At Horizon Physical Therapy, we are always striving to keep up-to-date and educated on the most cutting edge and effective therapies. We were the first clinic to bring Functional Dry Needling to the Athens area and we utilize world class equipment, like the Alter G—anti-gravity treadmill. Treating and improving performance of endurance athletes, like runners and tri-athletes, has been an area of specialization for Horizon since opening our doors in 2005. Recently, our clinicians have taken continuing education courses from experienced leaders in the physical therapy treatment of fitness athletes to better serve the growing Crossfit communities in Athens and Oconee. Horizon continues to lead the way and expand our scope in bettering performance and treatment of competitive and recreational athletes alike. With that being said, we would like to introduce you to a treatment that will be a game-changer for athletes and patients of all ability levels—Blood Flow Restriction Training (BFR).
BFR training is utilized as both a performance tool and a physical therapy treatment. This application works similarly to a blood pressure cuff — where blood flow to the exercising muscle is narrowed by a cuff in order to optimize muscle strength and hypertrophy gains. The HUGE advantage of BFR training is that you can effectively gain strength, muscle mass, and endurance by only lifting 30% or less of your maximal available muscle strength! This type of training is beneficial for a wide range of patients, from those 1 week out of a surgical repair (like a meniscus, ACL, or rotator cuff repair) to the in-season athlete who wants to continue training but does not want to hinder performance due to the muscle soreness required to gain strength. A patient who recently had surgery typically cannot bear full weight or is not allowed to stress the affected area intensely until the site has had some time to heal. With BFR training, we can mitigate the amount of time where muscles would typically atrophy and strength would be lost—In fact, with BFR, we are able to improve strength during times when patients sometimes lose strength due to immobilization.
So how does exercising with 30% or less of a 1 rep max actually increase strength when typically you need to be lifting at least 70% of your muscles full potential in order to increase strength? Simply put, BFR training reduces the amount of oxygen that the exercising muscle is able to obtain via normal circulation. Your muscles have 2 types of fibers—oxidative fibers and non-oxidative fibers. The oxidative fibers are the first to work when you exercise and they are more for endurance. The non-oxidative fibers are used for strength and speed production. BFR training allows you to use and strengthen those type 2 fibers in order to build strength without the associated muscle damage and typical delayed onset muscle soreness (DOMS). These are the basic principles behind why BFR training works. To read a more in-depth explanation on the science behind BFR training, refer to the research articles cited at the end of this blog.
You might be wondering, “Who is BFR training appropriate for and how do I know if it is a tool that will help my athletic or rehabilitation needs?” First of all, patients and athletes must be screened by a medical professional who is knowledgeable on the topic before BFR training is applied in order to make sure it is a safe intervention, on an individual basis. There are certain cardiovascular, metabolic, and musculoskeletal conditions for which BFR training would not be recommended. The physical therapists at Horizon PT are up-to-date on the most current research regarding BFR training and can let you know if it is a treatment that will benefit you. Below is a bullet list of some, but not all, who would benefit from BFR training.
- Post-surgical patients of the ankle, knee, hip, shoulder, elbow, and wrist
- Non-surgical patients who have had muscle atrophy in the extremities or trunk
- Patients or athletes who cannot tolerate high loads on their joints but need to continue to gain strength
- In-season athletes who cannot comprise performance for in-season strength training
- Endurance athletes who want to increase their VO2 max
- Recreational athletes/fitness athletes looking to build muscle mass.
Horizon Physical Therapy is proud to be able to offer this new and innovative intervention to improve the rehabilitation and performance of our patients and athletes. BFR training is currently being used in a rehabilitation setting at HPT. For those interested in the performance and athletic benefits of BFR, keep your eyes on Horizon social media as we will begin offering sessions of BFR training for purchase – just as we do running clinics and Normatec recovery boots. We hope to rehabilitate and train you harder and smarter with the inclusion of Blood Flow Restriction training in our practice, while continuing to bring you the latest and greatest interventions.
VANWYE WR, WEATHERHOLT AM, MIKESKY AE. Blood Flow Restriction Training: Implementation into Clinical Practice. International Journal of Exercise Science. 2017;10(5):649-654.Kubota, Atsushi, Keishoku Sakuraba, Sadao Koh, Yuji Ogura, and Yoshifumi Tamura. “Blood Flow Restriction by Low Compressive Force Prevents Disuse Muscular Weakness.” Journal of Science and Medicine in Sport 14.2 (2011): 95-99. Web.
Loenneke, J. P., G. J. Wilson, and J. M. Wilson. “A Mechanistic Approach to Blood Flow Occlusion.” International Journal of Sports Medicine Int J Sports Med 31.01 (2009): 1-4. Web.
Loenneke, Jeremy P., Jacob M. Wilson, Pedro J. Marín, Michael C. Zourdos, and Michael G. Bemben. “Low Intensity Blood Flow Restriction Training: A Meta-analysis.” European Journal of Applied Physiology Eur J Appl Physiol 112.5 (2011): 1849-859. Web.