Blood Flow Restriction Therapy (BFRT)

What it is/background:

BFRT was first invented by Dr. Yoshiakia Sato from Japan in 1966. BFRT has become popular with weightlifters, professional sport athletes, and medical professionals over the recent years. BFRT is a strengthening technique that uses a device similar to a blood pressure cuff, which safely restricts blood flow to a muscle.

How does it work:

A cuff is placed over the most proximal part of the limb that you are working on. The cuff applies an external pressure that will restrict venous blood flow while allowing arterial blood flow to the muscles. The lack of oxygen to the area will increase growth hormones, muscle strength, muscle hypertrophy, aerobic capacity, and improve recovery from injury. Typically, BFRT is performed at 80% limb occlusion pressure (LOP) in the lower extremity and 50% of LOP in the upper extremity. A limb protection sleeve is placed under the cuff to decrease friction. There are 3 protocols that you can choose depending on your rehabilitation goals:

  1. Strength training protocol:
    The intensity will be at 20-30% 1 RM. The person will perform a total of 4 sets (30 reps -15 reps -15 reps -15 reps) for one BFRT exercise. It is recommended to take a 30 to 60 second rest break between reps. The cuff is not deflated between sets but is deflated between exercises.
  2. Endurance training protocol:
    The person will perform a cardiovascular exercise, such as walking or cycling at 20-40% HRR or VO2 max.
  3. Passively without exercise:
    The cuff should be applied to the desired limb for a maximum of 5 minutes with a 3-5 minute rest break between sets.

What conditions do you use it to treat:

  • BFRT can treat a variety of conditions. Some examples include:
  • Generalized weakness
  • Upper or lower extremity fracture
  • ACL repair
  • Achilles tendonitis
  • Tennis elbow
  • Meniscus injury
  • Rotator cuff injury

Is it safe? Are there any risks or contraindications?

BFRT is safe when performed by trained medical professionals following the appropriate protocol. However, there can be common side effects when using this modality. They include:

  • Dizziness or fainting
  • Numbness or tingling in the limb
  • Muscle pain or DOMS

Additionally, not everyone may be appropriate for BFRT. So there are some contraindications that need to be considered before using. Some, but not all include:

  • Obesity
  • Poor circulation
  • Diabetes
  • DVT
  • High blood pressure
  • Infection
  • Pregnancy
  • Skin grafts
  • Cancer