Blood Flow Restriction:

What is it and why are we talking about it?

Apex now Offers Blood Flow Restriction Training

Blood flow restriction training (BFRT) is, simply put, training with cuffs on that restrict your blood flow. BFRT is a short and intermittent restriction of blood flow, both arterial and venous, which is performed by using a cuff/tourniquet to the upper or lower extremity. BFRT has recently been becoming more and more popular in the rehab and training world due to the many benefits that are being discovered. It has been shown to help increase muscular strength, size, and functional aerobic capacity in shorter time periods than traditional training with the added benefit of decreased stress on the body that you would get from traditional training.

Set-up the BRFT

There are different cuffs/bands out on the market, but only two that are FDA approved for safety. There are multiple ways that the cuffs can be utilized during training, but the set-up is always the same. The cuffs are placed either around the thighs or the arms as close to the trunk as possible. The PT then utilizes a cuff system to measure out limb occlusion pressure (LOP) and then reduces the pressure down to a certain percentage, differing on if it is in the upper extremity or lower extremity. This causes a full occlusion of venous flow and a reduction of arterial flow.

Demonstrating how to use the BFRT

The placement of the cuff is near the trunk of the body

TL/TR – watch a short video instead.

The Benefits of BFRT

Cell Swelling – Hypertrophy

There is increased protein synthesis and other processes that occur with the occlusion that help benefit muscle growth and low resistance loads.

Post-op atrophy (muscle wasting) is one of the biggest issues patients face after orthopedic surgery. The use of BFR can reduce overall muscle wasting, helping to maintain the size of the limb post-op and improve recovery time.

Muscular Fatigue – Strength

Less oxygen gets to the body distal to the cuffs, which increases the demand on the muscles. This increased demand leads to increased muscle fiber contraction and increased fatigue, which both can help promote general muscular strength.

People can lift at 20-30% of their 1RM vs. 60-80% of their 1RM to increase strength.


Due to the decreased blood flow from the occlusion of the cuff, heart rate (HR) must increase to allow the body to maintain a steady pace of exercise. Due to this increase in HR, you can work out for less time and with less stress while still receiving beneficial training to the heart.

These are not the only benefits that are being found with the use of BFRT, but they are some of the most important and beneficial.

Who BFRT should be used on:

  • Post-operative
  • People who are unable to tolerate high loads due to pain or other tissue limitations
  • The general healthy public to supplement their normal training

Who BFRT should not be used on:

  • Anyone under 15 and under (Not enough research to prove safety or danger)
  • Anyone with a history of deep vein thrombosis
  • Acute sickness or fever
  • Blood Pressure > 180/100
  • Early postoperative period
  • Higher class Arrhythmia or coronary ischemia
  • Pregnancy
  • Your Physical therapist will rule in or rule out if you are a candidate based on any red flags that you may mention or be asked about during your visit.

Why is Apex Talking about BFRT?

Apex Physical Therapy and Wellness has now started offering the use of BFRT with one of the FDA-approved cuff systems in all our clinics.

We hope to continue to provide the best treatment to our patients and we think that BFRT is a new tool that will allow us to help people who struggle to increase their strength and general level of activity due to pain and being more sedentary. It is not a magical tool and won’t work for everyone, but the research does show that it can be very beneficial to a lot of people and might just be the missing ingredient for someone in their rehab.

If you are interested in the use of BFRT or have any other questions, feel free to reach out to Apex and talk with one of the therapists to see if it can benefit you.

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