Learn more about blood flow restriction therapy, a popular technique that mimics high-intensity strength training.

Blood flow restriction training has been gaining in popularity for everyone from high-performance athletes to people recovering from injury. But what exactly is this relatively new technique? And is it safe and effective?

What Is Blood Flow Restriction Training?

Joseph Riddle, DPT, OCS, facility director, UPMC Rehabilitation Institute outpatient rehabilitation location in Natrona Heights 

“Blood flow restriction is a treatment modality that mimics high-intensity strength training,” says Joseph Riddle, DPT, OCS, facility director of UPMC Rehabilitation Institute outpatient rehabilitation location in Natrona Heights. “It’s a game-changer for improving the recovery process.”

Blood flow restriction training uses a band or a tourniquet that looks like a blood pressure cuff and is usually made of elastic or nylon. It’s placed on your arm or leg at the attachment point closest to the torso.

This reduces blood flow to that limb. Blood can still get to the working muscles, but it restricts the outflow back to your heart and lungs. Given a lack of oxygen in the muscle tissue, strain on the muscle increases.

The result: you can work the muscle at a low intensity while still getting the benefits of working out at a higher intensity. This is especially helpful for anyone at risk of muscle loss due to injury. According to Riddle, this type of training has been demonstrated to minimize quad muscle atrophy following knee surgery, which is very important for muscle function during recovery.

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How Blood Flow Restriction Works

When you use any muscle, the smaller fibers start working first. That’s followed by the bigger, more powerful muscle fibers, if needed.

When the muscle lacks oxygen, as it does in blood flow restriction training, those bigger fibers are recruited faster. Over time, they become more capable of generating force, making you stronger.

You can get these results by lifting heavy weights. But in cases where that’s not possible or practical, blood flow restriction can be a handy tool. Because you’re not working out at a high intensity, you won’t be likely to experience the same degree of soreness afterward.

“This technique promotes recovery and muscle growth,” says Riddle. “It’s beneficial for the whole body.”

The Evidence for Blood Flow Restriction Training

A systematic review published in The American Journal of Sports Medicine looked at studies of blood flow restriction training. There was evidence to support that it led to an increase in strength, muscle size, and sport-specific measurements. This was compared to performing the same exercises without restricting blood flow.

Research shows that with blood flow restriction, you can achieve muscle growth at about 20 to 40% of your one-repetition (rep) maximum for a particular lift. For example, let’s say you can squat 200 pounds. You could squat just 60 pounds and still see an increase in muscle size.

Typically, muscle growth occurs when you’re working at about 75% of your one-rep max or higher. So, in the example above, you’d need to be squatting around 150 pounds if working out conventionally.

What Does a Blood Flow Restriction Workout Look Like?

Everyone has different needs when it comes to exercise so Riddle and his team screen patients for the treatment that will work best for them and then select exercises based on their physical exam.

“In the quad muscle atrophy example, we may select an isolation exercise, such as knee extensions and include more complex and functional movements like squats or step-ups,” he says.

Riddle’s patients usually complete four sets of each exercise and progression is determined based on performance – much like traditional strength training. The rest time between sets is often 30 to 60 seconds.

To see results, it’s ideal to train with your therapist during regular treatment sessions two to three times a week. People who are doing blood flow restriction training for a limited time — say, less than three weeks — may benefit from training more often.

Is Blood Flow Restriction Safe?

Studies have shown that blood flow restriction training is just as safe as more traditional exercise. It can work for a wide range of ages, from adolescents to older adults.

“The application is broad,” says Riddle. “Blood flow restriction can be effective if you’re recovering from surgery or an injury. It can also be helpful for healthy, high-performance athletes.”

However, this treatment modality may not be appropriate for people with high blood pressure or vascular issues. If you’re wondering whether blood flow restriction training can help you, contact UPMC Rehabilitation Institute in Natrona Heights at 724-224-7090 or request an appointment online.

Our Natrona Heights facility is located at 1870 Broadview Blvd. next to UPMC Urgent Care. In addition to blood flow restriction training, the facility provides physical therapy and sports rehabilitation.

Editor's Note: This article was originally published on , and was last reviewed on .

Pete McCall. “Blood Flow Restriction Training: What You Need to Know." American Council on Exercise. Link

Ryan J. Wortman et al. “Blood Flow Restriction Training for Athletes: A Systematic Review." The American Journal of Sports Medicine. Link

Stephen D. Patterson et al. “Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety." Frontiers in Physiology. Link

About UPMC Rehabilitation Institute

The UPMC Rehabilitation Institute offers inpatient, outpatient, and transitional rehabilitation, as well as outpatient physician services so that care is available to meet the needs of our patients at each phase of the recovery process. Renowned physiatrists from the University of Pittsburgh Department of Physical Medicine and Rehabilitation, as well as highly trained physical, occupational, and speech therapists, provide individualized care in 12 inpatient units within acute care hospitals and over 80 outpatient locations close to home and work.