Blood Flow Restriction Therapy | What is it Anyway?

One of the first things you'll notice after a severe injury is that your muscles become weak and smaller. And it can seem like it takes forever to gain that strength and muscle size back.

We can all agree, gaining strength is one of the hardest things we do. It requires focus, dedication, and a detailed plan.

Figure 1 - Muscle Atrophy in the Shoulder and Thigh after an Injury.

 According to exercise science, the most effective way to gain strength and muscle mass is to strength train with loads at and above 65% of your one repetition maximum (1RM).

This type of resistance training triggers a variety of chemical events in our bodies that are vital for muscle growth. However, if you are injured, working out at 65% of your 1RM would be extremely difficult and painful.

 That’s where Blood flow restriction therapy (BFR) comes in. BFR is a tool we use in Physical Therapy to increase strength, muscle size, and even endurance with little to no resistance. Using BFR allows us to perform resistance exercises without the concern of placing additional stress on the injured body parts.

So, how does BFR work?

When we strength train our muscles go through a process called muscle protein synthesis. This means our body repairs damage muscle cells, builds new ones, and increases muscle size. 

Muscle Protein Synthesis > Muscle Protein Breakdown = Muscle Growth

However, if your muscles go through a period of time where it is not used, such as after a surgery or an injury, then muscle protein synthesis decrease and muscle tissue is lost. That’s why muscles get smaller (atrophy) after a surgery or a significant injury (figure 1).

 Research has shown us that high intensity strength training and blood flow restriction training produce similar results. The tourniquet system used for BFR training is designed to limit oxygen to the arm or thigh in order to create an environment in the tissue that leads to muscle protein synthesis.

 Equipment

There are multiple BFR devices on the market.

At SoledOut Performance we use the Delfi Personalize Tourniquet System due to its safety features and comfort. The Delfi device uses a specialized wide tourniquet at the top of the arms or legs. The tourniquet pressure is determined by a special machine that assesses the minimal amount of pressure needed based on your individual blood pressure.

Why Use it?

If you are injured you may not be able to load your injured area sufficiently to stimulate muscle growth.

With BFR training you can utilize light loads to stimulate muscle growth while still protecting the injured tissues. According to research, the benefits of blood flow restriction training can occur with loads as low as 20% of a one repetition maximum (1RM).

This is why BFR has become one of our favorite tools to use at SoledOut Performance & PT.

To learn more about Blood Flow Restriction Therapy, contact your local physical therapist or visit Owen Recovery Science, INC.

REFERENCES:

 Shoulder Atrophy Photo Credit: Dr. Lenny Macrina | https://lennymacrina.com/infraspinatus-atrophy-spinoglenoid-cyst | 2020

Quadriceps Atrophy Photo Credit: Dr. Blake Scott | https://modernphysio.ca/2022/11/07/acl-rehab-and-blood-flow-restriction-training/ | 2022

 https://owensrecoveryscience.com/clinical-trials/

 https://owensrecoveryscience.com/blog/  

 Kraemer WJ, et al. American College of Sports Medicine position stand: progression models in resistance training for healthy adults. Med Sci Sports Exerc 2002

 Nielsen, J. L. Proliferation of myogenic stem cells in human skeletal muscle in response to low-load resistance training with blood flow restriction.  J Physiology 2012

 Loenneke JP et al. The acute muscle swelling effects of blood flow restriction. Acta Physiol Hung 2012

 Kubota, Atsushi, et al. “Prevention of disuse muscular weakness by restriction of blood flow.” Medicine and science in sports and exercise 40.3 (2008)