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How Blood Flow Restriction Training Can Accelerate Your Rehab

atlanta bfr blood flow restriction decatur dr. mike physical therapy rehab Apr 18, 2024

Blood Flow Restriction Training (BFR) is a very popular modality utilized in the rehab world by now and rightfully so, due to its plethora of benefits. While recovering from an injury, BFR has the potential to accelerate your process via metabolic stress vs mechanical stress. Let’s use a calf strain as an example. The muscle itself has sustained some degree of trauma affecting the connective tissues and muscle fibers of the calf. In response, your body will send pain signals to the brain when the tissue is loaded in a way that it doesn’t have the capacity for. This is usually resultant of mechanical stress. Imagine tiny tears within the muscle that do not tolerate tensile loading. The pain signaling is important and should be respected!

So now what? To heal a muscle and restore its prior function, progressive overload is required for adaptations to occur. How can you possibly progressively overload a muscle that can’t tolerate strengthening? BFR! By restricting blood flow to the limb by a specified amount, we can create an environment that stimulates metabolic stress. Traditionally, heavier loads are required to increase muscle strength and mass but with the use of BFR, we can accomplish effective training at very low loads. Think of 20% 1RM with BFR vs 85% 1RM without. Not to be misconstrued as a replacement, heavy resistance training should be the primary method used in healthy individuals.

While the injury is in the healing process, BFR is a great way to get ahead of the game and stimulate muscle growth without over-stressing the healing tissue, instead of not loading it all during that time. Improvements in strength and cross-sectional area have also been demonstrated in the opposite limb being trained with BFR, suggesting a systemic effect. Systemic effects with the use of BFR include but are not limited to increased growth hormone, insulin-like growth factor, testosterone, and blood lactate levels. These effects are all beneficial in supporting muscular growth for improved strength and mass. From a therapeutic standpoint, the ability to achieve the hormonal and metabolic effects without physical stress is how rehab professionals can best utilize this tool. Once higher load training is well tolerated and not creating adverse effects, BFR is less relevant but could perhaps be used in a de-load manner. In summary, BFR training is an excellent tool at your disposal to have a great impact on outcomes while certain loading precautions are being implemented. It also isn’t limited to a muscle strain. BFR can be utilized to address any musculoskeletal injury that requires low external loading. The benefits extend far beyond strength and muscle mass and should be considered when addressing other areas of physical health!

1. Miller BC, Tirko AW, Shipe JM, Sumeriski OR, Moran K. The systemic effects of blood flow
restriction training: A systematic review. International Journal of Sports Physical Therapy.
2021;16(4). doi:10.26603/001c.25791

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Thanks for reading,

Dr. Mike, PT, DPT, CSCS, PES

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