Blood Flow Restriction F.A.Q.

What is blood flow restriction?

Blood flow restriction (BFR) uses a flexible nylon cuff applied to your upper arm or upper leg to inhibit and limit venous (veins) blood flow. With this restriction, you can complete simple exercises with lighter weight. This creates a similar amount of hypertrophy (muscular growth) as heavy lifting without causing strain or stress to your joints. Also, you see these changes in a 2-3 week period, compared to 8-12 weeks for a normal heavy lifting program.

Who benefits from BFR?

The treatment can be used for numerous diagnoses and cases. More common uses include rehab for orthopedic injuries and post surgery rehab. Patients who cannot lift or tolerate heavier weights, including those with arthritis, can significantly benefit from the therapy.

Is blood flow restriction therapy dangerous?

When used appropriately with a trained clinician, BFR provides you with a safe way to increase your strength and improve your recovery. Prior to attempting BFR, your therapist screens you to see if you are a candidate for blood flow restriction. There are very few conditions which prevent a patient from being able to use BFR. Those include: severe diabetes, active cancer, current and active blood clots, and other severe cardiovascular involvement. Your therapist reviews multiple precautions from your medical history prior to use of BFR.

How do you use BFR?

BFR requires the application of flexible nylon cuffs to your upper arms or legs while connected with tubing to the BFR unit. Your therapist selects 3-5 relevant exercises while BFR gets applied. While exercising, the unit inflates the band in order to restrict blood flow through your extremity. You’ll complete repetitions of the exercise for eight 30-second sets with a 5-10 second rest break between sets.

So restriction bands work for glutes?

Yes! Research shows muscle groups not below the cuff show a “whole-body” response to exercise. This means muscle groups like your glutes, rotator cuff and upper back muscles benefit from BFR despite not being below the cuff.

Does BFR increase my strength?

While BFR creates muscular growth, current research shows improvements in muscular strength too.

What type of injury benefits from blood flow restriction?

BFR can be used for repeated stress injuries, patients with “non-weightbearing” precautions and many athletic/orthopedic injuries.

How does BFR help these specific conditions?

• Knee ligament reconstructions – Due to the increased swelling, muscular disuse and atrophy (shrinking), BFR can be used within the first 1-2 weeks. This creates a foundation of muscular hypertrophy and strength. Most commonly, BFR targets the quadriceps, hamstring, calves and glute muscle groups.
• Achilles repairs – Surgery causes a severely weakened achilles. BFR allows a patient to do light strengthening exercises to build calf muscle strength while strengthening the achilles tendon fibers tendon to prevent re-injury.
• Knee cartilage repairs – After a meniscus repair, patients are often limited in the amount of weight they can place through their surgical leg. When indicated and recommended in this case, BFR helps build muscular strength with non-weight bearing exercises to prepare and increase the tolerance of the surgical leg.

• Muscle strains – After a muscle strain, generally a patient cannot lift weights as they normally would. BFR allows a patient to lift a lighter weight, while getting strength and hypertrophy benefits associated with exercising. This eases the patient’s return to their normal activities.
• Rotator cuff repairs – BFR assists in strengthening the stabilizing and supporting muscle groups. This helps create hypertrophy and strength improvements of the rotator cuff muscles even though they are “above” the BFR cuff. BFR provides a systemic effect allowing for strength and hypertrophy of all muscles involved in exercise.
• Symptomatic knee osteoarthritis – Patients with arthritic knees often experience increased pain with heavy weights used for exercises. As a result, the treatment is perfect for this diagnosis. We can get similar strength benefits with lighter weights and increased repetition which an arthritic knee tolerates better. Exercise  improves arthritic pain, but dosed carefully. This is where BFR becomes an asset.
• Total joint replacement – After suture removal, BFR helps basic lower strengthening with little to no weight.  This allows for comparable hypertrophy and strength improvements as one gets with heavy lifting.