An Intro to Blood Flow Restriction Therapy

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What is Blood Flow Restriction Training?

Blood flow restriction training (BFR) involves the application of specialized blood pressure cuffs to the limbs during exercise. By partially limiting the flow blood in our limbs using these cuffs, we can use low intensity exercise to signal to our body that high intensity exercise has been performed. This allows you to achieve similar results from low intensity exercise in situations where higher intensity isn’t able to be done.

How does BFR work?

By partially limiting the return of blood from the limbs, blood flow restriction creates a metabolic environment in the muscles that is similar to that experienced during high intensity exercise. This includes the production of Human Growth Hormone (GH) and IGF-1 (which are involved in the production of muscle) and the down-regulation of myostatin (which reduces the production of muscle). This results in the following effects:

  • hypertrophy at 20-50% of your 1 Repetition Max (WHAT??)

  • Fast tracks us from slow twitch fibre engagement to fast twitch fibre engagement which usually happens closer to muscle failure

  • 200-300% increase in GH & IGF-1

  • Builds stronger tendons

  • Reduced pain x 24hrs (use this as a window for walking/stairs/painful activities)

  • Bone fracture healing via increased GH which increases osteoblast activity and improves the balance of bone building vs bone breakdown

  • The effects noted above are systemic in nature meaning they affect more than the restricted limb

Who would benefit from BFR?

Almost anyone could benefit from the application of BFR however the people who would see the greatest benefit would include:

  • Athletes in competition phase 

    • This can allow them to continue to build muscle and make strength improvements while not resulting in uncomfortable muscle tearing that could affect performance

    • There is also some enhance recovery

  • Post-operative 

    • Reduce muscle wasting in non-weight bearing and low weight bearing states

  • Osteoarthritic pain / load dependent pain states

    • Allow for muscle growth and and strength gains using lower or more tolerable loads

  • Post-Fracture

    • Reduced atrophy during NWB or limited weightbearing periods

    • There is also some evidence demonstrating improved bone metabolism with BFR

Why would an athlete use BFR?

Athletes are in a constant state of balancing training type, volume and intensity while managing rest and recovery. BFR allows endurance athletes who are in the competition phase to add in strength work without causing muscle damage which may affect other workouts. BFR allows athletes in skilled sports already maxing out their training to add specific strength work in to address their weaknesses. During recovery weeks, athletes can utilize BFR to maximize strength and hypertrophy gains while volume and intensity remains low. 

Is BFR Safe?

Although the name itself can be somewhat frightening, the evidence to date indicates that the risks associated with BFR are similar to that of undertaking a regular exercise routine. As with any clinical intervention, however, there are considerations that are made before deciding to use BFR with a particular client.

Thank you for reading!

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