Strength Training’s Place In Sensory Processing Disorders

As a former strength and conditioning coach the ability to help people develop strength is near and dear to my heart.  However, in the world of rehabilitation we sometimes can lose sight of how resilient the human body is.

It may not be apparent, but the same principles used in strength and conditioning can be applied to those in rehabilitation to yield remarkable results.


Because of this I try to connect with other strength coaches and trainers to expand our profession, and have a greater impact on the clients we see.

This networking led me to a success story from a good friend, and strength coach, P.J Strebel. It was about how strength training helped a young boy with a sensory processing disorder – I had to reach out and learn more.

It is typical for Occupational and Physical Therapists to treat these patients using a handful of modalities, but the progressive overload from strength training is rarely one of them.  

This story further reinforces that strength and conditioning principles have their rightful place in physical therapy treatment plans.  Let this be a reminder to not let an individual’s diagnosis or our misconceptions guide our treatment, but rather use sound scientific principles to help our patients.

Hopefully this post will help us start exploring some of the (unconventional) benefits of strength training in the treatment of those with this type of condition.

Today’s guest post is by P.J Strebel.

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This is a story all about how (no, not that show, keep reading) strength training changed the life of a middle school boy with sensory processing difficulties.   Let’s call this boy: Wesley (changed for his privacy). Wesley is a good athlete and is one of the hardest working kids that has come through our gym doors.

However, it hasn’t always been rainbows and unicorns for Wesley within our program.  Wes started out in our elementary school program which is more play based and free-flowing.  It is essentially organized chaos. For someone who deals with sensory processing issues, this can become very overwhelming.  There are 15-20 kids hooting and hollering, running and jumping, throwing and kicking balls. It’s a blast.

A lot of really great things can occur during this time frame: kids can learn boundaries, they can learn how to play tag and not tackle someone, they can learn how to tackle someone, they can learn how to play as a group and discover and explore physical movement.  All good things. But for someone who has issues inputting all of these things in an environment, it can be disruptive and cause outbreaks and breakdowns.

Here is how the Occupational Therapist that Wesley is working with defines sensory processing and body awareness in his evaluation:

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You can see how the play-based group could be a difficult spot for someone who has trouble processing so much information at one time.  However, I do think that the younger play based groups, coupled with less screen time and more outdoor activity might actually help to decrease some of the sensory issues, but that’s left for another time.

After numerous conversations with Wesley’s parents we needed to figure out a new game plan to help get Wes where he would be successful. We started him in our middle school strength training program last summer in a smaller group setting as a trial basis.  He was a completely different kid.

Now, before we get into why the strength training helped, let’s take a look at the recommendations for Wesley from his OT:

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Take a look at the top section and other ideas:

  • Isometrics

  • Push ups

  • Pull ups

  • Deep breathing

  • Weighted carries

  • Tension

  • Laugh

*Aside:  we changed read a funny book, to get a funny strength coach.  It’s way better.

These are all beautiful things that should be implemented into a sound middle school strength training program.  But if we break this down even further and look back into the OT eval, it says that Wesley continues to seek out deep pressure.  In the younger groups this can be done through tag games, wrestling, tumbling, jumping off of things, etc. So put a kid who is searching for deep pressure and who has trouble processing and put him in a chaotic environment and it can lead to disaster.  It can cause too much rough housing, tagging too hard, throwing too hard, etc.

So let’s fix it…. But how?

Remove what’s harmful:  Big group, chaotic setting

Manipulate the environment: smaller group, organized setting

Add in what’s needed:  deep pressure

We can think of strength training of just adding more resistance. By adding weight to things like  squats, deadlifts, bench press and weighted carries we can create the deep pressure that Wesley was seeking out and do it in a way that he can also get the loaded benefits that come along with strength training.  

Fast forward a full school year and Wesley has been lifting 2 x week before school as well as a Friday afternoon and/or Saturday AM. He, his parents and his teachers have seen marked improvements in his ability to sit still, pay attention in class, he is getting less demerits for acting out.  We all feel it is because he is getting the input his body is craving before school, so he doesn’t need to seek it out.

Not only have we decreased his undesirable behaviors but we have also packed some muscle mass on him, we’ve increased his injury resiliency, we’ve improved his sports performance, he has also become more disciplined, he has become more confident, and his mental toughness is through the roof!  

If more elementary schools allowed for more free play and recess, and more middle and high schools implemented strength and conditioning into their PE programs kids would be able to sit and pay attention, test scores would go up, detentions would decrease and all around everybody would enjoy school a little bit more.  

Strength training for the win.

About the author:

P. J. Strebel is the Youth Program Director at Seacoast Sport Clubs in Portsmouth, New Hampshire, where he runs a youth program for athletes from grades 1 through 12                  Website




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