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Blood Flow Restriction Training Portland & Oregon City, OR

Blood Flow Restriction Training

What is blood flow restriction training?

Blood Flow Restriction Physical Therapy is a revolutionary specialized strength training technique which is used to accelerate the healing process of an injury by stimulating enhanced muscular growth through the use of a tourniquet.

Blood Flow Restriction(BFR) physical therapy is use of an intermittent surgical-grade tourniquet to restrict blood flow to a limb. In traditional strength training, loads of greater than 65% of 1-repetition maximum (1RM) are lifted during high-intensity strength training sessions, resulting in muscular hypertrophy and strength gains. Patient s who are post-surgical or have an injury, athletes in competitive seasons, or the elderly may not be able to handle these level of loads. With BFR training, much lighter loads can be used with exercises, while still getting the benefit of heavier lifting. These lighter loads are much more appropriate for rehab.


How does it work?

BFR uses a specialized tourniquet system which reduces arterial inflow and completely occludes venous outflow to the limb. This creates a hypoxic environment.

The exact mechanism behind BFR training is not fully understood. However, the current theory is that this hypoxic environment leads to higher lactate concentrations (which is a byproduct of anaerobic metabolism and high intensity training as well). This triggers Growth Hormone (GH), as well as Insulin Like Growth Hormone, which leads to muscular hypertrophy. Another mechanism behind BFR is that the tourniquet leads to a muscle pump effect. There is a swelling of the muscle, as well as a plasma volume fluid shift. This promotes protein synthesis, and leads to muscle gains.


What does a training session consist of?

On the first visit, the limb occlusive pressure (LOP) is measured, and then a personal training pressure is established. This is typically 50% of the LOP for the upper limbs, or 80% of the LOP in the lower limbs. The personal training pressure is set on the tourniquet system, and then the number of repetitions and sets is 30/15/15/15 reps. The first set of 30 reps is referred to as the priming set, which moves the muscle metabolism from aerobic to anaerobic. This first set usually feels relatively easy. As the patient finishes the 2nd, 3rd, and then 4th set, the metabolites are building up in the muscle and the exercise will appear more difficult. Each set is separated by at least 30 s of rest or using another muscle group. By the end of the sets, the muscles will typically be getting progressively more fatigued. The total time of the exercise sets is just under 7 min, and then the tourniquet is deflated again, and the muscle is allowed to perfuse again.


What kind of diagnoses benefit from BFR training?

  • Total joint arthroplasties
  • Achilles tendon repairs
  • Fractures Rotator cuff repairs
  • Muscle strains
  • Nerve injuries
  • Post-op ACL repair
  • Post-op cartilage arthroscopies
  • Tendinopathies

What are possible side effects or contraindications of BFR training?

Some of the possible side effects of using a tourniquet are temporary bruising, transient numbness of the extremity, or a dull pain. Another possible concern is the potential for nerve damage under the tourniquet cuff. The chance of these side effects occurring is small, and the risk is reduced by using 3rd generation tourniquet systems that utilize advanced safety features such as limb occlusion pressure personalized to each athlete or patient. Another feature that reduces the risk of side effects is the use of a wider cuff w ith a tapered , contoured fit so the pressure gradient is reduced. This minimizes damage to the skin or potential nerve injuries. The risk of side effects is very low with this sophisticated tourniquet system.

For more information, Contact our physical therapist at Oregon City, OR centers.