Blood Flow Restriction (BFR) is an intervention that physical therapists can use as an adjunct to strengthening exercises in your treatment plan. BFR addresses loss of muscle mass and strength, i.e. muscle atrophy, that has occurred with decreased use of a specific joint or area of the body. Muscle atrophy commonly occurs due to a period of immobilization, for example wearing a knee brace after an ACL repair, or a sling after shoulder surgery. However, BFR might also be appropriate for other injury presentations with associated muscle weakness if your therapist determines as such.
BFR training facilitates muscle hypertrophy. Muscle hypertrophy is an increase in muscle size and mass, or the opposite of muscle atrophy. Hypertrophy results in improved muscle strength and power. The recovery of muscle strength helps with returning to your desired activities whether that’s running, swimming, weight lifting, racket sports, or anything else meaningful to you!
Frequently Asked Questions about BFR:
How does it work?
Symmetry physical therapy uses the B Strong training system. These are pneumatic cuffs (similar to a blood pressure cuff) that are worn around either the top of the thigh or top of the arm. The bands are worn while performing exercises that are appropriate for your stage in your rehab. You will wear the bands for up to 20 minutes.
What’s the science behind it?
When the band(s) are inflated they partially decrease the blood flow to muscles in the targeted extremity. This makes the local muscle environment more anaerobic (less oxygen) and lowers the pH. This results in:
- Better recruitment of fast-twitch muscle fibers (type IIb) for the performed activity
- Activation and proliferation of stem cells
- Release of growth hormone via pituitary gland
- Protein synthesis needed for building muscle
How long has BFR been around?
BFR training was first known to be developed in Japan by Dr. Yoshiaki Sato in the 1960s. It has been used in the U.S. for the past 2-3 decades.
Does my doctor need to recommend it?
No, but your therapist will follow guidelines for who is a safe candidate to do BFR training. Also if you are post-op your therapist will reference your doctor’s protocol when incorporating BFR.
Will I be sore?
It is reasonable to experience more fatigue in your muscles while you are exercising with the BFR bands on. You may have some increased soreness, but it should not be extreme. Your therapist will monitor you throughout your visit and can make adjustments as needed.