Blood flow restriction training, also known as occlusion training, has recently become a popular rehab method for athletes and non-athletes alike. This type of training was first invented in the ’60s but only recently has a lot of research come out, proving its efficacy. Blood flow restriction (BFR) is an effective way to provide a stimulus to muscles while sparing the joints and cardiovascular system from the stresses of heavy weights. It makes 5lbs weights feel like 20lbs. You can get the benefits of heavier lifting without the risks of it. Sounds good, right? Let’s dive into the topic.
How Blood Flow Restriction Training Works
The basics of how BFR works is using a cuff or sleeve on an arm or leg to reduce the returning blood flow to the heart. While strapped to the cuff, the subject performs an arm or leg exercise. The restricted blood flow stimulates and accelerates the metabolic processes that create muscular fatigue.
In other words, it makes easy exercises hard. No need to complicate it.
If you haven’t experienced BFR, it’s a pretty crazy feeling. Let’s say you are used to doing three sets of 10 bicep curls with a 20lb weight in each hand. Using a properly tuned BFR machine, you probably couldn’t do 3×10 using a 5lb dumbbell. BFR can be highly effective, which is why it’s so popular in physical therapy settings. An injured athlete can use this tool to continue training their muscles at a high level without putting pressure on their ankle, wrist, or whatever body part is hurt. It is a novel and revolutionary tool proven safe in a rehabilitative setting.
BFR training is typically done with very light loads but high volume. The athlete that curls 20lb dumbbells will probably do roughly 3-5 sets of 10-15 reps with a 3-5 pound dumbbell. Again there are a variety of protocols that therapists may prefer, but in general, the practice is exclusively done with low loads and moderate to high volume. There are specific levels of occlusion, cuff placement, and training volume that research shows are optimal for best results.
BFR’s Rise in Popularity at the Gym
Given its popularity for physical therapy, BFR inevitably has found its way into gyms. If there’s a tool that can enhance muscular performance and physique, the athletes and gym bros and gals will eventually get their hands on it.
BFR was created for medical purposes. As such, high-tech machines are used to ensure safety. However, anybody can tie a rag around their arm and start BFR training. Anything that can be used to reduce the circulation at the limb can be effective for BFR training. This can be dangerous. Cutting off too much circulation can damage the cardiovascular system and could cause the user to pass out.
But with just a little knowledge from an internet search, anybody can learn and use BFR safely and effectively. It doesn’t create superpowers, however. It can be helpful to train through an injury and is shown to be able to build a little muscle. But it won’t turn you into a pro athlete or bodybuilder.
As with all things sports and aesthetics-related, there will be abusers. There are those who want and are willing to push a modality to the edge beyond its intended use to further enhance performance. BFR is intended to give a user the ability to get the benefits of heavier lifting while reaping the benefits of lifting light weights. It’s an exercise hack. So if a little is good, more is better right? We all know that isn’t always the case.
It has recently become popular to use BFR during regular heavy weight training. If it works for lightweights, surely it’ll make heavier weights more effective, right? Wrong. With heavyweights come equally big muscular contractions. These contractions are too strong for a properly inflated cuff to have its proper effect on the involved arteries and veins. Lifting lighter weights is the best way to get the most out of BFR training. Lifting heavy weights is counterintuitive to the logic of BFR.
Still, it’s worth investigating. A study was done where researchers had a group of men lift heavyweights along with BFR. They measured muscle strength and size development throughout an 8-week training program. They compared the results to another group that completed the same program but with no BFR. Their results demonstrated no differences in strength or size gains between the two groups. They did note that the BFR group had a more difficult time, so it did appear to have some effect, but no measurable differences were seen in the end.
Will BFR be recommended for heavier lifting in the future? Perhaps. Further research is needed, but early studies say no.
The main problem with BFR training is that the general population sees this as a performance enhancement tool, but it really isn’t, and its side effects can be dangerous. BFR training is gaining popularity in the athletic scene, and I don’t think this is a good thing. BFR should be used under medical and professional supervision, although it’s inevitable that everyday people and athletes will continue to use it. There are lots of companies out there manufacturing affordable and portable BFR devices. However, it can be dangerous, and it’s easy to mess up if you don’t know what you are doing. I don’t like it, but I also recognize there is no stopping its use, as it is generally seen as fairly safe.
I would encourage any athlete considering BFR training to do three things.
- Ask your doctor. There are many underlying conditions that would make BFR training a terrible idea for you that your doctor should be aware of, given your medical history.
- Seek guidance from an experienced therapist. Most PTs have zero exercises with BFR, but they are out there. Find one and learn to use it properly.
- Do your own research. I posted a couple of videos here. Pay close attention to their instructions, and find more videos or articles from reputable clinicians on how to properly use BFR training.
Lastly, don’t do it with heavyweights. It’s proven to not be helpful, and it increases the danger of something going wrong.