To improve the strength, size, and function of a muscle it is well known that moderate to high loads must be used to provide the necessary stimulus for tissue adaption. For those with injuries to a particular area this becomes a problem as they typically cannot tolerate exercises of a high enough intensity to stimulate the necessary changes needed to see true gains in strength and/or size.
For individuals not able to tolerate moderate to heavy weights, blood-flow restriction (BFR) training has been found to be very helpful. BFR is a training modality that involves the use of a specialized tourniquet (cuff) applied to the proximal aspect of a limb (usually at the upper arm or thigh) to induce occlusion of blood flow within the extremity. The cuff is typically inflated to a level which is adequate to impede all venous return while still allowing for partial arterial flow. Then, individuals typically perform an exercise utilizing 20-30% of their maximum with high repetitions (15-30 reps) for 3-5 sets with brief rest breaks of 30 seconds between. This protocol is based off of research conducted to determine an effective protocol to provide an adequate stimulus to improve muscle strength and size using the BFR modality.
So how does BFR allow for such impressive results with relatively low loads? To put it simply, BFR training induces a hypoxic (low oxygen) environment within the muscle while also allowing for swelling within the limb from an accumulation of blood. This leads to increase in metabolic stress, activation of myogenic stem cells, release of anabolic hormones such as human growth hormone (HGH) and IGF-1, and cellular swelling. This combination of factors creates an environment which is beneficial for stimulating and increase in muscle strength and size.
While the concept sounds dangerous, BFR has been found to be safe when applied appropriately and in individuals without contraindications for treatment. For this reason, it is important to consult a practitioner prior to beginning a BFR protocol to allow for proper assessment of risk factors. If BFR sounds like a treatment protocol that may benefit you, please contact us at APRS with an questions and to find out how you may benefit from this specialized treatment.
Nick Bechtold, PT, DPT, OCS, CSCS is a Board Certified Orthopedic Specialist physical therapist who specializes in treating orthopedic and sport-related injuries. Nick personally enjoys running, hiking, skiing, climbing, and weight training as well as helping individuals of all ages maintain a healthy, active lifestyle.