Blood flow restriction… What is it??

If I told you to tie a band around your legs to cut off circulation, and then asked you to squat, you would probably think I was out of my mind! But this is the new craze in the physical therapy, rehab, and strength world.

It’s called blood flow restriction training (BFR), and its applications are endless. Before we get into the uses, lets talk about how this works and why this all makes sense. I’ll try to turn all of the scientific jargon into the most applicable explanation. Blood flow restriction goes off of the idea that we are able to recreate muscle hypertrophy (muscle building), by restricting the blood flow to the muscle. We are able to trick the muscle into thinking it is being stressed by heavier loads, or that it is exerting more force then it actually is. Exercises done with BFR can be accomplished with only 10% of the exercises 1rep max! The blood flow restriction cuffs, will allow arterial blood into the muscle, but will restrict venous blood away from the muscle. This allows chemicals and hormones into the muscle yet restricts blood flow from leaving.

In this hypoxic state, (lacking oxygen), the body rushes growth hormone, as well as strengthens the collagen in the tendon, at a much higher rate then lifting without BFR. A molecule also known as myostatin, (responsible for inhibiting muscle growth), is also decreased under this type of training. This is huge for decreasing after workout soreness, or a phenomenon known as DOMS (Delayed-onset-muscle-soreness). This is the day or two after feeling when you squat for the first time in 3 months and feel like a new born baby deer trying to walk for the first time. So with this ability of working under lighter loads, we are able to decrease muscle soreness,as well as increase muscle growth.

Under normal muscle contractions, we are constricting blood flow to our tissues once we contract, and forcing much of the similar affects as above, yet we have to do it at much heavier loads. With BFR, we are able to recreate this cascade, at a much lighter load, and much less mechanical stress on the system. When restricting your muscles from blood and oxygen, your fast twitch muscle fibers, or type II fibers, are being targeted since there is a lack of oxygen. This helps increase hypertrophic gains, while allowing you to perform even more reps.

Now, why might this be useful? Why not just go and workout like a normal person without using amazon bought medical tourniquets like I did?

Well here are some of the current ways BFR is used:

  • Post-surgery muscle stimulation
  • Muscle hypertrophy
  • Decreasing muscle damage

There is actually a huge upside for athletes while in season. Like I said before, BFR recreates the feeling of stressing the muscle without the actual stress of loading it. This means you’re able to reap the benefits of maintaining muscle mass throughout the season, without the muscle soreness holding you back from upcoming games.

Another great use for this is for those coming off of an ACL surgery or possibly going into surgery. Pre surgery, we may be able to increase quadricep strength prior to surgery while working at a very light load, whereas post surgery we can see very similar effects. After ACL surgery, one of the biggest necessities for returning to play, or everyday life, is preventing quad atrophy (muscle loss) and improving quad growth. Using BFR is ideal for a person post surgery who requires the strength gains and girth, without exceeding the mechanical stress or causing discomfort.

Down to the good stuff, how should you implement this and what’s the set/rep scheme? Well to be honest, there isn’t much information out yet on the most effective sets or reps, but here’s what I have found used the most often.

If you do not have the high tech BFR cuffs, which I am sure you don’t if you’re reading this, then you want to put the pressure of the cuff around your arm/leg at about a 6-7 out of 10 pressure. The cuff should be placed right above the bicep, and below the deltoid, or the crease right below your shoulder muscle. On the leg, the cuff should be placed on the upper thigh. The loads being used should be at about 10% of a 1 rep maximum. As for the rep set scheme, what I have used is 30 reps, followed by 15 second break, followed by 3 sets of 15 with 15 seconds rest in between. Throughout this entire 4 sets, keep the cuff on and remove it once completed all for sets to feel an extraordinary pump.

30-15-15-15 with 15 seconds in between each set.

This can be done on both sides at each time, or one at a time. Now since there isn’t much research on the actual dosage, don’t be afraid to play around with the sets and reps based on the desired goal you are trying to achieve. This isn’t something I would use for every single exercise in your workout, but it is a nice supplemental addition to burnout at the end, or possibly add a shock to the system every once and a while. I found a cheap seat of tourniquets on amazon for about $8 which have been useful in a post workout arm burnout occasionally.

Hope this gave a little insight to a new cool topic, and maybe the spark of interest will cause more research in the future.

Alex Stewart SPT

https://thebarbellphysio.com/science-blood-flow-restriction-training/

https://drjohnrusin.com/blood-flow-restriction-scientifically-advancing-muscular-strength-hypertrophy/

https://www.ncbi.nlm.nih.gov/pubmed/12635796

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