Blood Flow Restriction hype or legit?

How legit Blood Flow Restriction?

Training with Blood Flow Restriction also know as occlusion, has gotten both clinicians and strength enthusiasts all over the globe, with everyone saying it work for lesser effort. We dive into this subject and clear out some myths about BFR and the application mechanics that makes it legit or all hyped up by a new tool in the industry. 

What is blood flow restriction(BFR) training? 

With claims such as below, you can see how and why it's gaining traction, let's start asking question, read on.

• "BFR has gained interest as an exercise technique and could be a revolutionary tool to decrease the time to return to sport postoperatively"

• BFR has been used in athletes and recreational training to obtain muscle hypertrophy. It can also be used in clinical populations that cannot perform high intensity exercises because of the stage of their condition or pathology involved.

• Blood flow restriction: A potential new approach to rehabilitation?

NOTE: A simpler way to understand what occlusion means is inducing blockage or closing of a blood vessel or hollow organ, which you may see often described in some websites as "occlusion training" etc. 

Clinicians, strength enthusiast, rehabilitation specialists all over are gaining traction with this new tool in the clinical seeing results, but are they all having the placebo ride as with some of the tools out there that gains popularity and then fades away like smokes. 

The aim of BFR, is to safely restrict venous blood flow from a working muscle while allowing arterial blood flow, which is usually done with low-intensity resistance training. Since the ability of that blood to escape is dramatically reduced, metabolic stress and cellular swelling are greatly increased. As a result, increased growth hormone, muscle hypertrophy, and muscle strength (are said) to occur. An increased of GH(growth hormones), hypertrophy of muscles, & muscle strength is seen both statistically and physical. 

Types of BFR cuffs

There are two types which is dominant for BFR induced training, below are the main ones that you would find for both rehab and strength programmes which includes occlusion. 

Pic 1 is a manual version that does not need any pump gauge and uses a number system where the user will just tighten and see from the number where they feel comfortable enough to carry on occlusion training with a clip. While this is easy to carry, just wrap, clip and train without the bulky items of the pumps and gauge, the material itself has been shown to lose elasticity after a few use. It as well does not fully restrict venous blood flow as much as the cuffs using a pump gauge. Plus points about this? It's cheap. 

Pic 2 is a sturdier occlusion cuff, with the user being able to adjust with more precision, restrict venous blood flow and more importantly while allowing arterial blood to flow back! It's not much of a drawback with the sports model as you would be able to adjust and the sports model usually will have a doppler to help the certified BFR practitioner make sure it's exactly what you need by slowly increasing or decreasing the pressure to balance the flow of arterial and venous flow. Plus point about this? Sturdier but at a cost for obvious reasons! 

What are some fo the benefits of BFR? 

With any new tool that is made available to anyone, you want to know the benefits in order to see if it will fit your conditions or goal(s). Listed below are some fo the benefits & contraindicated conditions as follows. The list is non exhaustive list: 

• Lower atrophy and loss of strength
• Increase in strength with only 30% loads
• Increase hypertrophy (the growth and increase of the size of muscle cells) 
• Improve muscle endurance in 1/3 the time
• Improve muscle protein synthesis in the elderly
• Increase your strength and hypertrophy after surgery
• Improve muscle activation in shorter time(session times are cut down!)
• Increase in growth hormone responses

Contraindications

When you have one or some of the conditions below which is a non exhaustive list, you are caustioned to use BFR training. Always seek a medical professional if you want to try it out but unsure. 

• Venous thromboembolism(VT)
• Impaired circulation or peripheral vascular compromise
• Previous revascularization of the extremity
• Extremities with dialysis access
• Acidosis
• Crushed/ fractured bone in extremities
• Extremity infection
• Tumor distal to the tourniquet
• Medications and supplements known to increase clotting risk
• Diabetes 
• Heart condition(stroke)

Who can use this? 

While anyone can apply this, it's always about safety, and if you want to be sure that you are not doing yourself more harm than good, ensure that you sit for a course to safely and efficiently be able to apply this in either a professional setting such as a clinic, rehab centre or personal use for family and friends. If you keep doing occlusion training and each time you are cutting out the arterial blood flow and not aware of how you release the cuffs, you may endanger yourself by a sudden rush of blood flow into the system or area! 

Reliability of BFR training

As for those who are concerned about evidence based tool, clinically speaking with all the current developments / research it is suggesting and showing plenty of positive than negative outlook. Below we have provided some links for you to read on and hopefully it will start a small little research to make your decision if this new tool will be clinically relevant both for professional use or personal. 

1. Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis.

2.  Blood Flow Restriction Therapy: From Development to Applications

3. Blood Flow Restriction Training: Implementation into Clinical Practice

4. The Effects of Blood Flow Restriction Therapy on Physical Performance in Adults as Compared to Standard Physical Exercise and Control Groups: Systematic Review 

More extensive reading can be found here

With all the above covered, there is still a lot more to learn as developments in validity of the research as some of the mechanics are not fully understood. Always seek to weigh out the risk to benefit ratio using any form of tool, so far, the BFR without any contraindicated condition(s) is showing positive results from post operative, to hypertrophy, to geriatric who needs to do less weight bearing exercises. Don't be surprised if you see BFR being used in a Sports Medicine Centre, Rehabilitation Facilities, High Performance gyms and even outdoor group training! 

If you are in Singapore and want to learn how to safely use this for personal or professional settings, we have a few course running to have you practise the next day after learning. BFR is seamlessly easy to blend into your practise if you see patients with pain or those who wants to build muscles with the least amount of loading! Let us know your interest by sending us your details on the link below and we will update you on our upcoming BFR certification course! 

BFR certification course interest