Is Blood Flow Restriction (BFR) Training For Me?
What Is BFR?
Blood flow restriction (BFR) training is a technique that was developed in Japan in the 1960’s. Since the mid 2000’s BFR has been popularized in weightlifting circles and seen extensive use in professional sports. Blood flow restriction training involves the use of bands or straps placed at the upper arms or legs. These bands are tightened or inflated, and partially limit the amount of blood flow underneath the band. Next, a series of exercises are performed with the tightened strap in place. Using this technique significant strength gains can be had with just a light load in less than half the time of traditional resistance exercises.
Why Should I Use BFR?
Blood flow restriction training allows for increased muscle hypertrophy and muscle recruitment with the use of lighter loads when compared to traditional strength training. Traditional strength training requires a minimum of 60% of an individual’s 1-rep max and at least 8-12 weeks duration in order to see physical adaptation. Strength and hypertrophy gains are seen at just 20% of 1-rep max in as few as 3-4 weeks with the use of BFR.
Since strength improvements can be had with a very light load, we can perform strengthening exercises on tissues that would otherwise not tolerate heavy loads. This means that people with injuries both recent and chronic are able to see strength gains while maintaining the integrity of their injured tissues. It also allows for post-operative patients to strengthen their affected limb in a safe fashion while still maintaining surgical protocols and to quickly rebuild atrophied muscle.
The benefits of BFR go beyond simple muscle strengthening and hypertrophy. Recent studies have shown that using blood flow restriction at light loads leads to the formation of stronger, more robust connective tissue and tendon adaptation similar to the use of typical heavy exercises. Additionally, BFR increases VO2 Max and local oxidative capacity for improved endurance sport performance.
There are a number of possible applications for blood flow restriction training including but not limited to:
- Post-operative rehab
- In-season athletes
- Endurance athletes
- Sprain & strain rehab
- Achilles tendinitis
- Golfer’s and/or tennis elbow (medial/lateral epicondylosis)
- Meniscus injury
- Fracture recovery
- Finger injury (ie: A2 pulley sprain)
- “Pre-hab” before surgery
So how does it work?
Blood flow restriction training works via two primary pathways. By limiting the amount of blood flow during exercise, your body is “tricked” into thinking that really difficult (i.e. heavy) exercises are being performed. On a cellular level, as oxygen levels drop in the muscles below the strap, enzymes that regulate protein synthesis are stimulated, and lead to muscle growth. Globally, a chemical cascade causes growth hormones to be released from the anterior pituitary gland and stimulate muscle development.
What Should I Expect?
Using blood flow restriction often feels like performing a very strenuous workout. As the cuff inflates you will naturally feel some pressure at the site. Below the cuff you may find that your skin turns a bit reddish, even a little purple and your veins may pop out a bit more too: don’t worry, this is totally normal. As with any hard exercise, you may find that you are a bit sore the following day or even the day after that. When performing exercises with the inflated cuff you may feel the quad burn as if skiing down an especially long run, leaden legs as if having run up a steep hill, or climbers often describe it as the feeling of getting especially pumped.
Is It Safe?
Under the guidance of a trained professional blood flow restriction is a very safe and effective tool. As with any exercise there is some inherent risk. With a thorough screen of possible factors that would exclude BFR as a treatment choice it can be performed very safely with your physical therapist.
Not Just a Gimmick
In the past two decades there have been hundreds of research articles, systematic reviews, and randomized control trials that have shown the benefits of blood flow restriction training and more evidence continues to come out regularly. In a 2018 post the British Medical Journal said: “we now even have clear guidelines for using BFRT…so why not give it a try? If it is good enough for professional athletes to help speed up recovery, why are we not offering it to the wider population?”
BFR at Union PT
While there are other clinics out there that offer BFR, at Union PT we are able to give individualized, one-on-one care to help you achieve your sport and wellness goals. Beyond BFR we are trained in manual therapy and movement analysis making sure you will get the most out of each visit. We are also outdoor athletes ourselves and understand the unique challenges of your sport.
There are many possible applications for BFR training from the acutely injured to someone with tendinitis(osis) to the post-operative patient to those with nagging injuries. To ensure a thorough diagnosis and see if BFR might be right for you, schedule an appointment at our Seattle-based physical therapy office.
About the author:
Jon Sparks, PT, DPT, CSCS is a physical therapist at Union PT in Seattle. He is experienced in treating acute and chronic industrial injuries, postoperative rehabilitation and orthopedic injuries. He enjoys staying up-to-date with evidence-based treatments. Outside the clinic Jon is thoroughly obsessed with rock climbing. When not climbing, he enjoys traveling, exploring new restaurants and snowboarding.