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Blood Flow Restriction Training: Deserving the Hype?

Updated: Sep 27, 2019

If you read my previous blog post or have been monitoring the sports world over the past several years, you have likely seen blood flow restriction (BFR) training. This technique, while not particularly new, is gaining traction in the rehabilitation world. BFR involves the utilization of a surgical-standard tourniquet and the performance of exercise at very low load and weight. But the incredible part of BFR is that we can simulate high-intensity exercise with only about 20% of your maximum capacity. So, we can exercise at low loads but achieve many of the benefits from high-intensity strength training.

In truth, high-intensity and loaded exercise is the gold standard for improving strength, tissue health, aerobic capacity, recovery from injury, systemic conditions, and even mental health. We can run into difficulties training at high loads, however, when we are recovering from injury, surgery, stress fracture, or deconditioning. Therefore, if we can utilize a technique to create the environment of high-intensity exercise without actually having to move these loads, perhaps we can achieve some of the same results. BFR accomplishes exactly this. But how?

So we know we want to simulate an environment of high-intensity exercise without having to move those loads. By doing this, we introduce a stimulus to your body and tissues which then begins a cascade of changes to improve your health and overall function. BFR causes this via multiple pathways. Let’s explore:

· Metabolite Stress

o By creating this environment of metabolites (chemicals that appear in response to exercise), we are able to confuse the body into releasing more lactate, which then causes an increase in human growth hormone.

o Human growth hormone doesn’t actually increase muscle mass, BUT it does improve your recovery drastically via increasing muscle protein synthesis.

· Protein Synthesis

o We know that HGH increases with BFR, but we also experience increases in mTOR (mammalian target of rapamyacin). Think of mTOR as the precursor to additional protein synthesis.

o You will experience 70% increase in the mTOR pathway following BFR. That’s 70% more work happening to improve your muscle protein synthesis!

· Ischemic Conditioning

o By creating an environment that is ischemic (low oxygen content) we are telling your body that the exercise we are performing needs more oxygen to complete it.

o This works on a whole-system level to decrease your inflammatory processes, improve neural function, and improve muscle recruitment.

· Satellite Cell Activation

o Scar tissue (fibrosis) formation occurs with injury or immobilization following surgery, and is removed via satellite cell activation.

o BFR increases satellite cell activation which in turn works to start tissue-changes to remove fibrosis and scar tissue.

· Endogenous opioids

o Did you know that your body creates its own opioids to control pain? Well it does!

o BFR increases lactate presence, which in turn increases the creation of endogenous opioids in your brain. Natural pain killers!

· Human Growth Hormone and Bone Health

o BFR results in an increase in human growth hormone as we discussed earlier, but this then causes an increase in osteoblast activity which works to repair bone. This is the primary driver for healing following a fracture or stress fracture.

· Angiogenic Growth

o An important part of healing and performance is the development of new capillaries and vascularity, in addition to bone healing.

o BFR causes a 6.5x increase in VEGf which then leads to an increase in capillarity of 14%!

I know I just tossed a lot of science and jargon your way. But to summarize, you can just remember that BFR causes improvements in strength, healing, bone health, capillary/blood vessel creation, pain reduction, and recovery.

You may be wondering what the training actually looks like! We use this tourniquet which feels much like a blood pressure cuff wrapped around your thigh or upper arm. Then we do exercise with low weight to the tune of a set of 30, followed by 3 sets of 15. That’s it! We will do one exercise per muscle group and you will begin to experience these awesome results.

Interested in learning more about BFR and how it can help you? Reach out to us today!

Keep training,



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