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Science Behind Blood Flow Restriction Therapy

Blood flow restriction builds muscle faster without heavy lifting. It is a popular and effective training method for athletes, healthy and elderly individuals and is also valuable in rehabilitation medicine. New research reports it is beneficial to cardiovascular health, has potential applications in treating diabetes, and may be valuable in neuromuscular disorders.

How does blood flow restriction work?

Blood flow restriction reduces the amount of oxygen and nutrients reaching the muscle while it is being exercised, which can lead to an increase in metabolic stress and muscle damage. When muscles are damaged it stimulates the body to repair and rebuild the muscles. Heavy lifting is usually necessary to achieve this result. However, blood flow restriction produces muscle growth and strength gains when the exercise is performed with lighter weights. The bottom line is that blood flow restriction delivers the benefits of heavy weightlifting without the risks. This makes it ideal for people who can’t lift heavy weights. Blood flow restriction prevents muscle atrophy and builds muscle.

Blood flow restriction has been shown to be effective for improving muscle size, strength, and endurance in a variety of populations, including older adults and those with various medical conditions. It can improve mobility and reduce the risk if falls and enhance rehabilitation after surgery or injury.

What is the science supporting blood flow restriction?

The science of blood flow restriction (BFR) is a growing field of study that seeks to understand the underlying mechanisms by which restricting blood flow to a working muscle can improve muscle function and growth.

BFR has been shown to be safe and effective therapy various conditions, including:

  1. Blood flow restriction can help to prevent muscle wasting and promote muscle growth, especially in older individuals and people with limited mobility. It can also help in cases where the patient has been immobilization from pain and recovery.
  2. Blood flow restriction can help to improve strength and endurance in athletes and people who engage in physical activity.
  3. Blood flow restriction improves functional sports performance including jumping, running, and sprinting, in healthy athletes.
  4. Blood flow restriction can reduce rehabilitation time after surgery or injury.
  5. Blood flow restriction has been used to aid in the rehabilitation of athletes after injury, as well as to treat conditions such as knee osteoarthritis and rotator cuff tears.
  6. Blood flow restriction has been used to help manage chronic pain and reduce the need for pain medication.
  7. It has also been shown to be beneficial for individuals with conditions such as knee osteoarthritis, where weight-bearing exercise may not be possible or safe.
  8. Blood flow restriction with low intensity resistance training can safely lead to increased lower extremity strength and function in people with Parkinson’s Disease.
  9. Studies report that BFR training increased muscle size and strength in upper body muscles including the chest and shoulders, biceps, and triceps.
  10. A recent study reports that the benefits of blood flow restriction extend beyond training. It can improve cardiovascular fitness and reduce pain and has benefits for postoperative rehabilitation.
  11. A 2022 study reports that blood flow restriction can decrease recovery time in postoperative orthopedic rehabilitation as well as injury prevention.
  12. A 2022 study found use after osteotomy or any procedure where bone drilling is used showed improved bone health.
  13. A 2019 study reports that blood flow restriction can improve quadriceps muscles and physical function after total knee replacement.
  14. Another 2019 study reports that blood flow restriction benefit extend beyond early postoperative recovery after ACL ligament reconstruction.
  15. A 2023 study reports that blood flow restriction benefits include decreased pain, improved function and quality of life for patients with neuromuscular disorders.
  16. A 2022 and a 2021 study reports that blood flow restriction with Low intensity training can be used for people with MS, and Parkinson’s.
  17. A 2021 study found that blood flow restriction with Low intensity resistance training may be helpful for patients with rheumatoid arthritis and osteoarthritis.

At. CAO Sports Performance we can teach you to workout smarter not harder, and recovery your strength and endurance after injury or surgery. Contact us to schedule a consultation and learn how we can help you achieve your performance goals and recovery after surgery or injury.

