Blood Flow Restriction Training

What is BFR?

Blood flow restriction (BFR) training implements the use of a tourniquet system to reduce arterial blood flow to, and venous blood flow from an injured limb. This restriction of blood flow helps stimulate different substances within the body with the ultimate goal of increasing muscle strength and size. Usually, BFR is paired with low level exercise so the user can get the same amount of physiological stress and intensity without the heavy load of regular exercise.
BFR was first founded in the 1960’s, and has gained world-wide familiarity over the past 20 years.

How does it work?

By cutting off most of the blood flow, most of the oxygen supply is also cut off from circulation. This hypoxic environment stimulates the release of metabolites and growth hormones that help recruit more muscle fibers, and promote protein synthesis to create more muscle cells.

How is it used/What does it do?

BFR uses a tourniquet that is placed either on the upper arm or upper thigh to restrict a specific percentage of blood flow while the user is performing exercises ranging from squats to overhead press, to cycling. Typically, to gain strength and hypertrophy people have to train at more than 65% of the individual’s one-repetition maximum (1RM) to induce adaptive changes to muscles. With BFR however, training at 20-30% of the individuals 1RM can have the same and sometimes better strength and hypertrophy gains compared to traditional high intensity training.

Who is it good for?

BFR is used in the physical therapy setting to treat a vast array of conditions. It is used post-operatively to improve strength following ACL reconstruction, rotator cuff repair, total joint replacements, and more. Studies have also shown that it can help with recovery from tendinopathies, bone fractures and ligamentous injuries. In short, any patient who is recovering from an acute or chronic injury of either the upper or lower extremities could find benefit in regular BFR training.

BFR Protocol

A typical BFR regimen will include 2-4 exercises to start then add more as the patient progresses. Each exercise is performed for 4 sets with a 30/15/15/15 repetition scheme, and moving at a pace of “2 seconds up, 2 seconds down.” There is a 30 second rest between sets, but the tourniquet stays inflated for the duration of the exercise.

BFR at Bespoke

At Bespoke, we use BFR on a daily basis for many of our patients. We are knowledgeable of the physiological mechanisms behind it and are up to date on the most recent research proving its viability in the clinic setting.