Blood Flow Restriction Training and its areas of application
I believe that Blood Flow Restriction Training (BFR Training) is a valuable tool that all strength athletes should know how and when to use. I can't think of an ambitious athlete who couldn't find a reason to use this type of training at some point.
It was sometime in 2008 when I first heard about BFT training and my reaction was similar to most reactions of this type.
"Is that safe? That can't be safe and harmless!"
"You'll never catch me doing that!"
"What a ridiculous way to train."
I believe that BFR training back then was presented more as towards those notorious bodybuilding "shock methods". It was presented at best as a way to supplement your current training and at worst as a novel stimulus that could potentially help you achieve gains that you could never have achieved otherwise.
Now that I think about it, at worst it was presented as a badge of honor by the pioneers who first used this method. Why? Because the bandages they used back then (usually knee bandages) were way too tight and the localized pain was much worse than necessary (and as you know, bodybuilders love pain as a badge of honor). Done correctly, BFR training should be about as painful as a normal work set of 15 reps to muscle failure.
The point is that at the time, I didn't know how restricting blood flow to the muscles could be a solution to any bodybuilding problem. I thought that there were many other ways to provide stimulus.
Looking back, I see that the problem was that I didn't fully understand how BFR training worked, nor did I understand why and when anyone should use such training. What makes a BFR workout so unique is that it can produce muscle gains that are virtually identical to the gains you can achieve with traditional high load training. However, when using a BFR workout, you are working with weights that are far below what you would traditionally use in most situations.
So BFR training is no better than high load training. However, its real advantage is that you can achieve the same results using lighter weights. You're probably wondering why on earth you would use the same weights that people who just want to tone their body use. When I found out that a BFR workout worked this way, I asked myself the same question. Yes, I was training primarily to maximize my hypertrophy and build muscle, but I also enjoyed being strong and liked the feeling of holding heavy weights in my hands.
However, as with many things (or all things), context matters and years later I have found myself in many situations where a BFR workout saved my ass. The situations I'll list here have occurred most frequently, but I also have situations that I suspect will recur until one day I make the decision to stop training.
Isolation training during competition preparation
BFR training can be particularly useful during the final weeks of a race preparation diet if used correctly. Of course, you should be able to maintain a good portion of your off-season performance, but you will also be so lean that your joints simply won't be as stable and resilient as they were during the off-season.
The simple fact of being able to use BFR training for my isolation exercises after the basic exercises has made my race preparation much more enjoyable. More enjoyable in the sense that I was able to minimize many of the training aches and pains I had previously experienced (such as tendonitis). In my opinion, BFR training has played an important role in keeping me healthy during my last two race preparations.
Once you get the hang of BFR training, it's easier physically. Those last sets of each training session in a well advanced race prep can be really tough and as crazy as it may sound, it can sometimes be easier to finish a sub-body training session with leg extensions a la BFR than without.
While smart training planning has helped me maintain about 90% of my off-season strength during contest prep, I feel that replacing some of my volume with lighter weight BFR squats has helped keep my joints healthy enough for such strength feats.
In addition to this, BFT training has helped me to a certain extent to avoid exhausting my mental willpower too early during a training session in advanced competition preparation. Successfully completing a leg training session in advanced competition preparation requires tremendous willpower and heavy weights sometimes feel particularly daunting in this situation. Having the option to pull the BFR card during this time can help maintain adequate training stimulus without depleting willpower.
Additional off-season volume
Interestingly, BFR training can also be used during the off season. I've had off-season front squat workouts where my knees were acting a little strange after squats, so I opted to pull the BFR card during subsequent isolation training to reduce the absolute load on my knees.
On other occasions, my main exercise was so exhausting that I opted for BFR training for my secondary exercises afterwards to alleviate the mental stress of moving heavy weights. All in all, pulling the BFR card is a way to ensure I hit my training volume while preventing me from compromising my recovery too much.
In addition to this, BFR training can be a great way to add volume to your training. For example, if you include 4 sets of direct bicep training in your program, then using BFR Training for this additional volume can help you better acclimate your connective tissue to the new demands.
Another benefit of BFR Training is that it causes less muscle damage compared to traditional training (1). It is much easier to recover from BFR training than from traditional training and this can be very useful during the first few weeks of extra volume.
So far so good, right? Perhaps you are now a little more interested in learning a little more about BFR training. In the following sections, I will discuss the different aspects of the practical execution of BFR training.
The right equipment
I have used everything from bands, knee wraps and medical blood tourniquets for BFR training. Most of us start with knee wraps or bands as these are readily available and almost everyone has them. These are a good start, but there are some limitations.
For example, you need a training partner to help you put them on your arms and it is also difficult to get the right pressure consistently. In addition, you need wider bands for the legs than for the arms. This can make knee supports too wide for the arms and bands too narrow for the legs.
