Pain Relief with Blood Flow Restriction (BFR) Training



Blood flow restriction (BFR) training can be very beneficial in rehabilitation from an injury. While you are unable to tolerate heavier loads, you can use BFR training with bodyweight or 20-40% 1RM to achieve similar results as heavy (> 70% 1RM) loads. You can also use BFR training to enhance cardiovascular adaptations to exercise, including improved VO2 max. BFR training also provides analgesic (pain relieving) effects. I’m going to summarize a study published in 2018 on pain relief in the knees of active men from the use of BFR training.


The study in 2018 was testing if BFR training could induce pain relief in 30 participants with anterior knee pain. The participants performed a shallow single leg squat, a deep single leg squat, and a step-down from 20 cm. The participants then had to rate their pain on a scale of 0-10.


The participants then performed 4 sets of seated knee extensions (low load training) with 80% occlusion (normal level of occlusion for BFR training in the legs). The leg extensions were performed at a tempo of 2 seconds concentric and 2 seconds eccentric with the use of the metronome to keep the exercise standard across the participants. The first set was performed to failure, followed by three sets of 15 repetitions with a 30-second break between sets.


After doing this simple BFR exercise that lasted only a few minutes, the participants repeated their testing by performing a shallow single leg squat, a deep single leg squat, and a step-down from 20 cm. They had to then report pain again on the same 0-10 scale. The median reduction in pain after performing one BFR exercise was 60%. This decrease in pain lasted for “at least 45 minutes.”


While this study only commented on the pain relief lasting for 45 minutes, it may last longer with the use of more individualized programming and performing more than 1 exercise. Possibly even more important is that you can use this time of reduced pain to train movements that may otherwise be painful, such as squats or jumping, to address any faults in technique as well as prepare to return to these exercises pain-free. You can also use this time to load up some weight to make more significant changes. A quote from the study, “The clinical implications are that low-load BFR exercise may be used to reduce pain and provide a window of opportunity for clinicians to optimally load otherwise painful tissues and joints.”


Here is a link to the article. The full text is unavailable for readers to view without a subscription, but you can review the abstract.


Any questions on BFR training? Reach out to us!


Corey Hall, PT, DPT

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