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Blood flow restriction (BFR) training

What is BFR?

Blood flow restriction (BFR) training is a training and rehabilitation strategy involving the use of a cuff or bands placed around a limb during exercise, to maintain arterial inflow to the muscle while preventing venous return (venous occlusion).

Why BFR?

BFR shows amazing potential in the sports medicine world by allowing a patient to improve hypertrophy (muscle growth) and strength without stressing or overloading their joints. BFR has been shown to require a substantially shorter period of physical activity to achieve the same muscle growth results (3-6 weeks vs 8-12 weeks). As a patient, this will allow you to rehabilitate more aggressively and decrease muscle atrophy, even when you have load/weight bearing restrictions secondary to your healing process or surgical protocols.

Who Benefits?

  • Immobile or mobility-restricted populations:

  • Bed ridden

  • Casted

  • Post-operative rehabilitation patients

  • Elderly

  • Athletic populations:

  • Active recovery

  • Decrease joint/tissue loads

  • Isolated exercises for “weak link” region

How does it work?

By reducing blood flow, one can create positive effects that will allow for a hypertrophy and strength response to the muscles that you would traditionally need a heavy load to achieve.

Studies show that working out at 80% of your one repetition maximum lift allows for hypertrophy, with BFR, working out at just 20% of this 1 rep max allows for the same hypertrophy response.

The Science

  • BFR allows for the use of Type 2 fast-twitch muscle fibers faster and more effectively

  • Increase in muscle protein synthesis

  • Increase in lactate to help with motor recruitment

  • Increase in growth hormone (by 1.7x) and other anabolic (positive) muscle growth factors

  • Growth hormone plays a role in collagen synthesis which could help with bone healing and plays a role in joint and tendon health

  • Increased cell swelling, increased satellite cell pool to allow for muscle memory

  • Decreased myostatin which leads to an increased ability for muscle hypertrophy and a decreased chance for fibrosis after injury

  • BFR creates an analgesic affect to reduce pain

Side Effects

  • Fatigued muscle

  • Mild soreness

  • Small chance of residual swelling in limb

  • Studies show NO greater risk of blood clot

Loenneke JP, Abe T, Wilson JM, Ugrinowitsch C, & Bemben MG (2012) Blood flow restriction: how does it work? Frontiers in Physiology, 3, 392.

Loenneke JP, Wilson GJ, & Wilson JM (2010) A mechanistic approach to blood flow occlusion. International Journal of Sports Medicine, 31(1), 1-4.

Nakajima T. Key considerations when conducting KAATSU training. Int J KAATSU Train Res. 2011;7(1):1-6

Nakajima T. Use and safety of KAATSU training; results of a national survey. Int J KAATSU Train Res. 2006;2(1):5-13

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