Blood Flow Restriction (BFR) Training Speeds Up Recovery After Surgery



Muscle breakdown, aka atrophy, happens incredibly fast after surgery or injury. When you’re injured or you’re not allowed to put any weight through one of your limbs or tolerate any load, in as little as two weeks that limb goes into a state of anabolic resistance and protein synthesis shuts down. This leads to a 30% loss of muscle mass in that limb!


This is a huge problem and will slow down your recovery significantly. BFR training in the early stages of post-op PT can help combat that muscle loss! Low intensity exercises with body weight or light weights that are safe for your healing tissues combined with BFR training can get you the same improvements in muscle size and strength as lifting at 70%+ of your 1-RM. Some people have even seen their surgical leg grow larger than their non-surgical leg within 3 months after ACL reconstruction surgery.


By limiting muscle atrophy and weakness early in post-operative recovery, we can limit complications after surgery and return to full activity faster. Many physical therapists and orthopedic surgeons have criteria for athletes to return to full activity in their sport. These criteria typically include a relative strength of 90% or greater of your non-surgical limb as well as other functional testing. Using BFR to limit muscle loss and improve strength faster will absolutely help you meet the criteria to return to your sport faster.


On top of these obvious benefits of using BFR to speed up your recovery after surgery, some other side benefits of this technique include reduced pain, reduced swelling, and improved range of motion. These benefits are mostly linked to improvements in cell perfusion and hormone levels seen with BFR usage.


If you have the option to get better faster, why wouldn’t you take advantage of it? There are some precautions and contraindications associated with BFR training, however if you are cleared for surgery (full occlusion with a tourniquet) then you will have met the requirements to perform BFR training (partial occlusion).


BFR training is a serious modality and should be treated as such. You want to use cuffs with adjustable pressures based off of your specific limb occlusion pressure (pressure needed to fully occlude blood flow). There are safety and efficacy concerns when the pressure is not monitored, such as when using wraps or straps. The pressure can be adjusted manually or automatically. Our system will auto-regulate your pressure throughout the workout to maintain the appropriate occlusion percentage as your muscle swells. You should work with a professional trained in proper usage of BFR.


For your reading pleasure, here’s an article from the Journal of Arthroscopy from 2 very accomplished and respected orthopedic surgeons supporting the use of BFR training after surgery: https://www.arthroscopyjournal.org/issue/S0749-8063(18)X0008-5


Interested in using BFR? Preparing for a surgery and want to get back to full activity faster? Contact us to chat more and learn if BFR is right for you.


Corey Hall, PT, DPT

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