Injuries
Blood flow restriction training – For injury rehabilitation and treatment of pain
Are you injured, or do you suffer from a chronic illness that makes it impossible for you to perform strength training in your rehabilitation?
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, a rehabilitation situation, or a pain problem that limits the activity level of the person and how heavily the area can be loaded. Research has proven that blood flow restriction training is effetive in rehabilitating or threating patients with cruciate ligament injuries, ligament injuries, meniscus injuries, osteoarthritis, patellafemoral pain, risk of atrophy (loss of muscle) as a consequence of immobilization and other injuries / pain disorders that prevent the use of heavy strength training.
Blood flow restriction is a usefull tool in your toolbox but no magic pill.
Understand blood flow restriction training as a bridge-building tool from early rehabilitation, where there injured area is load restricted, to when the person again is able to perform heavy strength training. In early rehabilitation, blood flow restriction training can maintain, protect, and increase muscle mass, due to the accelerated degree of fatigue, and it can shorten the time to be back at pre-injury strength level. In all cases, the end goal should always be a return to heavy strength training. Although blood flow restriction training is also effective in improving maximum strength, heavy strength training is superior on that part.
In rehabilitation, you combine your already existing rehabilitation exercises with blood flow restriction. If the patient has to perform isometric contractions, these can be combined with blood flow restriction. The degree of fatigue is increased and the effect of the exercise is improved, without changing the intensity and load on tendons, joints or ligaments. The same applies if the patient is allowed to cycle or do just weight-bearing exercises. Use blood flow restriction training with your already existing protocols.
For pain or osteoarthritis patients, blood flow restriction training can reduce the pain experienced during training. It can have a positive effect on traning compliance, and the pain and quality of life that the person experiences outside training.
Read more about various injuries below, or visit our Knowledge Lab to learn more about blood flow restriction training.
Click on the area for your injury or pain
Learn about the typical injuries and causes of pain where blood flow restriction training can be used in advantage. Read about blood flow restriction training, and if it is relevant for you.
Knee
- Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries
- Meniscus injuries
- Medial collateral ligament (MCL) and lateral collateral ligament (LCL) injuries
- Cartilage damage
- Patellofemoral pain syndrom (PFPS)
- Patellar tendinopathy (jumpers knee)
- Osteoarthritis
- Fracture (kneecap, tibia/fibula, femur)
- Total knee arthroplasty (TKA) / Total knee replacement (TKR)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Elbow
- Tennis elbow
- Golfer’s elbow
- Pitcher’s elbow / Thrower’s elbow
- Biceps or triceps overuse
- Fracture (elbow, ulnar, radius, humerus)
- Cartilage damage
- Osteoarthritis (OA)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Wrist
- Fracture (wrist or fingers)
- Ligament injuries
- Cartilage damage
- Tendon injuries
- Osteoarthritis (OA)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Ankle & Foot
- Ligament injuries – E.g. sprained ankle
- Achilles tendon rupture
- Achilles tendinopathy
- Fracture (tibia, fibia, foot)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Hip
- Hip impingement (femoroacetabular impingement)
- Damage to cartilage or labrum
- Proximal hamstring tendinopathy
- Tendinopathy
- Fracture
- Hip osteoarthritis (OA)
- Total hip arthroplasty / Total hip replacement
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Shoulder
- Shoulder impingement
- Damage to cartilage or labrum
- Rotator cuff injuri
- Osteoarthritis (OA)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Ankle and foot injuries
Blood flow restriction training is effective in protecting and maintaining the loss of muscle mass and strength that can occur from an injury in the ankle or foot. The most extreme cases are seen when the foot is completely immobilized in a cast, e.g. after an achilles tendon rupture. In these circumstances, the loss in muscle mass happens very rapid. In this case, blood flow restriction training can be targeted very specificially, to protect and stimulate the muscles that plantar and dorsal flex the ankle joint. In cases such as and ankle injury or similar distally located injuries, blood flow restriction training is also very usefull in training for other parts of the extremity (e.g. thigh and hip muscles) as they most often also are load or exercise restricted.
- Ligament injuries – E.g. sprained ankle
- Achilles tendon rupture
- Achilles tendinopathy
- Fracture (tibia, fibia, foot)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Knee injuries
Rehabilitation from knee injuries, or treatment of knee pain, is among the most researched and used in blood flow restriction training. Common to injuries or pain in the knee is that they often leads to a decrease in the activity level and participation in exercise. Regular strength training can be painful, in some cases contraindicated, because the injury does not tolerate heavy loading.
A knee injury can lead to a longer rehabilitation phase, in more severe cases surgical intervention with subsequent immobilization of the knee before rehabilitation can begin.
A knee injury can lead to a general loss of muscle mass and strength in the knee joint. Especially the quadriceps muscle atrophies very quickly.
Pain is experienced in everyday activities with knee bends and extensions such stairway walk and sit down-stand up motions.
Traditional heavy strength training can be difficult or impossible due to the injury itself or pain related to the injury.
We distinguish between acute injuries in the knee that immediately require extensive rest, immobilization or a surgical procedure, or as chronic knee pain.
- Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) injuries
- Meniscus injuries
- Medial collateral ligament (MCL) and lateral collateral ligament (LCL) injuries
- Cartilage damage
- Patellofemoral pain syndrom (PFPS)
- Patellar tendinopathy (jumpers knee)
- Osteoarthritis
- Fracture (kneecap, tibia/fibula, femur)
- Total knee arthroplasty (TKA) / Total knee replacement (TKR)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Acute injury
With a extensive injury to the knee, e.g. a tear of the anterior cruciate ligament (ACL), a surgical intervention (reconstruction) is often recommended, followed by a long rehabilitation phase and break from competitive sports, approx. 10-12 months. An injury that has required surgery often requires immobilization. Immobilization of the knee has a rapid and distinctly negative effect on the surrounding muscles. Blood flow restriction training can both slow down the loss in muscle mass before and immediatly after surgery, and also help you regain pre-injury muscle mass and strength earlier in your rehabilitation. Low load in combination with blood flow restriction allows us to initiate effective exercises early in the rehabilition, without overloading the concomitant tissue healing.
Chronic pain
Do you experience knee pain in everyday activities, e.g. stair climbing and sit-to-stand motion, blood flow restriction training can be an alternative to the regular and heavier strength training Several studies have shown that blood flow restriction training can increase muscle mass and improve strength, in people who experience knee pain during heavy strength training. This is also evident for patients with osteoarthritis. Occlude collaborates with several clinics and health centers that have great experience with the use of blood flow restriction training for paitients with osteoarthritis – Also as a supplement to GLA:D training.
Hip injuries
Although blood flow restriction training is primarily used in training of the muscles we can restrict distal to the cuff, blood flow restriction training can also be used in training of primary and assisting muscle groups proximal to the the cuff, i.a. in relation to hip injuries.
In multi-joint strength training exercises, e.g. a squat, muscles that are located both proximal and distal to the cuff are used to perform the squat movement. When the muscles distal to the cuff are exhausted more quickly, the remaining muscles, proximal to the cuff, must compensate to perform the movement, while the load remains the same. Thereby, these muscles also achieve a high degree of fatigue, despite the fact that they are not restricted.
- Hip impingement (femoroacetabular impingement)
- Damage to cartilage or labrum
- Proximal hamstring tendinopathy
- Tendinopathy
- Fracture
- Hip osteoarthritis (OA)
- Total hip arthroplasty / Total hip replacement
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Shoulder injuries
Common to the acute injuries and pain (chronic) in the shoulder is that they can be associated with a limitation of the activity level in everyday life and training participation. A shoulder injury can lead to a longer rehabilitation phase. Nn more severe cases, a surgical procedure may be necessary with subsequent immobilization of the shoulder / arm.
Regular strength training can be difficult or impossible due to the injury itself or pain of the injury.
A shoulder injury can lead to a general loss of muscle mass and strength around the shoulder joint (chest, upper back and deltoid muscles) and distal to the shoulder joint (upper arm, forearm)
Pain is experienced in everyday activities, e.g. where the arm is raised above head (shoulder abduction and flexion) There may be pain associated with carrying, lifting and pushing. Having an injury or chronic pain in the shoulder can be very disabling.
Although blood flow restriction training is primarily used in training of the muscles that can be restricted (distal to the cuff), it can also be used in training of primary and assisting muscle groups proximal to the cuff. This is beneficial in rehabilitation of shoulder injuries. Imagine a multi-joint strength training exercise, e.g. a push-up or bench press In these exercises, the triceps muscles (distal to the cuff) extends the elbow joint, and the chest and front side shoulder muscles (proximal to the cuff) flexes the shoulder joint. When the muscles distal to the cuff are exhausted more quickly, the remaining muscles, proximal to the cuff, must compensate to perform the movement, while the load remains the same. Thereby, these muscles also achieve a high degree of fatigue, despite the fact that they are not restricted. With our many years of experience in professional elite handball (and other throwing disciplines too), we carry alot of knowledge about blood flow restriction training to shoulder rehabilitation.
- Shoulder impingement
- Rotator cuff injury
- Damage to cartilage or labrum
- Osteoarthritis (OA)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Elbow injuries
Blood flow restriction training is effective in protecting and maintaining the loss of muscle mass and strength that can occur from an injury in the elbow. Injuries to the elbow often limits how heavily the elbow joint may be loaded. Blood flow restriction training are in these cases beneficial in protecting the muscles of the upper arm and forearm. This is relevant for the elbow flexor muscles, e.g. biceps, and the elbow extendor muscles, triceps.
- Tennis elbow
- Golfer’s elbow
- Pitcher’s elbow / Thrower’s elbow
- Biceps or triceps overuse
- Fracture (elbow, ulnar, radius, humerus)
- Cartilage damage
- Osteoarthritis (OA)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports
Wrist and hand injuries
Blood flow restriction training is effective in protecting and maintaining the loss of muscle mass and strength that can occur from an injury in the wrist or hand. The most extreme cases are seen when the hand is totally immobilized in a cast, e.g. in case of a wrist fracture. In these circumstances, the loss in muscle mass happens very rapid. In this case, blood flow restriction training can be used directly with the aim to stimulate and protect the muscles that controls the hand, e.g. when it needs to open up and squeeze.
In the event of an injury to the wrist, blood flow restriction training can also be usefull in training of the muscles proximal to the injury site (elbow and shoulder muscles), as the injury affects how intense or heavy the rest of the arm can be loaded.
- Fracture (wrist or fingers)
- Ligament injuries
- Cartilage damage
- Tendon injuries
- Osteoarthritis (OA)
- Pain due to heavy loading, or pain that limits everyday activity level or participation in sports