57. Blood Flow Restriction (BFR) Training: Chasing the (good) Pump

In episode #57 of the podcast, Dr. Kate and Dr. Kacy talk briefly about blood flow restriction (BFR) training including the science behind it, safety considerations, dosing of exercises and applications in physical therapy and specifically for endurance athletes. They talk about how they use BFR to improve rehabilitation for athletes with a diverse range of injuries including tendinopathies, bone stress injuries, and muscle strains. As explained in the episode, BFR allows for training of muscles and strength in an area of injury without overloading or compromising the healing tissue. They also emphasize the power of BFR to improve strength in endurance athletes and how this can lead to performance gains and more robust athletes! Dr. Kate and Dr. Kacy first discuss what BFR is and the principles behind its physiological effects in the body. As Kacy explains, “What we get when we use blood flow restriction training is we create this environment while we’re exercising that’s very similar to high intensity exercise. So, it’s as if we’re doing a high intensity effort, but we don’t have to load our body that much.”

They also talk about some of the principles and variables to consider with BFR training including occlusion pressure (i.e., how much blood flow is restricted), training sets and repetitions, placement of the cuff, and exercise selection. Dr. Kate and Dr. Kacy introduce the use of BFR with certain orthopedic procedures and treatment that falls under the category of “orthobiologics,” or the use of biologic agents to leverage a tissue healing response. Orthobiologics can include stem cell therapy, platelet rich plasma (PRP), and hyaluronic acid injections and Dr. Kacy briefly discusses what goes into the preparation of PRP treatments. Dr. Kate also mentions some fascinating research about not only the local muscle effects, but systemic effects of BFR including improving strength and conditioning in the contralateral limb!

Dr. Kate and Kacy also include some important information on safety considerations with BFR and talk about the use of a less safe form of BFR sometimes seen in gym settings that includes the use of bands that don’t register occlusion pressure and so do not standardize how much blood flow is going to the arm or leg. They recommend only using devices that monitor occlusion pressure for safety, and as Kate says, “Don’t chase the pump!” If you have been curious about BFR and interested in learning more, this episode is for you!