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The cutting edge in training and rehabilitation: Blood Flow Restriction Therapy

Posted on: March 9th, 2018 by Dr. Geoffrey S. Van Thiel

Pretty much everyone knows a steady supply of blood is necessary to promote healthy tissue growth and development. But recently, doctors and physical therapists have begun looking at a new technique that actually restricts blood flow to help improve muscle mass or hypertrophy, helping muscle tissue get bigger and rehabilitate without resorting to increasingly heavier weights and more and more reps. The technique is called blood flow restriction therapy or BFR, and it uses special restrictive “cuffs” to limit blood flow in specific muscles or muscle groups during workouts and physical therapy. Initially developed by medical researchers in Japan, blood flow restriction therapy has gained worldwide attention among bodybuilders as well as people recovering from specific types of injuries. Here’s how it work.

What Causes Muscle Hypertrophy?

Muscle mass increases when muscle fibers are subjected to mechanical stress – that is, when muscles are forced to bear physical loads like the loads exerted during weight-lifting and physical therapy. Those loads stimulate a “signaling cascade” that in turn recruits special muscle fibers known as type 2 or “fast twitch” fibers – the fibers that are responsible for muscle mass growth or hypertrophy.

Of course, not every load is heavy enough to trigger that cascade. For instance, lifting something lightweight like a can of soup relies on type 1 or “slow twitch” muscles; in lighter loads, the signaling cascade isn’t triggered and type 2 muscle fiber recruitment doesn’t occur. The key to muscle hypertrophy is to use weights that are heavy enough to promote type 2 fiber recruitment without overburdening or straining the muscle. So how much weight is that? According to the American College of Sports Medicine, under normal circumstances, a muscle load of between 60% and 100% of the muscle’s capability is about right. That means a lot of lifting of progressively heavier weights in order to improve the mass and weight-bearing ability of a specific muscle.

How BFR Works

Type 2 muscle fiber recruitment (and the signaling cascade that triggers recruitment) depends to some degree on the amount of available oxygen in and around the muscle tissues. When a muscle is forced to bear a heavier load, it consumes more oxygen, and eventually, the amount of available oxygen decreases. That’s when the signaling cascade “kicks in,” recruiting type 2 fibers to help bear the additional load so the muscle can continue to perform.

BFR works by “tricking” the body into recruiting those type 2 “fast-twitch” fibers even when lighter weights are used. How? Through careful application of special cuffs – much like the cuffs used to measure blood pressure – that restrict the flow of blood and oxygen to the muscles. The cuffs create an anaerobic environment that in turn triggers recruitment of type 2 muscle fibers much earlier. As a result, athletes and patients in physical therapy can increase muscle size without resorting to heavier and heavier weights – and that means muscle gains can be seen in far less time and with less risk of overexerting the muscle tissue. In fact, studies show with BFR, muscle mass increases with loads of only about 20% to 30% of the muscles maximum load instead of the usual 60% to 100%.

“Muscle stimulation has always been difficult with post-op patients simply due to the fact that it is extremely difficult to stimulate the Type 2 muscle fibers in the body when using mostly body weight exercises early on.  BFR allows therapy to get you back faster,stronger, and safer than before.”  Taylor Riley, PT, DPT

Not surprisingly, BFR is especially popular among athletes looking to increase muscle mass in less time, but it’s also very popular in physical therapy, helping patients with limited or compromised mobility regain muscle strength more quickly, even when their mobility issues limit the use of heavier weights.

“Blood Flow restriction training has been a huge compliment to the medical and performance care of our athletes.  Allowing Athletes to perform exercise earlier during the rehab process with less loading on their joints accelerates the rehabilitation process, returning them to sport sooner with less setbacks.  I just wish I knew about blood flow restriction training sooner!”  Jonathan E. Gallas, PT, DPT, CSCS

BFR is not a “DIY” muscle-building technique; as “accessible” as the technique may seem, professional medical guidance is essential for optimal delivery of oxygen-rich blood for healthy tissue growth and function, and of course, to prevent potential tissue damage. Under the skilled guidance of a healthcare provider, BFR can play an important role in helping patients build healthy muscle tissue and regain strength and mobility, especially when injury, surgery or other physical issues limit the use of traditional therapeutic techniques.

To find out more about BFR, call OrthoIllinois Rehabilitation at 815-484-6990 and schedule a consultation today.