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I often see people doing unilateral exercises at the gym, but almost none of them do the same thing.

For instance, if someone wants to do X sets of Y reps of an exercise unilaterally, they can do :

  • Alternate reps: left, right, left, right,... then pause, then repeat X times.
  • Alternate sets: left * Y, right * Y then pause, then repeat X times
  • Alternate exercises: left * Y, then pause, then repeat X times, then right * Y then pause, then repeat X times

What are the advantages and disadvantages of these 3 methods ? Is there any difference ?

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In my opinion the alternate reps or sets methods you mentioned is the best way to go because it is the most time efficient. I personally always go for the alternate sets, but I guess for stuff like biceps curls for example you could easily do alternate reps aswell.

Think about it, why would you do a set for, let's say your left arm but not for your right, then pause and after that train the right arm, which wasn't even trained before/had a long(er) pause (than needed). I'd say there is absolutly no benefit from the third option whatsoever.

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