Blood Flow Restriction Training


Blood Flow Restriction Training


What is Blood Flow Restriction Training (BFRT)?

The first time I saw someone holding a three pound dumbbell with a cuff around their arm grunting about how badly it burned, I thought, “No way.” But once I tried it two separate times as part of a rehab program for my own knee and shoulder, I realized that BFRT was no joke.


BFRT works by partially restricting arterial inflow to the muscle and fully restricting venous outflow from working muscles. This basically means that only some oxygenated blood flows into the working muscles and no deoxygenated blood flows out of the working muscles. BFRT uses low loads (20-30% of 1 RM), high reps (15-30) and short rest intervals (30 seconds). In doing this, muscular size, strength, and endurance can improve in similar proportions to that achieved by heavy weightlifting. Studies show that, “short duration, low intensity BFR training of around 4-6 weeks has been shown to cause a 10-20% increase in muscle strength. These increases were similar to gains obtained as a result of high-intensity exercise without BFR” (Physiopedia 2020).


For those with whom heavy lifting may be contraindicated, such as after surgery or injury, BFRT becomes a very useful tool to use as part of the rehab process to improve strength and muscular endurance. Many bodybuilders also utilize BFRT to increase muscle size.


So how does BFRT work? The cuff is placed above the muscle you want to strengthen. For example, if you were trying to strengthen the knee post ACL surgery, the cuff would be placed at the very top of the thigh. Because blood flow is restricted to the muscles, oxygen supply to the muscles is also limited. Muscles below the cuff then have to work harder to make a muscular contraction because of reduced oxygen delivery. The increased fatigue of the muscles under BFRT mimics the fatigue experienced by muscles during heavy lifting, which is why we see similar results in hypertrophy with both methods.


History of BFRT

BFRT began in Japan in the 1960s and was created by Dr. Sato, a guy just looking to make his muscles bigger. Dr. Sato experimented using homemade tourniquets and called the practice Kaatsu Training, which means “training with added pressure.”


Dr. Sato spent years experimenting with blood flow restriction and even ended up in the hospital a few times due to his homemade tourniquets. (BFRT should only be done by a professional; please don’t try tying bands around your arms and legs in hopes of increasing muscle size.) Through his many years of experimentation and extensive research, it became clear that blood flow restriction could be effective in increasing muscle size, strength and endurance. While still used by many bodybuilders, BFRT is now gaining traction in the clinical setting as a means to rehab from injury or surgery.


What can BFRT be used for?

We know that lifting heavy weights makes you stronger. But what happens when someone is unable to lift heavy weights due to injury, surgery, illness, or other restrictions? How can we still elicit the same muscular adaptation? Enter BFRT.


BFRT is used post-surgery, such as after an ACL surgery, but can also be used for minor injuries as well. Let’s say you tweaked your shoulder doing snatches at Crossfit. You have pain while doing any overhead movement now, so BFRT could be a useful tool to maintain or increase strength and muscular endurance through that area so that your shoulder is stronger when it becomes time to return to those overhead movements.


Ready to get your BFRT on?

Maintaining intensity of training and overall strength following injury or surgery is one of the biggest challenges for athletes and gym-goers. BFRT is one of the strategies we utilize at Prime to build strength and maintain the intensity you had prior to injury, so that you can get back on the field or in the gym. Are you coming back from injury and feel ready to train, just not quite at 100% intensity? Are you trying to prevent regression at the gym after you got a minor tweak in your shoulder or knee? Just curious about how tough BFRT really is? Reach out to info@primeperformancerehab.com today to see if BFRT could be a good fit for you.