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Blood Flow Restriction Training

By Ian Halderman, DPT

In the world of rehabilitation there are many treatment techniques at the disposal of health care professionals to address musculoskeletal pain and dysfunction. One of the biggest problems for people recovering from injury or surgery is muscle weakness and atrophy (decreased muscle size). As the cost of health care increases, it is important that we use effective and research-driven treatment to maximize outcomes while minimizing costs and recover time.

A promising area of rehabilitation is a treatment technique known as blood flow restriction training (BFRT) which is the use of a tourniquet to intermittently restrict blood flow to and from working muscles. This effective therapy allows for muscle size and strength gains to be achieved using much less weight during resistance training.1

What are the benefits? Some of the many benefits of BFRT include increased muscle size and strength and positive changes to vascular and bone tissue.2 As mentioned earlier, muscle atrophy is one of the biggest issues after surgery and injury; BFRT can overcome atrophy using a significantly less weight load than with traditional training methods. Evidence suggests that it can take training with 60-80 percent of your maximum lifting capacity to induce muscle growth or hypertrophy.3 BFRT allows for similar gains to be achieved while loading the body with only 20-30 percent of a person’s maximum lifting capacity.2

Who is it for?  BFRT is for those who want to get the most out of their rehabilitation and minimize the negative effects of injury, surgery and atrophy. It can be used in a wide range of patient populations including injured, elderly, youth, athletes, and healthy untrained individuals.2

Is it safe? Applying a tourniquet to a limb and exercising may not sound safe, but evidence suggests otherwise. BFRT research has been reviewed extensively, and the evidence shows that correct implementation presents no significant increased risk over traditional exercise methods.4 BFRT is not for everyone as there are some health conditions and factors that may limit someone’s compatibility. It is an intense form of muscle training that can induce significant muscle soreness. It is important that you get evaluated by a licensed health care professional who is certified in this training method.

Where can I receive BFRT? BFRT can be performed by a licensed rehabilitation professional with the certification, knowledge, experience and equipment to safely apply this training method.  Clinicians should be certified through Owens Recovery Science, a leading organization that researched and developed Blood Flow Restriction Therapy devices approved by the FDA.

Ian Halderman is a Doctor of Physical Therapy with Avid Physical Therapy. His specialty is orthopedics and sports medicine and he completed his orthopedic residency with Team Movement for Life. He can be contacted at if you have any further questions on Blood Flow Restriction Training

References: 1) Slysz J, Stultz J, Burr JF. The efficacy of blood flow restricted exercise: a systematic review and meta-analysis. J Sci Med Sport. 2016;19(8):669–75. doi: 10.1016/j.jsams.2015.09.005; 2) Jessee MB, Mattocks KT, Buckner SL, et al. Mechanisms of blood flow restriction: the new testament. Techniques in Orthopedics 2018; 00:00:1-7; 3) Garber CE, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc.2011 Jul;43(7):1334-59. doi: 10.1249/MSS.0b013e318213fefb; 4) Hughes L, Paton B, Rosenblatt B, et al. Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. J Sports Med 2017;51:1003-1011. doi:10.1136/bjsports-2016-097071.

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