Blood Flow Restriction Therapy
What is BFRT
Blood Flow Restriction Therapy (BFRT) is defined as “the brief and intermittent occlusion of arterial and venous blood flow using a tourniquet while at rest or exercising”. This type of therapy is designed to help augment
skeletal muscle adaptation (muscle growth)
improve bone density
along with systemic and cardiovascular benefits
Typically for us to obtain these benefits we would have to strength train at 70% of our 1 RM. For many individuals due to pain, joint irritation, injury, or lack of time they are unable to train at the normal required intensity for true muscle growth. BFRT simulates this high intensity environment through partial occlusion of blood flow, allowing us to get similar benefits of high intensity training with low load resistance training, or low intensity endurance training.
At the cellular level, BFRT creates the production of growth hormone and recruitment of Type 2 muscle fibers, which we know are essential for hypertrophy of a muscle and quick improvements in strength.
Blood Flow Restriction Therapy can easily be incorporated into your rehab program to augment the benefits. At our clinic there is no additional cost to using BFRT it is simply another tool we can use to help achieve your goals. Although this is a fairly new service we are offering as a clinic, most of our therapists have 5-10 years of using BFRT clinically.
Who is it indicated and not indicated for?
Although typically seen with individuals trying to rehab an injury, improve performance, or status post orthopaedic surgery, BFRT can actually be very beneficial among a wide age group (teens to geriatrics) and for anyone trying to improve their strength or bone density
As a physical therapist, we take a detailed screening of our patients to make sure they are appropriate for this intervention, however some of the common risk factors and comorbidities include:
Cardiovascular disease (as well as anyone at risk of a blood clot)
History of cancer
Lymphedema or excessive postoperative swelling
Pregnancy
Infection
Diabetes
What to expect?
At each evaluation, our therapists will perform a thorough history and physical examination to determine strength and mobility deficits, as well as determine whether BFRT is an appropriate intervention for the patient. Following the initial examination, we can get started right away and begin using the cuff at the patients first follow up appointment.
For the lower extremity, we place a cuff (picture) around the top of an individual’s leg. Our cuffs inflate to 50-80% of your Limb Occlusion Pressure (this is defined as the pressure that fully restricts full blood flow to your extremity). Once the cuff inflates, they are ready to start exercising.
We typically perform anywhere from 3-5 exercises per session, and the goal is high repetitions at a low resistance, which creates fatigue of the muscle. Typically we start with double leg exercises and progress to more isolated single leg exercises as tolerated. Patients will notice muscle fatigue both above and below the cuff of that extremity, which we have found can be really helpful in treating a variety of conditions (see below).
After the session we may end with foam rolling, manual work, or stretching to help lower your heart rate and recover before leaving the clinic.
Patients will typically feel like they had a workout following a BFRT session as although the exercises are low resistance by design, due to the inflated cuff, your muscles are working really hard and will feel fatigued. Patients rehabilitating an injury are usually very pleased as they feel they were able to exercise without pain.
Benefits across the spectrum: Pelvic floor and Bone health
Although there is more research to be done in this particular area, there is high level evidence that muscles above the cuff experience carryover in strength gains with all lower extremity exercises. For individuals in pelvic PT who demonstrate pelvic floor weakness, this intervention may be beneficial to help strengthen pelvic floor indirectly. Strengthening your pelvic floor can be helpful to treat incontinence, prolapse, and many more diagnoses.
We also know that as we age, bone density typically decreases, creating an increased risk for osteopenia, osteoporosis, and subsequently stress fractures. There is also a known decrease in muscle mass production in men with loss of testosterone, and in women with loss of estrogen. BFRT has FDA approval for muscle mass improvements and has been shown to help improve bone density. We believe that this may be a very beneficial intervention for women who are looking to improve overall bone health as they age.
Blood Flow Restriction Therapy can easily be incorporated into your rehab program to augment the benefits. At our clinic there is no additional cost to using BFRT it is simply another tool we can use to help achieve your goals.
To work with our team of experts and learn more about how we can support you!
We are excited to partner with Smart Tools on their clinical devices.
They have extended a coupon for our blog subscribers WIM10r will get you 10% off your purchase. Many of our patients have purchased units to use at home with their home exercise program. We always recommended working with a physical therapist to make sure this is a safe and appropriate intervention for yourself and to develop a home program before using it.