Blood Flow Restriction Training (BFR)
Blood Flow Restriction (BFR) is a training method involving strategic vascular occlusion of blood flow to targeted muscles during exercise or activity. While this may sound counterintuitive, research has shown promising beneficial effects on the body and is often used in a clinical setting to augment strength and hypertrophy gains during early phases of rehabilitation with individuals who may not be able to tolerate high loads.
BFR training is a technique whereby a tourniquet is fixed on an individual’s proximal limb to restrict venous blood flow out of the working muscle while simultaneously allowing lower pressure of arterial blood flow into the muscle. The restricted blood flow during exercise results in a metabolic stressful environment in the muscle similar to what is seen after lifting heavy loads. This physiological stress activates bio pathways responsible for muscle hypertrophy stimulating muscle growth. Research studies have also discovered that there is a hormonal component to this method of training. BFR training triggers the release of anabolic hormones, Growth Hormone (GH) and Insulin-like Growth Factor 1 (IGF-1). GH plays a key role in collagen synthesis or the processing of collagen needed to repair tendon, bone and cartilage within the body. IGF-1 production is associated with muscle growth within the body, which is spiked during BFR training.
Research have shown the standardized protocol in achieving physiologic adaptations to that of traditional strength training when using BFR training is using low loads between 20% - 30% 1RM, aiming to reach 75 repetitions within 4 sets, first set consisting of 30 repetitions followed by 15 repetitions in subsequent sets, resting 30 secs in-between. While this protocol has consistently produced positive results in increasing skeletal muscle and strength, further research needs to be conducted to understand intricacies of all outcomes.
While BFR training has shown to produce remarkable outcomes, it is essential to consider safety and approach cautiously. It is recommended to seek professional guidance from healthcare professionals experienced with BFR training to ensure proper technique and safety. The level of pressure applied should be appropriately individualized to the participant. Proper training frequency and duration of BFR sessions should be monitored to prevent overtraining.
BFR training presents a promising path for clinicians and individuals seeking to enhance muscle growth, strength, and rehabilitation. However, further research needs to be conducted to understand all of the intricacies that come along with application. It is vital to approach this method of training with caution, seeking professional guidance and current literature to understand how to appropriately implement into a regimen.
Written by Dr. Courage Jacobs, DPT
References
Hughes, L., Paton, B., Rosenblatt, B., Gissane, C., & Patterson, S. D. (2017). Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. British journal of sports medicine, 51(13), 1003-1011.
Lorenz, D. S., Bailey, L., Wilk, K. E., Mangine, R. E., Head, P., Grindstaff, T. L., & Morrison, S. (2021). Blood flow restriction training. Journal of athletic training, 56(9), 937-944.
Mattocks, K. T., Jessee, M. B., Mouser, J. G., Dankel, S. J., Buckner, S. L., Bell, Z. W., Owens, J. G., Abe, T., & Loenneke, J. P. (2018). The application of blood flow restriction: Lessons from the laboratory. Current Sports Medicine Reports, 17(4), 129-134.
Patterson, S. D., Hughes, L., Warmington, S., Burr, J., Scott, B. R., Owens, J., ... & Loenneke, J. (2019). Blood flow restriction exercise: considerations of methodology, application, and safety. Frontiers in physiology, 533
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.
