematic review of proximity to failure and hypertrophy.
- British Journal of Sports Medicine (2018): meta-analysis of protein supplementation and resistance-training gains.