Blood Flow Restriction Therapy FAQs

free weights

By Tyler Lusignan

Therapydia NOLA

Blood Flow Restriction Therapy or BFR is a brief and intermittent occlusion or restriction of arterial and venous blood of the upper or lower extremity (arm or leg). BFR can be used to augment skeletal muscle adaptation, promote systemic metabolic and cardiovascular changes while at rest or with low intensity endurance or resistance activities. BFR has been found to be safe when applied with pressures relative to the cuff and when used with individualized limb occlusion pressures. 

Question: How does blood flow restriction therapy work?

Answer: BFR works in simplest terms by promoting muscle hypertrophy at low loads. Historically, building muscle required working out at a higher percentage of an individual’s one rep max (typically 70% of 1RM) or lower percentages (30-50% of 1RM) until failure. Researchers have shown that training with BFR at 20-40% of 1RM can produce similar hypertrophy results. While traditional thoughts about building muscle were centered around mechanical stress, BFR has introduced the idea of metabolic stress producing similar results. The exact physiological mechanism for this is not fully understood at this time, but the most consistent theory states that the BFR promotes greater metabolites that elicit an anaerobic response in the muscle and as a result muscle swelling and muscle fiber recruitment occurs. 

Question: When is it used?

Answer: BFR can be used for anyone who is attempting to build muscle and return to their prior level of functioning. BFR should not replace high load resistance training altogether, but rather be a bridge to lifting heavier weights when an individual can not tolerate heavier weights. BFR can be used by those individuals who have undergone recent surgery and need to protect their surgical site. This protection period of time requires avoiding heavy weights, but with BFR lighter weights can be used to elicit hypertrophy gains in as little as four weeks while still protecting the surgical site. BFR can also be used in the elderly population who may be experiencing deconditioning and want to begin strengthening again. Finally, BFR can be used in the healthy and athletic population. This population can promote muscular metabolic adaptation while also decreasing training loads and promoting activity longevity and performance enhancement via neural adaptations. 

Question: What are the benefits of Blood Flow Restriction Therapy?

Answer: The benefits of BFR therapy include:

  • Improved muscle mass
  • Improved muscle strength
  • Improved cardiovascular endurance 
  • Increased positive bone density metabolites
  • Increased functional outcomes
  • Increased self efficacy 

Question: Is Blood Flow Restriction Therapy a safe practice?

Answer: When used in a controlled environment and by trained professionals, BFR is a safe training alternative to a wide variety of individuals with varying training levels. To determine a participants level of risk, a numerical scale is used to ensure patient/client safety concerning BFR contraindications. 

Some of these contraindications include: 

  • History of DVT
  • Acute sickness or fever
  • Currently pregnant 
  • High blood pressure (>180/100 mmHG)
  • Early post-op periods 
  • Cardiovascular disease – high class arrhythmia or coronary ischemia 
  • Rhabdomyolysis
  • Varicose veins 

Some precautions include: 

  • Subcutaneous hemorrhage 
  • Extremity numbness
  • Delayed Onset of Muscle Soreness (DOMS)
  • Feeling cold or Raynauds 

If BFR is something you are interested in and or have questions about, please feel free to make an appointment at your local Therapydia. We have certified and trained physical therapists that will help you implement BFR into your routine and get you back to your physical activity goals quicker and stronger than ever! 

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