Updated: Apr 24
Blood flow restriction (BFR) training got its start in the 1960’s in Japan under the name KAATSU training. Since then, it has been used in the military setting. The military used it as a way to return amputees to the battlefield by helping them build up strength with missing limbs.
BFR training has become more widespread and has been used by professional athletes and collegiate programs to improve performance and recover faster from injuries. As the use of BFR training became even more popular, it has trickled down into physical therapy clinics and high-end fitness centers. Some devices are cheap and unreliable, whereas others are more expensive, FDA listed, and tested for accuracy.
BFR training hacks the body to achieve a metabolite buildup response to low-intensity (20-40 % HR/1-RM) exercise, which was previously only achievable through high-intensity (> 70% HR/1-RM) exercise. This will cause the body to respond with the appropriate hormones and lead to improvements in muscle size and strength.
Check out these 8 ways that BFR training can help you out:
1. Improve Muscle Strength and Size
Making gains in muscle size and strength are typically done by training at higher intensities, such as 70+% of your 1-RM. These gains can be made with BFR training at 20-40% of your 1-RM. It’s all about your net protein (amount of protein synthesis minus your protein breakdown). Some other factors that play a role in increasing muscle strength and size are significant increases in gene expression like mTOR1c (protein synthesis), increases in hormones like Growth Hormone (GH) and Insulin Like Growth Factor 1 (IGF-1) all of which signal the body to grow muscle and recover faster. Additionally, there is a down regulation, or blocking, of the Myostatin gene. This is important because, the less Myostatin the more muscle growth you will have.
2. Improve Endurance
BFR training can help improve your VO2 max via lactate production. Increased lactate production increases cognitive ability, increases motor recruitment, and increases the number and efficacy of your body’s mitochondria. Increased mitochondria means increased oxygen consumption and increased energy production. This all happens in relatively short bouts of BFR training and means that muscular endurance is improved in less time than with traditional endurance or interval training.
3. Activate More Muscle Fibers
With low-intensity training, the muscle environment remains in an aerobic state, meaning that it is using oxygen. When you apply BFR cuffs during low-intensity training, it creates an environment that is lacking oxygen (similar to high-intensity training). This is important because it causes you to fatigue your slow-twitch muscle fibers and activate your fast-twitch muscle fibers to perform the movement. Without releasing the cuffs, the environment will remain anaerobic and you will continue to recruit more and more muscle fibers that you otherwise would not have used. This leads to more muscle growth, strength, and power!
4. Quicker Workouts
For endurance athletes looking to get in a strength training session or for anyone looking to workout at submaximal loads for long durations to get a “pump” or for hypertrophy, it can take a long time to get through a workout. BFR training allows you to workout at submaximal loads, but speed up the fatigue process to get the same results in a faster session.
5. Improve Athletic Performance
Athletes of all types, shapes, and sizes can benefit from BFR. The ability to increase in-season training volume without increasing the demand for recovery allows the athlete to maintain higher levels of strength and muscle size throughout the season without jeopardizing game-time performance. In fact, the ability to maintain higher levels of strength and size may actually help increase in-season performance. If it is good enough for elite athletes and the military special forces, it is good enough for you!
6. Increase HGH Levels
Human growth hormone (HGH) increases by up to 300% with the use of BFR training. Increased HGH leads to increased insulin growth factor-1 (IGF-1). When combined with higher testosterone levels, this stimulates muscle growth. BFR training can help with testosterone replacement therapies. This is more natural than using supplements.
7. Avoid Muscle Atrophy and Weakening After Surgery
BFR training helps you recover faster after surgery. This is my favorite utilization of this modality because the impact is that much greater! Typically after surgery, you will deal with pain, swelling, stiffness, and weakness. After a knee surgery (i.e. ACL reconstruction, total knee replacement, arthroscopy, etc.), your quads will have difficulty activating and you will be on precautions to avoid lifting and squatting. When all of this happens, you lose a lot of muscle size and strength. For the reasons in #1, you can use BFR training with low-impact, low-intensity exercises to fight off muscle wasting.
8. Recover From Tendon Injury
As we talked about earlier, BFR training can increase HGH levels by up to 300%. HGH helps with muscle and tendon healing. Also, tendon rehab can be challenging due to the high levels of pain typically experienced during exercise. Research shows us that BFR training can mitigate the pain response in tendons during exercise while at the same time allowing you to build up strength and tissue resilience.
If you are interested in trying out BFR training, contact us to get started.
Corey Hall, PT, DPT