We are thrilled to announce the launch of a groundbreaking set of Continuing Education Units (CEU) courses tailored exclusively for Athletic Trainers – a comprehensive educational program on Blood Flow Restriction (BFR) training. All of our courses and certifications are proudly approved by the Board of Certification (BOC).
Building on the growing success of our state-of-the-art BFR technology, we are excited to empower Athletic Trainers with cutting-edge knowledge and practical skills to revolutionize their training programs.
Introducing Suji – Pioneers in BFR Technology and Education:
At Suji, we are passionate about pushing the boundaries of athletic performance and recovery. As a company that offers state-of-the-art BFR technology, it was a natural progression for us to extend our expertise to the education sector. By developing these specialized CEU courses, we aim to empower Athletic Trainers with the knowledge and practical skills to leverage the immense benefits of BFR training for their athletes.
Unlocking the Power of Blood Flow Restriction Training:
Blood Flow Restriction (BFR) training has emerged as a game-changing technique in the realm of sports medicine. BFR training enables athletes to achieve remarkable physiological adaptations with reduced training loads. The advantages of BFR training are vast and we want to empower Athletic Trainers to utilize BFR across a range of use cases.
Our CEU courses offer Athletic Trainers an unparalleled opportunity to delve into the science, principles, and practical applications of BFR training. Developed by industry-leading experts, these courses provide a comprehensive curriculum that equips professionals with the expertise to optimize athletic performance and facilitate efficient injury recovery.
Course Highlights:
Conclusion:
Suji – the pioneers in BFR technology, have now released cutting-edge CEU course for Athletic Trainers. Approved by the BOC, these courses are poised to revolutionize athletic training practices, equipping Athletic Trainers with the knowledge and practical skills to optimize performance and expedite injury recovery. Embrace this unique opportunity to stay at the forefront of sports medicine and unlock the potential of BFR training for your athletes. For more information click here or contact us at sales@sujibfr.com]]>Anterior cruciate ligament (ACL) rupture is a highly prevalent orthopedic injury, with over 120,000 injuries occurring each year in the United States. Rehabilitation timeframes are typically between 6 and 12 months with many sufferers encountering muscle atrophy, strength loss, joint effusion and arthrogenic muscle inhibition. ACL repair represents one of the most studied orthopedic injuries and thus rehabilitation techniques have evolved over several decades. Blood flow restriction (BFR) training is rapidly emerging as a viable strategy at multiple stages of ACL rehabilitation and is widely considered an integral part of gold-standard ACL injury management. The use of BFR in ACL management was first explored over 20 years ago as a passive strategy to minimize muscle loss in the first 2 weeks post-surgery (Takarada, 2000). Since then, interest in BFR as a rehabilitation strategy has grown exponentially, and more research has sought to explore the use of BFR in a progressive model through all stages of rehabilitation from pre-surgery conditioning, right the way through to a return to sporting performance.
The aim of this blog is to provide a framework for BFR to be used as a part of a holistic and progressive management strategy, across the various stages of ACL rehabilitation.
Rehabilitation following ACL surgery can begin even before the surgery has started. Increasing lower limb muscle strength prior to surgery is believed to attenuate the deterioration of muscle mass and function in the aftermath of invasive surgery. The adequately named “preconditioning” program presents a unique challenge to deliver an exercise stimulus sufficient to increase muscle mass without exacerbating effusion and pathology in a joint that has suffered significant trauma. A recent randomized controlled trial explored the use of a BFR intervention in the 10 days prior to ACL reconstruction surgery on maximal muscle strength, muscle endurance, surface EMG and muscle blood flow (Zargi et al 2018). As few as 5 BFR exercise sessions were completed, and resulted in significant improvements in muscle endurance, muscle activation and blood flow within the first 4 weeks after ACL reconstruction. These findings demonstrate that a short-term BFR training program may be a valuable addition to standard rehabilitation programs for patients elected for ACL reconstruction surgery. This protocol used a high volume set and rep scheme (3x sets to volitional failure), combined with a low training intensity (40 repetition maximum) and a high absolute pressure (150mmHg with a wide cuff). These variables suggest that biasing the programming variables to achieve a high level of metabolic stress may be an effective pre-surgery strategy to achieve sustainable change in muscle endurance and activation.
Within the confines of a clinical research facility, the use of BFR has started as early as 2-days post-surgery. The objective of this phase is preventing muscle disuse atrophy and strength loss, minimizing joint effusion and pain management. Passive application of BFR can stimulate muscle protein synthesis and has been shown to minimize muscle atrophy when applied as soon as 2-days post ACLR surgery. The most common protocol is 5 sets of 5 minutes occlusion with 2-3 minutes of rest. Higher occlusion pressures, perhaps full limb occlusion (100% LOP) may be required to provide a sufficient stimulus to trigger muscle adaptation. Combining passive BFR with neuromuscular electrical stimulation has also been shown to be an effective strategy to increase muscle mass in post-traumatic knee injury. Three papers have thus far explored the use of BFR within the first 10 days post-ACL surgery and have not reported any incidence of an adverse event or contraindication (Takarada et al 2000, Iversen et al., 2016, Prue et al., 2020). Prue et al (2022) implemented BFR + LI resistance exercise intervention at 9 days post-surgery and reported a small number of episodes of dizziness, paraesthesia and itching.
