Blood Flow Restriction Training 101    

What Conditions Can BFR Support and What is its Definition?

Blood flow restriction therapy (BFR) can be highly beneficial for patients with various conditions and wellness needs. Whether their focus is on simple muscle-building for fitness or on receiving post-operative rehabilitation in NEPA following a knee replacement, hip replacement, ACL, or meniscus surgery, BFR can help.

As Physiopedia explains, the technique “combines low-intensity exercise with blood flow occlusion to produce similar results to high-intensity training. It has been used in the gym setting for some time and is now quickly gaining popularity in clinical settings.”

BFR is implemented via elastic bands, which partially restrict the venous blood (oxygen-deficient blood flowing from the limbs back to the heart). This action causes muscles to work harder, thus offering a higher gain of condition. Aided by the elastic bands, BFR workouts involve alternating between periods of exercise and rest.

Traditional Use in Strength Training

Blood Flow Restriction therapy originated in Japan during the 1970s as a type of resistance training. Dr. Jeremy Loenneke published the first study on BFR training in 1998.

Clinical Applications

In the early 2000s, Johnny Owens, an Army physical therapist, first experimented on himself, using BFR to boost strength and hypertrophy. He then began utilizing it on active service members, primarily amputees.

It seemed a natural step for many therapists to take BFR from the gym into the clinic. Many patients suffer from health conditions that preclude the use of traditional strength training exercises. BFR provides much of the benefit of intensive training without all the risks. 

What the Research Says

For an athlete with traumatic injury:

In addition to recovering muscle to a greater extent than standard rehab alone, the addition of BFR to ACL rehab exercises appears to have a protective effect on bone. See the research here.

For a person with knee replacement:

Muscle and strength gains surpassed those typically reported after total knee arthroplasty (TKA). Outcomes suggest that home-based BFR exercise is feasible, safe, and effective. BFR exercise after TKA is promising and warrants further research.

For the older adult who can’t tolerate heavy loading:

Blood flow restriction training/rehabilitation may be the answer, according to these findings.

How BFR Helps Speed Recovery from Knee Replacement and Other Surgeries

The hypertrophic effect, produced with less physical effort due to blood flow restriction, helps strengthen and build muscle fibers faster, individuals for whom traditional strength training poses a risk. Following is an overview of the circulatory system and the hypertrophic muscle strengthening principle. 

Circulatory System Basics

The heart is the body’s main pump. Its function is to provide the rest of the body with blood. Muscles and other tissues require this blood supply to provide nutrients for maintenance, growth, and healing. The circulatory system is made up of arteries and veins.

Arteries and Veins – What’s the Difference?

The Purpose of Veins

Veins carry deoxygenated blood from bodily tissues back to the heart to receive fresh oxygen. Veins work against gravity to return blood to the heart.

The Purpose of Arteries

Blood is carried away from the heart by arteries. The blood carries nutrients and hormones to cells, as it removes waste products like carbon dioxide.

How Muscles Grow Stronger and Larger

The Hypertrophy Principle  

Hypertrophy means an increase in muscle volume or mass. Since there is little evidence that human muscles enlarge through an increase in the number of muscle fibers, it seems the primary way muscles increase in volume is by increasing the cylindrical volume of each individual muscle fiber. Overloading muscles in training by increasing volume leads to stronger muscle fibers. BFR can accelerate the process.

Is Blood Flow Restriction Therapy Right for Me?

Ask yourself the following questions to get a feel for whether you would likely benefit from the technique:

  • Do you have pain in your lower back, knees, shoulders, etc., that prevents you from lifting weights?
  • Are you interested in finding a way to get stronger and healthier, all while avoiding pain?
  • Have you recently had a total knee replacement or hip replacement and now suffer from swelling and stiffness that prevents you from performing more difficult exercises and activities you love to do? 

Contraindications and Safety

Every person considering BFR therapy should be assessed for conditions that could possibly be contraindications of tourniquet use. Those with poor circulatory systems, obesity, diabetes, sickle cell trait, renal compromise, or severe hypertension may face risk. Potential contraindications also include venous thromboembolism, peripheral vascular compromise, infection of an extremity, lymphadenectomy, cancer, acidosis, open fracture, increased intracranial pressure, use of drugs known to increase clotting risk.

Blood hemostasis and muscle damage from inappropriate tourniquet uses are BFARs primary safety concerns. 

BFR Can Speed Healing Following:

  • Knee replacement recovery
  • Hip replacement recovery
  • surgery to repair ACL
  • ACL reconstruction
  • Meniscus repair surgery

The procedure may look scary.  But testimonials tell of the benefits. 

At Cawley Physical Therapy and Rehab, we take pride in providing one-on-one, completely individualized, fun therapy sessions geared to your specific needs. To find out if BFR therapy is appropriate for your condition, contact a physical therapist in NEPA today.