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Blood flow

restriction training

Blood flow restriction training (BFRT) is a technique that uses a pressure cuff to create blood flow occlusion while performing low intensity exercise. It has been shown to produce similar results as high intensity training.


What is blood flow restriction training?

Exercising at a low intensity (20-40% 1RM) while using a blood pressure cuff to restrict arterial blood flow and occlude venous outflow from the working muscles. This training method has been shown to increase strength, muscle hypertrophy, aerobic capacity, and help decrease muscle atrophy following immobilization or post-operatively.

BFRT can be used with injuries and conditions that cannot tolerate the high load and intensity of traditional strength training due to pain or sensitivities. BFRT allows low intensity training to result in muscular adaptations similar to those seen at higher intensities!

High intensity training is the gold standard for strength and hypertrophy, however BFRT can help bridge the gap between injury and pain that result in strength deficits and a traditional strengthening program. BFRT has also been shown to be beneficial to be used alongside a traditional strength and conditioning program.

Blood Flow training

What does blood flow restriction training treat ?

BFRT can be effective to treat injuries such as:

  • Osteoarthritis

  • Patellofemoral pain

  • Meniscal injuries

  • ACL injuries

  • Tendon injuries

  • Post-operative

  • Muscle strains


However, BFRT would be beneficial to anyone wanting to build muscle strength or mass.

Are there precautions or contraindications?

Stretches and treatments
  • Cardiac implications

  • Hypertension

  • Renal dysfunction

  • Pregnancy

  • Varicose veins

  • Hx of DVT/blood clot

  • Clotting disorder

  • Cancer

  • Hx of stroke

  • Lymphatic dysfunction (lymphedema)

  • > 70 years old

  • Open wound, active infection

  • Obesity 

  • Diabetes

What does the research tell us?

  • Following ACLR, they found less atrophy, pain and swelling when using BFRT + low load compared to high load, or low load exercises without BFRT (Kubota et al.,

  • Following ACLR weeks 2-16, they found a significant increase in strength and hypertrophy in the BFRT group compared to the non BFRT group (Ohta et al., 2003)

  • In Patellofemoral pain syndrome they found similar strength benefits with low load + BFRT and high load without BFRT but they found the patients had less pain over an 8 week time frame (Giles et al., 2017)

  • In knee osteoarthritis they found similar outcomes in strength and muscle mass, but with less knee pain with low load BFRT vs. high load (Bryk et al., 2016, Ferraz et al., 2018)

  • Bowman et al., 2020 found that there can also be benefits to the muscles above the cuff as well as the non BFRT limb in strength and muscle circumference- this could relate to systemic or cross-over effects 

  • Improvements in strength and function in achilles rupture patients (Yow et al., 2018)

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