How Blood Flow Restriction Training Can Expedite Your Recovery
Unless you closely follow professional sports and current advancements in injury recovery, you've probably never heard of blood flow restriction training. The early origins of this intervention can be traced back to Japan in the 1960's, but it wasn’t until the 2000's when it started getting more extensively researched as a potential aide to recovery and rehabilitation.
Blood flow restriction (BFR) training involves the brief and intermittent application of a specialized tourniquet device to reduce arterial inflow while completely occluding venous outflow in a limb. This can be done while you're exercising for max benefit, but can also be done at rest.
This type of training is ideal for anyone who is not currently capable of lifting heavier weight, but is looking to prevent atrophy and achieve meaningful strength gains to improve their daily function. Traditional resistance training guidelines recommend exercising at an intensity that is greater than 65% of a 1-repetition maximum (1RM) in order to achieve muscle hypertrophy. Patients who are experiencing higher levels of pain or are restricted by post-surgical healing precautions are not capable of exercising with heavier loads, which typically results in strength loss and muscle atrophy. Using BFR training, patients can exercise with significantly lower loads (20-30% 1RM) while still achieving a meaningful increase in strength.
You may be wondering how this works, and while the exact mechanism behind BFR training is not fully understood, essentially an acute hypoxic event is created in the limb. This results in the body switching over to anaerobic metabolic pathways and recruiting larger, fast twitch motor units. BFR studies have shown that this results in a significant rise in lactate, human growth hormone, insulin-like growth factor, myogenic stem cells and a downregulation of myostatin.
Additionally, BFR training produces muscle swelling even in the absence of exercise. This cellular swelling appears to be enough of a stimulus to initiate muscle protein synthesis and therefore minimize atrophy and even encourage hypertrophy. In simpler terms, BFR tricks your body into thinking it is working out at a high intensity despite the training load being low.
The use and safety of BFR is widely reported in the literature. The most common risk is temporary bruising at the site of the tourniquet, transient numbness of the extremity, or a dull pain from the tourniquet. Research studies have specifically looked for potential markers of thrombus formation after use and have not found any. Depending on the exercise protocol, occlusion typically lasts for 10 minutes or less before the cuff is deflated. This process may be repeated three to five times with a rest provided between each set.
The use of autoregulated devices like the Delfi unit used by MyMichigan Health significantly minimizes the occurrence of any adverse reactions. A conversation with your health care team can determine if BFR is a safe and appropriate approach for you.
Matt Fogal, P.T., D.P.T., is a physical therapist at MyMichigan Medical Center Midland. He has a special interest in orthopedics, sports injury and prevention and blood flow restriction. He is currently welcoming new patients to his office in the Campus Ridge Building. To make an appointment, call (989) 837-9100.
