By: Genevieve Gyulavary, DPT
Step into any progressive performance training center and you might see your fellow athletes wrapping a limb with what would appear to be a tourniquet, doing 90 seconds of air squats, and calling that ‘recovery’. Well, actually it is. In the rehab community, this practice is commonly referred to as Blood Flow Restriction Training/Therapy. Although it may seem a little bit ‘out there’, published research shows mounting evidence that it aids significantly in recovery.
What Is Blood Flow Restriction Training?
So what’s going on physiologically? The idea behind blood flow restriction training is to decrease blood flow to commonly sore muscles such as quads, hamstrings, forearms, and calves, creating a hypoxic event occluding 50-80% of blood flow. In doing so, anabolic growth factors, fast twitch fiber recruitment, and muscle protein synthesis are all increased. This is a dream combination for those looking to recover faster, come back from injury with less muscle mass lost, decrease pain, increase strength, and show improvements in overall movement performance. Using this suggested range (50-80%) the applied pressure is great enough to occlude venous flow to the muscle while maintaining arterial inflow. Therefore, the athlete maintains strength while lifting lighter loads, and reducing the overall stress on the affected muscle. An enticing prescription in order to combat the effects of training or recovering from an injury without losing strength in the process.
Who Can Benefit From Blood Flow Restriction Training?
Blood flow restriction training has gone from a niche concept to a mainstream practice, used across the continuum from orthopedic rehab settings to boxes across the nation. Johnny Owns, MSPT of Brooke Army Medical Center, first began using this technique on wounded veterans he was treating for limb salvage and those who had encountered significant loss of muscle mass during combat to see if they could regrow tissue. Clinicians who were trialing this found that applying a tourniquet to this population in conjunction with exercise, created a change in muscle size and strength at very low weights. This cascaded from military practice to elite athletes coming back from ACL tears and major surgeries in the NFL, NHL, and pro golf.
How Does Blood Flow Restriction Training Work?
By compressing the affected muscle into a tight wrap and bringing it through its allowable range of motion edema is forced into the lymphatic system for drainage; compression influences joint position and range of motion as well as neurological adaptations. When you release the tourniquet a rush a blood is sent to the muscle, bringing nutrients for growth and healing as well as clearing out intramuscular junk.
Mechanical effects: influences fascial glide (the glide of the surface covering muscles), centralization of joints within their spaces, excursion of swelling, and increased hypertrophy.
Neurological effects: pain management, increased proprioception, increased recruitment of fast twitch muscle fibers anaerobic gains: power and speed.
Does Blood Flow Restriction Training Work?
A meta-analysis was performed looking at the research that exists on low-intensity blood flow restriction. Certain criteria’s were established based on current and available research. The studies had to compare low-intensity endurance training to blood flow restriction, populations had to have similar baseline characteristics, and outcomes had to include at least one measure of muscle hypertrophy. The analysis found that blood flow restriction resulted in significant strength and hypertrophy gains when incorporated 2- 3 days per week.
A randomized control trial examined blood flow restriction by low compressive force to prevent muscular weakness in non-weight bearing extremities. This study was intended to simulate atrophy that would occur form an injury resulting in non-use of the muscle. Eleven healthy males had their ankles casted and immobilized for two weeks and were instructed to use crutches. Subjects were dived into a control group (no intervention) and a restricted blood flow group. Strength was measured at the knee extensors and the ankle plantar flexors at the end of two weeks. Changes in isometric and concentric contractions were significantly smaller in the RBF group showing that restriction of blood flow (with 50 mm Hg cuff) reduced muscular weakness.
Blood Flow Restriction Training For Recovery
Adding in blood flood restriction, just as you would use self-myofascial release (aka foam rolling) is an excellent way to promote recovery and influence healing without losing strength. Application of this developing method may be worth implementing into your routine in conjunction with other conventional forms of rehab. Consult a physical therapist in order to determine the best parameters for your specific situation.
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ABOUT THE AUTHOR
- Kubota, A, et al. “Blood Flow Restriction by Low Compressive Force Prevents Disuse Muscular Weakness.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Mar. 2011, ncbi.nlm.nih.gov/pubmed/21035395.
- Loenneke, J P, et al. “Low-Intensity Blood Flow Restriction Training: a Meta-Analysis.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, May 2012, www.ncbi.nlm.nih.gov/pubmed/21922259.