Can we reduce strength deficits and restore them earlier with Blood Flow Restriction Training (BFRT)? Does BFRT reduce pain?
Blood Flow Restriction Training, is a unique way to maintain muscle strength during recovery. It involves wrapping an arm or leg with a pressurised cuff (like a large blood pressure cuff) to partially restrict blood flow while performing exercises. This allows a person to build muscle using very light weights (only 20–30% of their max) or with NO weights at all, with high repetitions and short rest periods. This is especially helpful because rehabilitation must start immediately after an injury, as acute injuries like an ACL tear quickly cause a loss of muscle strength and size. Even overuse injuries require careful load management to ease pain and improve performance.
Experts Agree on the recommendation to use BFR in ACL rehabilitation (Kotsifaki et al., 2023). High intensity strength training is the best option to get these improvements. However, due to pain and tissue healing, high intensity strength training is often difficult in the acute stage of an injury.
Current research is suggesting that BFRT could:
- Reduce pain (e.g. in patellar tendinopathy).
- Reduce loss in bone mineral density and bone mass
- Possibly reduce swelling
- Possibly resolve activation problems
- Maintain or improve aerobic capacity, muscle mass and muscle strength with Aerobic BFRT
- Improve physical functioning and quality of life
Is it safe?
Short answer is yes, it is safe in adults and adolescents.
There is a misconception that it creates blood clots. The evidence does not support this, rather it suggests that it may reduce the possibility of a blood clot.
- BFR is safe if the following requirements are met:
- Medical screening passed
- Rule out absolute contra-indications (e.g. DVT, uncontrolled hypertension, diabetes, varicose veins)
- Consider relative contra-indications
- Blood pressure assessment
- Applied by an experienced and trained therapist
Summary:
- BFR can be a bridge towards High Load Training
- Research suggests it increases muscle mass and strength and reduces pain
- BFR complements but does not replace exercise-based rehabilitation