by Dr. Ashley O'Rourke PT, DPT, ATC, LAT
Blood Flow Restriction (BFR) training is a technique that combines low intensity exercise with blood flow occlusion that produces similar results to high intensity training. It has been used in the gym setting for some time but it is gaining popularity in clinical settings...
What is Blood Flow Restriction Training (BFR)?
Blood Flow Restriction (BFR) Training is a strategy that involves the use of cuffs (tourniquet) placed around the proximal (upper part of the) limb inflated during exercise to a specific pressure with the aim of maintaining arterial inflow while occluding venous return. When performing BFR for resistance training purposes, relatively light loads of around 20-30% of 1 RM (rep max) with high repetitions per set (15-30) and short rest intervals (30 seconds) between sets allow a person to increase strength without the stress/strain of heavy lifting. This is particularly beneficial following injury or surgery when strengthening is indicated for recovery, but heavy loads would be painful, contraindicated or place too much stress on the tissue. Resistance training with BFR has also been shown to increase post-exercise muscle protein synthesis and elevate growth hormone levels.
Because the outflow of blood is limited using the cuff, capillary blood that has a low oxygen content collects and there is an increase in protons and lactic acid. The same physiological adaptations to the muscle eg. release of hormones, hypoxia and cell swelling, will take place during the BFR training with low intensity exercise as would occur with high intensity exercise.
How is it performed?
A tourniquet is placed around the limb during exercise to restrict the blood flow from the working muscle. This causes a localized hypoxic environment, leading to faster muscle fatigue which results in a multitude of beneficial physiological adaptations. The "max" pressure is determined by finding at what pressure there is a "loss of pulse". The cuff is then set somewhere between 40-80% of that max pressure or "loss of pulse" pressure depending on the limb being worked. Exercises are performed while the cuff is inflated. The cuff is deflated during periods of rest between sets. See example protocol below:
Strengthening Protocol:
START WITH 1-2 EXERCISES
MAXIMUM OF 5-6 EXERCISES
FREQUENCY: 2 TO 3 TIMES PER WEEK WHEN BODY WEIGHT OR 15% TO 30% 1 RM TRAINING IS
SAFE
UPPER EXTREMITY: 40% - 50% Loss of Pulse
LOWER EXTREMITY: 60% - 80% Loss of Pulse
4 TOTAL SETS (30 SECOND BREAK BETWEEN EACH SET)
SET 1: 30 REPS
SET 2, 3, 4: 15 REPS
DEFLATE CUFF 10mmGH INCREMENTS WAIT 1 MINUTE BETWEEN EXERCISES
What are the benefits?
Research has shown when combined with appropriate training programs, blood flow restriction can:
- Improve Muscle Strength
- Enhance Aerobic Capacity
-Increase Muscle Hypertrophy
Contraindications:
With blood flow restriction, the biggest concern always brought up is safety.
Contraindications include:
History of deep-vein thrombosis
Pregnancy
Varicose veins
High Blood pressure
Cardiac Disease
Rhabdomyolysis
Precautions include:
Subcutaneous hemorrhage
Numbness
DOMS
“Feeling Cold”
Nonetheless, when used in a controlled environment by trained and experienced personnel, blood flow restriction training appears to provide a safe training alternative for most individuals regardless of age and training status. This is a brief summary of contraindications and precautions. Learn more here!
What Bands Should I Purchase?
•Product: @airbandsbfr
•Rating: 10/10
•Why these? SIMPLICITY
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If I had these cuffs at my last clinic, I would have done BFR Training sooooo much more with my patients/clients.
With the cuffs I had access too, I simply didn’t have the time. It took too long to manually calibrate, manually inflate/deflate the bands after each exercise and keep track of the person's rest periods while juggling 3 patients at once. The process was also too complicated for a non-professional to do it themselves.
THESE bands are a GAME-CHANGER.
They are Bluetooth and link to an app on your phone which provides all of the screening criteria. They then auto calibrate for each individual. Once calibrated, all you have to do is hit the “inflate” button on the app and it automatically inflates to the proper pressure for that particular patient. When finished, just hit “deflate” on the app and start your rest period. It’s THAT simple.
•No ultrasound required to listen for the pulse
•No ultrasound gel making a mess
•No manual pump that you must attach and detach
•Compact & convenient
•Saves time
•Easy enough for patients to use on their own
Everything is AUTOMATED! I seriously wouldn’t use any other bands now that I know these exist. Get yours TODAY!!
•••
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