I love the quote Stronger people are harder to kill. . . ” – Mark Rippetoe. This can ring true on so many levels. One obvious realm that his is true is physical strength. Yes, if you are stronger, you can lift things with greater ease and move through your environment easier. Life is generally “easier” when you are more physically fit.
Traditionally, building strength and hypertrophy involves the grind of high-intensity resistance training. ACSM recommends lifting at 70-80% of your 1 Rep Max. Unfortunately, sometimes certain circumstances, like an injury, illness or unique situations, high resistance training is not possible (it may not be safe).
In these situations, Blood Flow Restriction (BFR) Training can be an absolute GAME-CHANGER! BFR is not just some “hype” for the Gym-Bros to get bigger biceps. BFR has been endorsed by a robust portfolio of over 500 peer-reviewed papers and triumphant tales from the military to professional sports arenas.
What is Blood Flow Restriction Training?
Blood flow restriction (BFR) uses a special type of cuff to apply pressure to the proximal aspect of limbs (arms or legs). The amount of pressure applied is calculated and personalized to each patient at every session. Using a specific, personalized pressure optimizes the safety and the results you can achieve with BFR. When a proper amount of pressure is applied, the cuff should be partially restriction atrial inflow and fully restrictions venous outflow. There are many type of cuffs out there; the most important thing is that the amount of pressure should be PERSONALIZED – by accurately measuring the full limb occlusion pressure (LOP) and calculating a certain percentage based on your goals.
How does BFR work?
By reducing the amount of oxygenated blood getting to the working muscles and temporarily trapping the byproducts of exercise below the cuffs, you are able to “trick” your body into thinking that it is working much harder that the actual intensity of the exercise. This allows you to get many benefits including similar increases in size and strength, and tendon adaptations as lifting heavy weights. But HOW?
·The restricted blood flow to your arm or leg creates an anaerobic environment. (Fun Fact: The 2019 Nobel Prize in Physiology or Medicine was awarded to William G. Kaelin Jr., Sir Peter J. Ratcliffe, and Gregg L. Semenza for their discovery of hypoxia-inducible factor, a key transcription factor that regulates gene expression in response to decreases in cellular oxygenation.)
·Using BFR has been shown to stimulate increased fiber type recruitment. Usually, with low resistance/intensity workout, we rely mostly on Type I fibers and do not recruit type II fibers until we reach a higher speed or intensity. With BFR on, we see Type II fiber (the fibers responsible for power, speed, and strength) activation even with very low resistance.
·Exercising at LOW-resistances with BFR on stimulates a cascade of metabolites (byproducts of exercise). One of these metabolites is Lactate (this is what causes the sensation of “muscle burn”). As lactate pools in the working muscles, multiple other metabolites and processes are signaled in the body leading to many benefits such as protein synthesis (how we build muscle), muscle stem cells (for healing and building), angiogenesis (the formation of new capillary beds), a significant increase in human growth hormone (HGH), and a down regulation of myostatin (this help reduce the amount of fibrosis during healing and allows satellite cell differentiation).
·Using cuffs to indluce specifics amounts of blood flow restriction also stimulates Cell-Swelling. Yeah, I know, you are used to hearing swelling in a negative frame (like after an injury), but Cell-Swelling – is a GOOD thing! Cell-swelling is what you get when you lift heavy. Many people refer to this as “the pump”. Cell-swelling is essentially an increase in the hydration state of the cell which stimulates muscle growth.
So, Who should use BFR and When is it helpful?
BFR has been found to be safe when applied to appropriate people (yes there are some contraindications and precautions – you should discuss these with your health care provider before trying BFR). Following an evaluation and safety screen, people who are appropriate for BFR training would likely benefit greatly during:
Prehabilitation:
- Due to the massive increase in HGH, BFR stimulates an increase in collagen synthesis. This provides a protective benefit to muscles, tendons, and ligaments. This may help prevents many common overuse injuries and improve recovery from unpreventable sprains and strains.
- Pre-surgery: Prehab is common when you are having a planned surgery. The better strength and mobility you go in with, the better you come out with.
- BFR has been shown to have an analgesic effect. This means you get pain relief simply from doing low-resistance exercises with BFR applied. *This pain relief has been shown to last up to 24 hours.
- Adding blood flow restriction to low load exercises, we are able to induce significant strength and hypertrophy gains in as little as 2-4 weeks (it takes 8-12 weeks to gain muscle size with regular high load resistance training).
Rehabilitation:
- Frequently, after an injury or surgery, we can not safety lift heavy resistance. BFR provides a mechanism to minimize the atrophy commonly seen after injury/surgery.
- Optimize strength and hypertrophy – bridge the gap between low resistance and get back to high-resistance quicker.
- blood flow restriction training does not markedly increase muscle damage (High resistance training does) – optimizing recovery and improving ability to progress through rehab.
- Support healing soft-tissues with a myriad of chemicals and hormones to optimize quality of the healing tissue.
- Tap into pain-relief after injury or surgery to improve your ability to progress in rehab.
- Angiogenesis (producing new capillary beds) – lay the foundation for bringing improved blood flow to the area and achieve a greater response to loading. (We see greater strength and hypertrophy gains in those who have more capillary beds).
- Support bone health: Multiple studies have investigated the benefits of BFR for bone health. Maintaining bone density after a surgery is an incredible benefit!
Sports Performance: The research studies around BFR and sports performance have been exploding! There are numerous studies looking into the benefits of BFR for
- Improved recovery (after a big event)
- Pre-event BFR to improve performance and time-to-fatigue
- Improved aerobic capacity and endurance
- Increased VO2 max
- Increased sprint speed
- Maintain muscle size and strength without a the dip in performance caused by muscle soreness
Athletes rejoice! BFR is your secret weapon to optimizing your abilities and competitiveness. BFR is an incredible tool for competitive athletes to compliment their current training programs to achieve new levels. Just as your normal training changes in-season and out-of-season, the way you would use BFR is vastly different in-season and out-of-season!
Safety Spotlight
BFR has been show to be safe for a wide range of populations when applied to appropriate people by educated, trained and experienced clinicians. There are contraindications and precautions. You should be evaluated by your clinicians prior to use of BFR. Please discuss any concerns with your qualified clinician. This blog does not provide personalized medical advice
Blood Flow Restriction Training stands as the beacon of innovation in injury rehabilitation and sports performance. Here at Alpha Osteopractic in Hampstead, NC, we’re thrilled to offer this cutting-edge training method. Dive into your journey of recovery and performance optimization by contacting us at 910-216-0726 or filling out our contact us form.
Get scheduled today to check out the benefits of blood flow restriction for your physical therapy, rehab or performance optimization!
Medical Disclaimer
All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.
