Blood Flow Restriction Therapy

As the saying goes, work SMARTER not HARDER!!!

What is Blood Flow Restriction Therapy?

Blood Flow Restriction (BFR) Therapy is a technique that uses a pneumatic cuff placed around an extremity (arm or leg) while performing exercise. The cuff is inflated to create pressure and mechanically occlude partial arterial and complete venous blood flow. This results in accumulation of metabolites that increases muscle force and promotes muscle growth. The goal of BFR is to improve muscle strength and stimulate muscle growth with low level exercise.

Who would benefit from Blood Flow Restriction Therapy?

Individuals dealing with muscle weakness and/or atrophy would be appropriate for blood flow restriction therapy. The ideal candidates are post-operative patients recovering from orthopedic or sports medicine surgeries, however, individuals dealing with injuries or pain that limits their ability to exercise are great for BFR as well. Any patient or individual that cannot tolerate high load and/or high intensity exercise would be appropriate for BFR. For example, patients who suffer ACL tears and subsequent ACL reconstruction surgery experience muscle atrophy and bone loss. In order to protect the graft early in their rehabilitation, high intensity resistance exercises are contraindicated so BFR is an option to strengthen the leg muscles without jeopardizing the surgical repair or reconstruction.
BFR close up

How does this work?

Muscle strengthening and growth (hypertrophy) can be achieved using mechanical tension and metabolic stress by obtaining release of hormones, hypoxia, and cell swelling. The blood flow restriction technique mimics these effects by recreating the hypoxic environment using the inflated cuff. Due to reduction of capillary blood flow, there is an increase in protons and lactic acid and thus, the same physiological effects of release of hormones, hypoxia, and cell swelling are achieved (Spranger et al., 2015).

Is BFR effective?

Studies have shown that low intensity blood flow restriction technique results in increase in the levels of muscle activation and muscle swelling without muscle damage (Wilson et al., 2013). Short duration, low intensity BFR technique of around 4-6 weeks has shown to cause 10-20% increase in muscle strength which were similar to high-intensity exercise without BFR (Pope et al., 2013). A study of rehab following ACL reconstruction found that BFR combined with exercise mitigates muscle atrophy and facilitates early return to function (Lambert et al., 2019).

Is BFR safe?

In the majority of cases, blood flow restriction is a safe modality to add to your exercise program but this should definitely be supervised by a licensed healthcare or rehab professional. Our clinicians at Muscle & Joint Physical Therapy are certified through Owens Recovery Science which is leader in the research in education on blood flow restriction therapy. We only use the PTS Personalized Tourniquet System for Personalized Blood Flow Restriction Rehabilitation (PBFR) which is manufactured by Delfi Medical Innovations, Inc, a world leader in tourniquet technology and safety. The PTS for PBFR device is specifically designed to safely regulate and control tourniquet pressure for PBFR applications and includes advanced personalization and safety features. Less expensive and less sophisticated devices are available but we are committed to using the best and safest on the market.

Key Benefits of Blood Flow Restriction Therapy

Lambert, B., Hedt, C. A., Jack, R. A., Moreno, M., Delgado, D., Harris, J. D., & McCulloch, P. C. (2019).
Blood flow restriction therapy preserves whole limb bone and muscle following ACL
reconstruction. Orthopaedic Journal of Sports Medicine, 7(3_suppl2), 2325967119S00196.

Pope, Z. K., Willardson, J. M., & Schoenfeld, B. J. (2013). Exercise and blood flow restriction. The Journal
of Strength & Conditioning Research, 27(10), 2914-2926.

Spranger, M. D., Krishnan, A. C., Levy, P. D., O’Leary, D. S., & Smith, S. A. (2015). Blood flow restriction
training and the exercise pressor reflex: a call for concern. American Journal of Physiology-Heart and
Circulatory Physiology, 309(9), H1440-H1452.

Wilson, J. M., Lowery, R. P., Joy, J. M., Loenneke, J. P., & Naimo, M. A. (2013). Practical blood flow
restriction training increases acute determinants of hypertrophy without increasing indices of muscle
damage. The Journal of Strength & Conditioning Research, 27(11), 3068-3075.

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