Blood flow restriction training can help patients make greater gains in strength training while lifting lighter loads, reducing overall stress. Blood flow restriction therapy (BFRT) is achieved by applying external pressure on the limbs through a cuff while performing rehabilitation. The applied pressure is sufficient to maintain arterial inflow while occluding venous outflow distal to the occlusion site. The goal of blood flow restriction therapy allows patients to gain greater strength gains while lifting lighter loads, thus reducing the overall stress that is exerted on the limb.
BFRT works by decreasing blood flow to working muscles with the goal of promoting hypertrophy and preventing disuse atrophy of muscles. This treatment is usually used during exercise, but may also involve the use of compression devices alone. Blood flow restriction (BFR) training is a technique that was developed in Japan in the 1960s. Since the mid-2000s, BFR has been popularized in weightlifting circles and has been widely used in professional sports.
Blood flow restriction training involves the use of bands or straps placed on the upper arms or legs. These bands tighten or inflate, and partially limit the amount of blood flow under the band. Next, a series of exercises is performed with the strap tightened in place. With this technique, significant strength gains can be achieved with just a light load in less than half the time of traditional resistance exercises.
During BFR training, a patient or athlete exercises with a narrow elastic band around the upper parts of the exercising arm or leg. This band partially restricts venous blood flow, but does not affect arterial flow to the limb. This produces a systemic response compared to heavy weight training. Performing high repetitions of a particular exercise while wearing the elastic band and wearing light weights will allow the patient to receive the strengthening benefits of lifting heavy objects without the stress to tissues that may be healing from a recent injury or surgery.
With elastic cuffs, there is initial pressure even before inflating the cuff, resulting in a different ability to restrict blood flow compared to nylon cuffs. The same physiological adaptations to muscle (e.g. hormone release, hypoxia, and cellular swelling) will take place during bfr training and low-intensity exercise that would occur with high-intensity exercise. BFR training is relatively new in the world of physiotherapy, but patients who are unable to lift heavy weights and fight atrophy have already seen the benefits.
People with certain conditions should not participate in BFR training, as injury to the venous or arterial system may occur. Simply put, exercising with lighter weights while using blood flow restriction causes a local disturbance of homeostasis, since the muscle that works does not receive enough blood flow to maintain contractions. Before including BFR in your care plan, an experienced physical therapist will carefully consider the indications and contraindications, and will work closely with the prescribing physician. Recent studies have shown that the use of blood flow restriction with light loads leads to the formation of stronger and more robust connective tissue and tendon adaptation, similar to the use of typical heavy exercises.
It is this philosophy that has established EXCEL as the leading provider of physical therapy in New Jersey. When you finish the exercise, you should remove the cuff and allow normal blood flow to return to the muscle. The findings emphasize that the magnitude of muscle damage seems to be attenuated after a first session of resistance training with BFR, demonstrating a protective loading effect through this type of exercise. The key to BFR is that the pressure must be high enough to occlude venous return and allow blood to accumulate, but it must be low enough to maintain arterial inflow.
The perceived envelope tension, on a scale of 0-10, has also been used to perform BFR training. Any muscle or muscle group that is weak after injury, illness, or surgery can benefit from blood flow restriction training. BFR training can be seen as an emerging clinical modality to achieve physiological adaptations for people who cannot safely tolerate high muscle tension exercise or those who cannot produce volitional muscle activity. Blood flow restriction training is a method that the physical therapist can use to improve muscle strength quickly and safely with low-intensity exercise.