Blood Flow Restriction training: or how to get more from doing less.

blood flow restriction training | Arana Hills Physiotherapy

That’s the dream right, to get more of anything by doing less for it ? Or is that just me..ok just me.

For effective rehabilitation of soft tissue and bone related injuries the magic tends to happen when we hit the higher ends of our our capabilities. This is typically at 60-70% and over of our maximum ability. You can read more how to work this out here.

However in the early stages of rehabilitation and injury, this may be unachievable or too risky to the affected tissues. So we are potentially delaying our progress or possibly missing out on getting the process and flying start.

However there is a way we can train people without risking the healing tissue to get similar results in the muscles, ligaments and tendon to that seen in heavy based strength training.

Enter blood flow restriction training.

This novel training method restricts blood flow to the target area via a cuff while the person exercises. This results in partial restriction of arterial blood inflow to muscle, but, most significantly restricts venous outflow from muscle.

Less is more, however there is a price to be paid.

The good news is that similar effects to using 70% 1RM of an exercise can be achieved using only 10-20% 1RM. That’s a significant reduction in load that is far safer structurally in the early stages post operatively or post injury.

However the downside of this type of training is the very temporary discomfort that is associated with it.

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What is the science behind it ?

The major effect that BFR has physiologically is that it appears to help increase the concentration of growth factors and metabolites in the target area. These include various ions, growth factors and everyone’s favourite LACTATE.

These are essential components in the repair and remodelling of injured tissue and ligament or tendon reconstructions.

Does blood flow restriction training have a place in injury rehab ?

BFR training is in its infancy in musculoskeletal rehabilitation but early results look promising for a wide range of conditions. These include:

  • Tendon and ligament related disorders e.g achilles tendinopathy
  • Post surgical rehabilitation eg ACL Reconstruction , ankle ligament reconstruction.
  • Knee osteo-arthitis.
  • Patello-femoral joint pain.
  • Osteoporosis has been shown to be positively affected.
  • Individuals who are too weak to exercise at 70% 1RM.

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How is blood flow restriction training performed ?

Here Chris Gaviglio from the Gold coast suns explains how to use BFR Cuffs.

A cuff is place round the target area and inflated to anywhere from 40%–80% of the pressure required to occlude the venous system. The bigger the limb the greater the pressure required.

Around 4 sets of 15 0- 20 reps with 30 -45 seconds rest appears to be the ideal way to use this technique.

It is a safe form of exercise and does appear to be a useful tool depending on where you are in relation to your exercise capability. It appears to be an excellent way to get the some of the benefits of high load strength training at a low load.

Blood flow restriction is not a substitute for heavier training but a way to bridge the gap from low intensity early stage rehabilitation to higher intensity mid to late stage rehabilitation.

It can be uncomfortable to do, but it is short lived and may be a useful tool in your return to full fitness.



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Giles, L., Webster., K. E., McClelland, J, & Cook, J. (2017) Quadriceps strengthening with and without blood flow restriction in the treatment of patellofemoral pain: a double-blind randomised trial. British Journal of Sports Medicine. doi: 10.1136/bjsports-2016-096329