Blood Flow Restriction Training: A New Way to Build Strength and Recover from Injury?
What is BFR Training?
Imagine you're trying to build muscle or get stronger, but lifting heavy weights is just too painful or difficult, perhaps because of an injury, surgery, or a condition like arthritis. That's where Blood Flow Restriction (BFR) training comes in.
BFR, also known as "occlusion training," is a special exercise method where you wear a cuff, similar to a blood pressure cuff, on your arm or leg. This cuff is inflated to a specific, gentle pressure that partially limits blood flow to the muscle you're working. It's essential to emphasise that this is a partial restriction, not a complete cutoff of blood flow. The best way to do this is with a special cuff that can measure exactly the amount of pressure needed for you.
Why is BFR Different and Helpful?
Normally, to build bigger and stronger muscles, you're told you need to lift heavy weights – usually more than 70% of the most you can lift just once. And while heavy lifting is still a great way to get strong, recent research shows that you can also build muscle with lighter weights if you work until your muscles are fatigued.
But BFR is special because it can help you build muscle and strength even with very light weights, sometimes as light as 30% of what you can lift once. This is a huge benefit if you're injured, just had surgery, or have a condition that makes heavy lifting painful or risky.
Think of it this way:
If you're recovering from an injury or surgery: You might not be able to put a lot of stress on the injured area. BFR lets you work those muscles with light weights, helping you keep your muscle size, prevent weakness, and start exercising earlier in your recovery.
If you have painful joints (like knee arthritis): Heavy lifting can often make joint pain worse. With BFR, you can get the same benefits for muscle size and strength as heavy lifting, but with much less joint pain because you're using lighter weights.
Beyond building muscle, BFR training also seems to have other benefits. It might help improve your bone health, and in older adults, it could help prevent the natural loss of muscle mass that comes with ageing.
How Does BFR Training Work? (The Science Bit, Made Simple)
When you use the cuff during BFR training, your muscles don't get as much blood and oxygen. This creates a unique "stress" on the muscle. This stress, combined with the normal effort of exercise, tricks your muscles into thinking they're working much harder than they actually are. This tricks them into growing bigger and stronger, even with light weights. Scientists are still learning all the exact details of how this happens, but the results speak for themselves.
Is BFR Training Safe?
It's natural to worry about limiting blood flow. However, many studies have looked into the safety of BFR, and they conclude that when done correctly, BFR is generally as safe as regular exercise.
Serious problems are very rare. There have been a few, very uncommon reports of severe muscle damage, but this is usually in people who have been inactive for a very long time, have an infection, or certain other health issues. For most people, the risk of muscle damage is very low.
You might feel some muscle soreness the day after BFR training, similar to how you feel after a new or intense workout. This is normal and usually goes away within a day or two.
There's also been some discussion about how BFR might affect your heart rate and blood pressure. While it's always important to be aware of this, especially if you have heart conditions, high blood pressure, or circulation problems, the risk can be greatly reduced. This is done by:
Checking with your doctor first: This is crucial, especially if you have any pre-existing health conditions.
Using individualised cuff pressures: The pressure should be tailored specifically for you, not a one-size-fits-all approach.
Using the lowest effective pressure: Research shows that you don't need very high pressures to get good results. Using lower pressures is safer and still provides the same benefits
Concerns about blood clots have also been raised, but studies in healthy people and older adults with heart disease haven't shown an increased risk of blood clots with BFR training. Sometimes, you might feel some numbness in the limb with the cuff. This usually means the pressure is too high, which is why getting the right, individualised pressure is so important.
In a Nutshell:
BFR training is a promising new way to help people build muscle and get stronger, especially if they can't lift heavy weights due to injury, surgery, or long-term conditions like arthritis.
It appears to be safe, especially when guided by professionals and following established guidelines.
The most important things are:
Talk to your doctor or a healthcare professional to make sure BFR is right for you.
Make sure the cuff pressure is customised for you and kept as low as possible while still getting a good training effect.
BFR offers a smart alternative to traditional heavy lifting, helping you recover, build strength, and maintain muscle even when heavy exercise isn't an option. Scientists are continuing to learn more about BFR's full potential and how to make it even safer and more effective for everyone.
References:
Jessee, M. B., Buckner, S. L., Mouser, J. G., Mattocks, K. T., & Loenneke, J. P. (2016). Letter to the editor: Applying the blood flow restriction pressure: the elephant in the room. American journal of physiology. Heart and circulatory physiology, 310(1), H132–H133.
Hughes L, Paton B, Rosenblatt B, et al Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysisBritish Journal of Sports Medicine 2017;51:1003-1011.
Schoenfeld, B. J., Wilson, J. M., Lowery, R. P., & Krieger, J. W. (2016). Muscular adaptations in low- versus high-load resistance training: A meta-analysis. European journal of sport science, 16(1), 1–10.
Wortman, R. J., Brown, S. M., Savage-Elliott, I., Finley, Z. J., & Mulcahey, M. K. (2021). Blood Flow Restriction Training for Athletes: A Systematic Review. The American journal of sports medicine, 49(7), 1938–1944.
Minniti, M. C., Statkevich, A. P., Kelly, R. L., Rigsby, V. P., Exline, M. M., Rhon, D. I., & Clewley, D. (2020). The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review. The American journal of sports medicine, 48(7), 1773–1785
Patterson, S. D., Hughes, L., Warmington, S., Burr, J., Scott, B. R., Owens, J., Abe, T., Nielsen, J. L., Libardi, C. A., Laurentino, G., Neto, G. R., Brandner, C., Martin-Hernandez, J., & Loenneke, J. (2019). Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety. Frontiers in physiology, 10, 533.
