The Benefits of BFRT
- Greater muscle hypertrophy (size) and strength can be achieved than in comparison if performed in ‘free-flow’ i.e. without restriction
- Cardiovascular capacity (VO2 Max)
- Muscular endurance/activation
- Bone health
- Decreased joint pain during exercise
- Prevent muscle atrophy post-operatively
- With typical high-load training, the threshold for building muscle strength and hypertrophy is typically 12-16 weeks working at 60-80% 1RM
- 69% of the clinical population experience greater gains in muscle strength with the addition of BFRT in low load exercise. It will be best utilised as a bridge toward heavy load training, without restriction
How Does BFRT Work?
- Typical workout sets for BFRT are 4 sets of 30, 15, 15, 15 reps (20-50% 1RM), 30-60sec rest, 2-3 times per week. Can be as much as 1-2 times daily for acceleration of recovery in early rehab post injury/surgery
- Automated BFR cuffs that have the ability to hold a desired pressure are recommended for use when they are accessible to an athlete
- Individualised cuff pressure to specific muscle groups has yielded a better result for BFRT, leading to decreased discomfort during its use. This should be individualised to the patient’s arterial occlusion pressure (use 50% of this for upper body muscles and 80% for lower body muscles)
Summary
- A caveat of BRFT is that it is unlikely to be any more effective than high-load resistance training at achieving desired outcomes. Therefore, it is usually reserved for those who are ‘load-compromised populations’
- Overall, there is a lack of evidence for BFRT in tendon rehabilitation, but preliminary results largely support its use. Its best use is only when load is compromised by presence of pain. Use prior to heavy load (gold standard) for therapeutic effect, and not as the sole modality in tendinopathy rehab, as it can improve associated muscle strength and power to help assist RTP up 80% over 6 weeks
- Application and dosage of BRFT should be less than 20min for lower limb muscles and less than 15min for upper limb muscles, with at least 3min in between muscle group uses to allow for reperfusion of tissues
- In ACL adolescent patients, BFR is proven safe as soon as 8 days after operation, with no increase in risk of blood clotting seen.
- BRFT has been reported during bed rest for prevention of muscle atrophy, however research on this type of use is still developing
So come in and see our physiotherapy team to see if blood flow restriction can aid you in your recovery!
References:
Hughes et al (2017) – Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. Brazilian Journal of Sports Medicine, 51(13). 1003-1011.
Bond et al (2019) – Blood Flow Restriction Resistance Exercise as a rehabilitation modality following orthopaedic surgery: a review of venous thromboembolism risk. Journal of Orthopaedic & Sports and Physical Therapy, 49(1). 17-27.
Burton and McCormack (2022) – Blood Flow Restriction Resistance Training in Tendon Rehabilitation: A Scoping Review on Intervention Parameters, Physiological Effects and Outcomes. Frontiers in Sports and Active Living.
Cognetti et al (2022) – Blood Flow Restriction Therapy and its use for Rehabilitation and Return to Sport: Physiology, Application, and Guidelines for Implementation. Arthrosc Sports Med Rehabil. Jan 28;4(1):e71-e76.
Australian Institute of Sport (2021) – Blood Flow Restriction Training Guidelines, https://www.ais.gov.au/position_statements/best_practice_content/blood-flow-restriction-training-guidelines