Blood Flow Restriction Therapy

Blood Flow Restriction Training

 

 

Kinesio-tape, cupping, hyperbaric training… Those red welts all over the back of Michael Phelps in 2016 Olympics. The colorful tape stretched across the deltoids of both Kerri Walsh-Jennings and Misty May-Treanor in 2012… These are just a few of the cutting-edge techniques and performance enhancers that we have seen all over the media!  But what about blood flow restriction training? Blood flow restriction training has been introduced in the military and with professional athletes and is on its way to becoming the new “hot topic” in the world of physical therapy and strength and conditioning, and we’re here to keep you informed!

Blood flow restriction training is a technique where cuffs or wraps are placed around a limb during exercise. These cuffs or wraps maintain arterial blood flow IN to the working muscle but partially prevent venous blood flow OUT of that same muscle.  This alteration of blood flow into and out of the muscle theoretically produces a series of physiological reactions and metabolic stress such as:

  1. Increased cellular swelling

  2. A build-up of metabolites, like lactic acid, which stimulate growth hormone

  3. Increased recruitment of our body’s Type II muscle fibers—those are the larger fibers responsible for strength and power!

 …. All of these reactions lead downstream to an increase in muscle synthesis!

The next question is, what makes blood flow restriction training different than regular resistance training?

It is been proven through research to maximize strength gains, one needs to complete resistance exercises at 70% of their 1 repetition max (the maximum amount of force that can be generated in one maximal contraction). However, sometimes this is not feasible, particularly in a physical therapy or rehabilitation environment where patients may be immobilized post-surgery, may be in the early acute stages of an injury, or perhaps they simply cannot tolerate the mechanical stress of such high resistance! Research has shown an alternative to this would be exercising with low-loads of 20-30% 1RM until failure. This technique is useful early on, BUT the strength gains are not as significant when compared to conventional high resistance training.

Now, we introduce blood flow resistance (BFR) training! BFR-training can be used as an excellent and practical method to gain muscle strength in patients who are not able to exercise with high-load resistances. Research has shown that low-load resistance training with blood-flow restriction has been shown to produce significant hypertrophy and strength gains, even when using loads as low as 30% 1RM!!!! To take it one step further, low-load resistance training with blood flow restriction has been shown to lead to similar results of conventional resistance training with high-loads (70-90% 1RM)!!! The application of BFR-training in a clinical setting and endless and could benefit patients of all ages and backgrounds.

With any training technique, there will always be safety precautions and contraindications. Contraindications for BFR-training include patients with DVT, high blood pressure, varicose veins, cardiac disease, and pregnant women. However, to ensure safety, certifications are available for physical therapists to learn the proper and effective application of BFR-training in the clinical setting.

The research available on BFR-training is still very preliminary, but we look forward to the expansion of knowledge regarding this new hot topic! If you have any further questions, please contact Marycate Givnish, SPT at Marycate.givnish@temple.edu.

Useful links: https://www.youtube.com/watch?v=2fMUpxqJq48&feature=youtu.be

References: Hughes L, Paton B, Rosenblatt B, Gissane C, Patterson SD. Blood flow restriction training in clinical musculoskeletal rehabilitation: A systematic review and meta-analysis. Br J Sports Med. 2017. doi: bjsports-2016-097071

 

 

 

 

                                                                                             

Blood Flow Restriction Training

 

 

Kinesio-tape, cupping, hyperbaric training… Those red welts all over the back of Michael Phelps in 2016 Olympics. The colorful tape stretched across the deltoids of both Kerri Walsh-Jennings and Misty May-Treanor in 2012… These are just a few of the cutting-edge techniques and performance enhancers that we have seen all over the media!  But what about blood flow restriction training? Blood flow restriction training has been introduced in the military and with professional athletes and is on its way to becoming the new “hot topic” in the world of physical therapy and strength and conditioning, and we’re here to keep you informed!

Blood flow restriction training is a technique where cuffs or wraps are placed around a limb during exercise. These cuffs or wraps maintain arterial blood flow IN to the working muscle but partially prevent venous blood flow OUT of that same muscle.  This alteration of blood flow into and out of the muscle theoretically produces a series of physiological reactions and metabolic stress such as:

  1. Increased cellular swelling

  2. A build-up of metabolites, like lactic acid, which stimulate growth hormone

  3. Increased recruitment of our body’s Type II muscle fibers—those are the larger fibers responsible for strength and power!

 …. All of these reactions lead downstream to an increase in muscle synthesis!

The next question is, what makes blood flow restriction training different than regular resistance training?

It is been proven through research to maximize strength gains, one needs to complete resistance exercises at 70% of their 1 repetition max (the maximum amount of force that can be generated in one maximal contraction). However, sometimes this is not feasible, particularly in a physical therapy or rehabilitation environment where patients may be immobilized post-surgery, may be in the early acute stages of an injury, or perhaps they simply cannot tolerate the mechanical stress of such high resistance! Research has shown an alternative to this would be exercising with low-loads of 20-30% 1RM until failure. This technique is useful early on, BUT the strength gains are not as significant when compared to conventional high resistance training.

Now, we introduce blood flow resistance (BFR) training! BFR-training can be used as an excellent and practical method to gain muscle strength in patients who are not able to exercise with high-load resistances. Research has shown that low-load resistance training with blood-flow restriction has been shown to produce significant hypertrophy and strength gains, even when using loads as low as 30% 1RM!!!! To take it one step further, low-load resistance training with blood flow restriction has been shown to lead to similar results of conventional resistance training with high-loads (70-90% 1RM)!!! The application of BFR-training in a clinical setting and endless and could benefit patients of all ages and backgrounds.

With any training technique, there will always be safety precautions and contraindications. Contraindications for BFR-training include patients with DVT, high blood pressure, varicose veins, cardiac disease, and pregnant women. However, to ensure safety, certifications are available for physical therapists to learn the proper and effective application of BFR-training in the clinical setting.

The research available on BFR-training is still very preliminary, but we look forward to the expansion of knowledge regarding this new hot topic! If you have any further questions, please contact Marycate Givnish, SPT at Marycate.givnish@temple.edu.

Useful links: https://www.youtube.com/watch?v=2fMUpxqJq48&feature=youtu.be

References: Hughes L, Paton B, Rosenblatt B, Gissane C, Patterson SD. Blood flow restriction training in clinical musculoskeletal rehabilitation: A systematic review and meta-analysis. Br J Sports Med. 2017. doi: bjsports-2016-097071