  • Lixandrão ME, Ugrinowitsch C, et al. Magnitude of Muscle Strength and Mass Adaptations Between High-Load Resistance Training Versus Low-Load Resistance Training Associated with Blood-Flow Restriction: A Systematic Review and Meta-Analysis. Sports Med. 2018 Feb;48(2):361-378. doi: 10.1007/s40279-017-0795-y. PMID: 29043659.
  • Saatmann N, Zaharia OP,et al. Effects of Blood Flow Restriction Exercise and Possible Applications in Type 2 Diabetes. Trends Endocrinol Metab. 2021 Feb;32(2):106-117. doi: 10.1016/j.tem.2020.11.010. PMID: 33358931.
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  • Baker BS, Stannard MS, et al. Does Blood Flow Restriction Therapy in Patients Older Than Age 50 Result in Muscle Hypertrophy, Increased Strength, or Greater Physical Function? A Systematic Review. Clin Orthop Relat Res. 2020 Mar;478(3):593-606. doi: 10.1097/CORR.0000000000001090. PMID: 31860546; PMCID: PMC7145054.
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  • Chang H, Yao M, et al. Effects of Blood Flow Restriction Combined with Low-Intensity Resistance Training on Lower-Limb Muscle Strength and Mass in Post-Middle-Aged Adults: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 Nov 25;19(23):15691. doi: 10.3390/ijerph192315691. PMID: 36497769; PMCID: PMC9735845.
  • Zhang T, Tian G, Wang X. Effects of Low-Load Blood Flow Restriction Training on Hemodynamic Responses and Vascular Function in Older Adults: A Meta-Analysis. Int J Environ Res Public Health. 2022 May 31;19(11):6750. doi: 10.3390/ijerph19116750. PMID: 35682336; PMCID: PMC9180641.
  • Dankel SJ, Jessee MB, et al. The Effects of Blood Flow Restriction on Upper-Body Musculature Located Distal and Proximal to Applied Pressure. Sports Med. 2016 Jan;46(1):23-33. doi: 10.1007/s40279-015-0407-7. PMID: 26446893.
  • Cognetti DJ, Sheean AJ, Owens JG. Blood Flow Restriction Therapy and Its Use for Rehabilitation and Return to Sport: Physiology, Application, and Guidelines for Implementation. Arthrosc Sports Med Rehabil. 2022 Jan 28;4(1):e71-e76. doi: 10.1016/j.asmr.2021.09.025. PMID: 35141538; PMCID: PMC8811521.
  • Watson R, Sullivan B, et al. Blood Flow Restriction Therapy: An Evidence-Based Approach to Postoperative Rehabilitation. JBJS Rev. 2022 Oct 3;10(10). doi: 10.2106/JBJS.RVW.22.00062. PMID: 36191086.
  • Kilgas MA, DenHerder AE, et al. Home-Based Exercise With Blood Flow Restriction to Improve Quadriceps Muscle and Physical Function After Total Knee Arthroplasty: A Case Report. Phys Ther. 2019 Nov 25;99(11):1495-1500. doi: 10.1093/ptj/pzz110. PMID: 31392999.
  • Kilgas MA, Lytle LLM, et al. Exercise with Blood Flow Restriction to Improve Quadriceps Function Long After ACL Reconstruction. Int J Sports Med. 2019 Sep;40(10):650-656. doi: 10.1055/a-0961-1434. Epub 2019 Jul 23. PMID: 31342480.
  • Reina-Ruiz ÁJ, Martínez-Cal J, et al. Effectiveness of Blood Flow Restriction on Functionality, Quality of Life and Pain in Patients with Neuromusculoskeletal Pathologies: A Systematic Review. Int J Environ Res Public Health. 2023 Jan 12;20(2):1401. doi: 10.3390/ijerph20021401. PMID: 36674158; PMCID: PMC9858892.
  • Anderson KD, Rask DMG, et al Overall Safety and Risks Associated with Blood Flow Restriction Therapy: A Literature Review. Mil Med. 2022 Aug 25;187(9-10):1059-1064. doi: 10.1093/milmed/usac055. PMID: 35284924.
  • Douris PC, D’Agostino N, et al. Blood flow restriction resistance training in a recreationally active person with Parkinson’s disease. Physiother Theory Pract. 2022 Mar;38(3):422-430. doi: 10.1080/09593985.2020.1762812. Epub 2020 May 13. PMID: 32400274.
  • Cohen ET, Cleffi N, et al. Blood-Flow Restriction Training for a Person With Primary Progressive Multiple Sclerosis: A Case Report. Phys Ther. 2021 Mar 3;101(3):pzaa224. doi: 10.1093/ptj/pzaa224. PMID: 33351952.
  • Dos Santos LP, Santo RCDE, et al. The effects of resistance training with blood flow restriction on muscle strength, muscle hypertrophy and functionality in patients with osteoarthritis and rheumatoid arthritis: A systematic review with meta-analysis. PLoS One. 2021 Nov 10;16(11):e0259574. doi: 10.1371/journal.pone.0259574. PMID: 34758045; PMCID: PMC8580240.

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