Blood Flow Restriction (BFR)

BFR is defined as exercise that is based on blood flow moderation involving compression of the vasculature proximal to the exercising muscles. The goal of blood flow restriction training is to restrict venous return while still allowing some arterial flow by strategically wrapping your proximal limbs. By restricting the veins > the arteries, blood can keep pooling into a working muscle. This causes a myriad of processes at the cellular level that are still being explored today.

Indicated Populations include:

  • Healthy Populations

  • OA or Arthritic Joints that need strengthening.

  • Post surgical (e.g. ACLR)

  • Post immobilization

  • Weightrestrictions/limitations

Risks / Adverse Reactions

  • The biggest risk factors come from a few variables: improper tourniquet width, too much tourniquet pressure, and improper placement of the tourniquet.

  • Petechial haemorrhage (i.e. severe bruising)

  • Dizziness\ Syncope / Hypotension

  • Acute autonomic dysreflexia

  • DVT

  • Neuropathy

  • Rhabdomyolysis

There are some high-end pressure cuffs that can be used to wrap your limbs for BFR, but any wraps will work. Some people use ace bandages or knee/elbow wraps. Others use run-of-the-mill hospital tourniquets. For both the upper and lower body, you want to wrap at about a 7 out of 10 on the tightness scale. 50% occlusion for the upper body and 80% for the lower body. Low Load ( 20-40% 1RM Max) High reps >15. Other Higher quality companies produce their own protocols which are worth looking into such as Owens Recovery System, Katsuu, Voodoo Floss, etc.

General rules of Strengthening / exercises apply. Bodyweight & Free weights are both appropriate. Sets and Reps: 30/15/15/15. 30 reps with a 2 second concentric and 2-second eccentric contraction 30 seconds rest 15 reps 30 seconds rest 15 reps 30 seconds rest 15 reps 30 seconds rest. Plyometrics, power, speed exercises not typically used.

Injury, surgery and disuse can lead to neurologic inhibition, atrophy, weakness, & sarcopenia in addition to predisposition of aging Selective inhibition of fast-twitch early Imbalance of protein synthesis & protein degradation. BFR shows promising result because it addresses many of these factors listed associated with injury.

Jean-Paul ParenteauBFR, blood flow restriction