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Understand the mechanisms behind blood flow restriction training

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What is blood flow restriction training?

Blood flow restriction training is a physiological shortcut to achieve muscle growth, strength improvements and improved physical function, with minimal load on tendons and joints.

In blood flow restrictiom training, a cuff, with a fixed pressure, is applied to one of the body’s extremities – Either an arm or a leg. The cuff restricts the oxygen supply to the muscle (hypoxia) causing an accelerated degree of the fatigue.
In contrast to conventional strength training, blood flow restriction training uses low loads, approximately one-third of the weight normally used during strength training. The combination of low load and high muscle fatigue makes blood flow restriction training particularly relevant for rehabilitation (after injury or surgery), or in subgroups that do not tolerate training with high load (osteoarthritis and pain patients, the elderly, etc.). Non-injured athletes and strength training enthusiasts can also benefit from blood flow restriction training, as an addition to conventional strength training. This applies when the goal is to build muscle mass, increase strength and as a periodization tool in elite sports.
The effect of blood flow restriction training is well documented. No less than 450 scientific studies have been published on the subject ranging from training and rehabilitation protocols, determination of individual occlusion pressure (AOP), physiological mechanisms, safety and contraindications. This enables us to use blood flow restriction training targeted at the individual patient or client.

Blood flow restriction training can be used in advantage in those contexts where a patient, client, or athlete, is limited in the use of conventional heavy strength training. It can be an injury, rehabilitation or pain issue which limits the physical activity level of the person and how heavy tissue, joint or tendons can be loaded.

“Blood flow restriction training is best understood as a physiological shortcut to achieve muscle growth, strength gains and improved physical function, with minimal load on tendons and joints”

The purpose

How blood flow restriction training works

We also know blood flow restriction training as “blood flow restriction exercise” or “occlusion training”. The abbreviation “BFR” is often used. In blood flow restriction training, cuffs are used to partially restrict the arterial inflow and completely restrict the venous return.

The purpose is, to create inadequate oxygen supply to the extremity. The partial restriction of the arterial inflow to the extremity, makes it gradually more difficult for the body to transport oxygen out to the working muscles, thus they get fatigued faster and earlier than during the same work but without restriction (free flow training). Anaerobic energy turnover will increase, and larger motor units (consisting of more type-2 fibres) will be recruited as a compensation to the decrease in oxygen supply, with blood flow restriction training. Bi-products, mainly from anaerobic glycolysis, will accumulate, and the restricted muscle(s) are exposed to metabolic stress, which will accelerate the degree of fatigue. A high degree of muscle fatigue is ultimately crucial to the training response we observe with blood flow restriction training. Despite the very low loads, blood flow restriction training is a very potent stimuli to promote muscle growth, and as a result of that also very effetive to increase muscle strength and improve physical function.

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To whom is blood flow restriction training relevant for?

Research has shown that training with low external load (< 30 % of 1RM) during blood flow restriction training, is just as effective in increasing muscle mass as traditional heavy strength training (> 60% of 1RM).

The combination of low load and high muscle fatigue makes blood flow restriction training particularly relevant for rehabilitation (after injury or surgery), or in subgroups that do not tolerate training with high load (osteoarthritis and pain patients, the elderly, etc.). Visit our overview of injuries and experience the relevance of blood flow restriction training i rehabilitation. Non-injured athletes and strength training enthusiasts can also benefit from blood flow restriction training, as an addition to conventional strength training.

Blood flow restriction training is neither harmful nor dangerous for the healthy patient, however you should always take the following reservations and considerations before you begin:

  • Carefully read the guides and user manual that comes with all Occlude products.
  • Gradually expose to blood flow restriction. We recommend Occludes run-in protocol for new users
  • Adhere to official guidelines about maximal blood flow restriction time and use individualized pressures
  • Screen for contraindications