Medical tourniquets were initially my choice for the arms and I used them in combination with knee supports for the legs. However, the problem with medical tourniquets was that they wore out quickly.
They are simply not made for the hundreds of repetitions you do with them week after week and will quickly lose their integrity. It has happened to me several times that they have disintegrated during a set. For this reason, I always had at least 3 pairs of these dust bands on hand.
This was the case until recently when I ordered a pair of BFR bands from a company whose advertisements I continuously saw on my cell phone. My biggest question was whether these bands would last, as my arm training at the time consisted of ¾ BFR training. But even after 5 months of training, these bands are still as good as new.
Putting on the bands
Now that you have your BFR bands to hand, you can get started. The confusion about whether more is better is something we should address immediately. If you put the bands on a little tighter than recommended, there is a good chance that you will achieve a lower training effect. Furthermore, this can make a training method that is normally safe and harmless potentially dangerous.
Using the good old 1 to 10 scale, I would recommend most people start with a 6 on their upper arms and a 7 on their legs in terms of band tightness. It is worth mentioning that you should also apply the bandages to your thighs when using them for calf training.
Once applied, the supports should not be so tight that they feel uncomfortable. Remember that we only want to reduce venous blood flow while maintaining arterial blood flow into the muscle (this is why the pump is so great - the blood flows into the muscle but cannot drain out.
Your fingers and toes shouldn't go numb during the workout and you shouldn't feel any pain. You should just feel something strange wrapped around your arm and your first set should feel almost normal.
Let's start the workout
The pace of the workout should be similar to what you would use in a traditional workout with weights. This means a powerful concentric movement and a controlled eccentric movement where gravity is not in control.
You may find this difficult at first as the localized pain will be similar - if not more - to the 15th repetition of a set. Over time this will improve and for this reason you should use the same weight for the first few workouts while focusing on the correct technique of the repetitions.
When it comes to choosing the correct weight, it is best to start with a low weight (and for beginners this weight may seem very low) until you get used to BFR training. This is basically the advantage of BFR training.
A good rule of thumb is to choose a weight with which you can perform 15 repetitions without bandages and only use 40% of this weight. Over time you will be able to increase, but the weights used in BFR training should never be anywhere near what you would use in traditional strength training. For example, I can do 8 to 10 reps of barbell curls with 40 to 50 kilos, but I usually just use an empty Olympic bar for BFR curls.
The most common method for BFR training is the 30, 15, 15, 15 series. Your first set consists of 30 repetitions with 30 seconds rest between this set and your first set of 15 repetitions.
This set and repetition scheme has been used repeatedly in the past in some of the most important studies on BFR training. However, there are a few modifications I've made during my nearly 10 years of BFR training. Here are two of my favorite schemes besides the old scheme I just mentioned:
The 30,15,15,15+ scheme
This is almost the same scheme as the classic one, but if you feel that you have a few more reps than usual in reserve, then you can do more than 15 reps on the last set.
For me, if I've been able to do more than 20 reps on the last set during the last few workouts, it's a sign that I'm not just having a good day, but that it's time to increase the weight slightly. This is a good way to achieve an autoregulation style progression in a BFR workout. The 20,20,20,20 pattern For some people, the 30 repetition set is quite taxing and they find it difficult to get above 12 repetitions on the last sets. This is the case even when the weight is appropriate, as I have seen this myself with others I have instructed. This seems to be especially the case with larger lower body muscles.
With the 20, 20, 20 scheme, the total number of reps is similar and my personal experience has been that the second cluster set is slightly higher quality than with the traditional volume distribution. So the 20, 20, 20, 20 pattern is more balanced and allows for more quality training.
If you find that you are dropping from 30 reps on the first set to 12 reps on the second set, then before you adopt the 20, 20, 20, 20 pattern, make sure that you have not simply tightened the band too tight (i.e. a degree of tightness of 6 to 7 out of 10, no pain, no numbness, no tingling and no purple discoloration of the extremities).
Summary
In this article I have given you some reasons to consider BFT training and shown you what such training should look like. So the next time you find yourself in one of the many potential situations I mentioned above that are typically associated with pain, you now have a new tool at your disposal.
For me, BFR training has proven to be very useful and practical over the last decade. This type of training is often misunderstood as dangerous, impractical or a new trend that will quickly pass. In reality, BFR training is a scientifically well-researched and safe training tool that has been in use for more than a decade and is unlikely to disappear anytime soon for the reasons mentioned above.
I hope you make some serious gains and hope that this article has helped to improve the quality of your BFR training sessions.
References:
- Sudo, M., Ando, S., Poole, D. C., & Kano, Y. (2015). Blood flow restriction prevents muscle damage but not protein synthesis signaling following eccentric contractions. Physiological Reports, 3(7), e12449. http://doi.org/10.14814/phy2.12449
Source: https://3dmusclejourney.com/blood-flow-restriction-training/
https://3dmusclejourney.com/blood-flow-restriction-part-2/