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The Basics of Blood Flow Restriction

The concept of cutting down your blood flow to IMPROVE healing may seem counter-intuitive, but truly it’s not! Blood flow restriction training (BFR) is constantly becoming more popular in both the rehabilitation world and the fitness world in general.

How does it work?

BFR uses a cuff that is similar to a blood pressure cuff to reduce the amount of blood flow to an appendage. First, the amount of pressure needed is calibrated to each person by finding what pressure is needed to block 100% of blood flow. Once that is found, this person will work at a certain percentage of that. Training is not completed with blood flow fully blocked. Reducing blood flow to the working muscles also reduces the amount of oxygen and other necessary components reaching the muscle. This is the same thing that occurs when we work out at higher loads and intensities. Therefore, we get very similar effects as to what happens under those high-intensity conditions. The body starts bringing in growth hormones necessary for hypertrophy (muscle building).

For whom does it work well?

This is a great idea for anyone who is currently unsafe to perform high-intensity exercise but will benefit from starting to build muscle strength right away. Someone who has had surgery would be an absolutely great candidate for this. As a good example, research has shown improvement in results with rehab for ACL reconstruction. Acute injuries are also perfect for this. If someone has had a sprain, tendinitis, etc, they can start building the effects of load on their training, even if it’s too painful or unsafe to perform at high intensity. Research is also showing positive results for those who have osteoarthritis.

The bottom line of the benefits of BFR is that it gets you to reach the important benefits of heavy resistance training at a quicker stage in the recovery process. This allows you to get back to what you love sooner!

Is this a safe way to train?

Yes! Your therapist should be trained in identifying factors that are a negative indicators for treatment. These include certain cardiac issues, history of strokes, clotting, pregnancy, and blood vessel insufficiency. Your therapist will be able to determine whether it is safe to perform based on your medical history.

On top of this, your training should be monitored. Common side effects include soreness, bruising, and some discomfort (BFR can be quite uncomfortable at times). Your therapist will follow up with you on these effects and guide you on what to do to help manage this. Overall, any major negative events from BFR are EXTREMELY rare. BFR is as safe to use as any other method of treatment.

You don’t have to be a therapist or medical professional to perform BFR. Trainers and coaches are using this more frequently as an adjunct to their training regimen, which is great to see! One common method seen in the gym that should be noted is the use of tying bands around your arm or leg. This is an ok method but is a little less safe. This is much less regulated than using the cuffs that measure pressure, which your physical therapist would be using.

When the cuffs are on, we always put the cuffs as close to the torso as possible. That’s because the thickest parts of your arms and legs are the upper arm/deltoid area and the upper thigh. The protection of the muscle and soft tissue doesn’t allow for damage to blood vessels. It’s much safer there and cuffs should always be applied there! It can also be used on one or both legs OR arms at the same time. We never train both arms and legs simultaneously with BFR.

So tell us what you think. Is BFR something you would be willing to try? If you’ve been hurt, we are the people to talk to about how to get back on a smart training plan on your way to recovery! BFR could be the piece you need to get that done!

Give us a call at 719-285-9670 or email to talk about your path today!

a man standing with his arms crossed in front of him.

Dr. Scott Runyon

Backcountry Physical Therapy

We Help Mountain Athletes Not Only Recover From Injuries, But Build Them Back Stronger Than They Were Before, So That Injuries Are Less Likely To Happen Again!