Blood flow restriction (BFR) is a training method which involves restricting arterial and venous blood flow in a working muscle during exercise (Scott et al. 2015). The technique of BFR, uses a tourniquet cuff system that applies an external pressure to the most upper region of the targeted limb. When the cuff is inflated, there is a gradual mechanical compression of the vasculature underneath the cuff which impedes the venous return. This results in inadequate oxygen supply (hypoxia) within the tissue.
BFR exercise is shown to produce increases in muscle hypertrophy (muscle size) and strength. It is well documented that muscle hypertrophy and strength adaptions with BFR resistance exercise are significantly greater than those achieved with low-load resistance exercise (Yasuda et al 2005).
The benefit of BFR training when compared to high-load resistance training, is that BFR resistance training requires only to use 20-40% of an individual’s 1RM, compared to high load resistance training requiring 70-80% of an individual’s 1RM to achieve hypertrophy.
This essentially means, that BFR training can be performed with reduced load, while achieving strength and hypertrophy changes. The benefit of this is that we can exercise to achieve muscular changes, while reducing load/stress to the joint or joints involved.
In our clinical setting, BFR training is beneficial for patients in a number of circumstances, but primarily those who require muscular strength changes but also require reduced loading. An example of this is following ACL reconstruction. Utilising BFR training in the early stages of rehab allows us to work on the important goal of increasing quadriceps strength and hypertrophy, whilst maintaining low loads of stress on the recently operated knee. This therefore reduces stress on the graft and meniscus, while also reducing the risk of pain and swelling in the knee, whilst optimising strength changes.
The Physiotherapists at Restore Function endeavour to use the most recent evidence-based treatments such as blood flow restriction training to maximise rehabilitation. We also combine BFR with other treatment modalities such as the Pilates Reformer. If you have any other questions regarding blood flow restriction training or if it may be beneficial for you, please contact the Restore Function Physio Team.
Hughes, L., Paton, B., Rosenblatt, B., Gissane, C., and Patterson, S. D. (2017). Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis.Br. J. Sports Med.51, 1003–1011
Manini, T. M., and Clark, B. C. (2009). Blood flow restricted exercise and skeletal muscle health. Exerc. Sport Sci. Rev.37, 78–85.
Larkin, K. A., Macneil, R. G., Dirain, M., Sandesara, B., Manini, T. M., and Buford, T. W. (2012). Blood flow restriction enhances post-resistance exercise angiogenic gene expression. Med. Sci. Sports Exerc.44, 2077–2083
Scott, B. R., Loenneke, J. P., Slattery, K. M., and Dascombe, B. J. (2015). Exercise with blood flow restriction: an updated evidence-based approach for enhanced muscular development. Sports Med. 45, 313-325.
Yasuda, T., Abe, T., Sato, Y., Midorikawa, T., Kearns, C. F., Inoue, K., et al.(2005). Muscle fiber cross-sectional area is increased after two weeks of twice daily KAATSU-resistance training. Int. J. KAATSU Train. Res.1, 65–70