
What is Blood Flow Restriction Training?
Have you ever had surgery on your arm or leg, where after the bandages and stitches come off you notice a size difference in the limb? This change in circumferential size is likely due to atrophy, or shrinkage in the size of the muscles. This is a common side effect of how the body responds to injury or surgical invention. The problem, though, is that it can take a longer to time to restore the muscle size than it did to lose it.
Muscles gain strength by being stressed with loads. Let’s use a dumbbell bicep curl as an example. Your goal is to gain size in your bicep muscles. If you use a 5 lb. dumbbell and perform 3 sets of 20 reps a few times a week, you will get stronger but to a point. The strength gains will be more associated with a neural adaptation and you likely won’t see any hypertrophy. Conversely, if you used a 30 lb. dumbbell and did 3 sets of 4 reps of curls a few times per week, you would likely develop both improved strength and size of the muscle. In rehabilitation, we are usually dealing with injured or surgically repaired tissues. The problem is, injured tissues cannot tolerate the loads necessary to increase strength and hypertrophy, which lengthens the time of rehab and duration to restore normalized girth in the affected muscle. That is where Blood Flow Restriction Training comes in.

BFRT is a safe and effective method to build muscle size and strength by utilizing low-intensity resistance at sub-maximal levels, yet you still reap the benefits of high-intensity resistance training. BFRT essentially tricks the brain and body into thinking it is performing high-intensity exercise without applying the high loads to the tissue. It helps with recovery from injury or surgery by being able to work muscles with significantly less intensity while reaping the benefits similar to high-intensity resistance training.
How does it Work?
BFRT is performed by having the patient wear an adjustable cuff around either their thigh or arm, set to a specific and individualized pressure determined by an external doppler. The cuff is worn for short and intermittent periods and restricts a percentage of arterial blood flow and venous return. This restriction in blood flow causes physiological changes that mimic changes associated with high-intensity exercise. BFRT makes easy exercises at low intensities seem really hard by causing fatigue and muscle failure to occur much sooner.
Watch the video below to see BFRT in action. The man in the video is lifting only 4lbs of weight, but his right quadriceps muscle begs to differ. It feels more like it 30 or 40lbs!
History of BFRT
BFRT was originally developed by Yoshiaki Sato of Japan in the 1960s. After fracturing his ankle while skiing, he was placed in a cast and told by his physician it would take ~6 months to heal. Unhappy with the lengthy prognosis his doctor estimated, Sato began experimenting with exercises while in his cast. He began applying elastic bands to his upper leg while performing long-duration isometric exercises several times per day. As a result, his muscles did not atrophy, and he fully recovered within a six-week period.
In 2011, BFRT was first brought onto the U.S. rehabilitation scene by the military in an effort to help soldiers with skin and tissue grafts heal. Later with experimentation and research, rehab programs were developed to aid in strengthening the limbs of soldiers needing prosthetics. The successes of BFRT in the military caught the attention of strength and conditioning specialists and soon became a mainstay in both professional and collegiate training rooms. As more research was performed on the effectiveness and safety of BFRT, the modality has now become popular amongst physical therapists for the care of everyday athletes, just like the ones we treat at Move Empower Concierge Physical Therapy.
Would I Benefit From Blood Flow Restriction Training?
BFRT is ideal for populations who have limitations to high loads on their joints or tissues. At Move Empower Concierge Physical Therapy, we use BFRT with many upper and lower limb problems. From Runner’s Knee pain, post-operative tendon repairs, fractures, to rotator cuff problems. BFRT is just one tool in the treatment box. It is a great way to help accelerate one’s rehab, recover faster, and return to a higher quality of life. It is not, however, the end all, be all of your physical therapy plan of care. It is one tool in the tool box to help get you back to the activities and sports you love to do.

Curious if Blood Flow Restriction Training would benefit you? Give us a call at 512-659-5615 or take advantage of our complimentary 20 min Discovery Session to speak with one of our physical therapists! It’s a great way for us to learn more about your injury and determine if we are the best fit for you. Click here to schedule your Discovery Session!