In an applied setting, many practitioners will avoid the use of BFR in the early stages post-surgery amid fears of an increased risk of a thromboembolism and anecdotal concerns about exacerbating acute joint effusion. While there is little evidence substantiating these concerns when BFR is used appropriately (initial evidence suggests BFR training may reduce joint effusion post ACL surgery), Hughes et al. (2019) proposed a criteria-based assessment to commence the use of BFR training post-surgery. This list included a return to basic muscle function and joint health demonstrated by:
Perhaps the most common use of BFR training is in combination with low-intensity resistance exercise to target improvements in muscle mass and strength during early-stage re-loading. The benefits of BFR combined with resistance exercise are well documented, with improvements in muscle hypertrophy being comparable to heavy traditional resistance exercise, and improvements in strength superior to an exercise matched control. When compared traditional rehabilitation strategies like high-intensity resistance exercise, BFR combined with LI-RT has resulted in:
When compared to an exercise-matched control group, BFR combined with LI-RT has resulted in:
Programming within this phase should be consistent with principles of progressive overload and specificity. Metabolic stress and mechanical load should be systematically increased through changes in limb occlusion pressure/time under occlusion and intensity respectively. Training loads between 20-40% 1RM combined with cuff pressures between 40-80% LOP are recommended for improvements in muscle strength and hypertrophy.
After ACL reconstruction many individuals do not completely regain quadriceps size and muscle strength. Persistent quadriceps asymmetries predispose individuals to altered joint loading and gait mechanics, limited physical function and joint, increased risk of re-injury, and early onset of osteoarthritis. Long-term strength deficits are often associated with other signs of joint pathology and therefore regaining muscle size and strength can pose a significant challenge. Recent research from Kilgas et al (2019) explored a home-based BFR intervention in individuals with persistent muscle atrophy and strength deficits 5 years post-ACL reconstruction. Within the study a 4-week BFR intervention resulted in a ~10% increase in quadricep muscle mass, and a 20% increase in knee extensor muscle torque, while returning the limb symmetry index to 99±5% across all markers. Further research from Noyes et al (2021) explored this concept across various post-surgical patients including total knee replacements and meniscus repairs, alongside ACL reconstruction who were on average 5.3 months post-surgery. In this prospective study, patients had undergone ~5 months of traditional rehabilitation and presented with persistent strength deficits in the quadriceps (43%) and hamstrings (38%). After 6 weeks of BFR training most patients experienced improvements in muscle torque by >20% in both muscle groups.
The use of BFR training has now become commonplace in the management of ACL reconstruction rehabilitation. As we learn more about the practical implications of BFR training, and the mechanisms through which BFR influences the neuromuscular and skeletal muscle systems, we identify more potential use-cases throughout the ACL rehabilitation journey. Further research is still required to fully explore the efficacy of BFR as a rehabilitation strategy, however with 20+ years of research and 30 peer-reviewed publications, the initial evidence is too promising to ignore. Practitioners are encouraged to establish clarity in their purpose when implementing and programming BFR into their rehabilitation protocols and have clear systems in place to track progress and monitor for setbacks.
Hip and groin pain presents an enormous challenge for practitioners involved in diagnosis, rehabilitation and prevention. The complex anatomy, along with a lack of understanding of the aberrant mechanisms that predispose an athlete to injury makes the management of these injuries notoriously difficult. A systematic review evaluating risk factors for groin injury identified four key factors that might predispose an individual to injury: a previous history of groin injury, reduced hip adductor strength (absolute and relative to hip abductor strength), more elite levels of competition and lower levels of sport-specific training (Emery et al 2015). These injuries are a significant burden to professional team sports. A recent meta-analysis demonstrated that hip, groin and pelvis injuries accounted for 28.3% of all injuries in men’s ice hockey (Szukics et al 2022). While in elite level soccer these injuries account for between 13 and 20% of all injuries (Sherman et al 2018).
The etiology of hip and groin injury remains poorly understood, at a fundamental level these injuries typically occur as a disconnect between the load (both acute and cumulative) that the region is exposed to, and the capacity of both the contractile and non-contractile tissues. Certain injuries will require that these tissues are unloaded and rested, while others demand an increase in tissue capacity. For this reason, rehabilitation methodologies that are capable of impacting muscle, tendon and boney tissue, and that are a low mechanical cost, are of great interest in the management of groin injury.
Blood flow restriction training has recently gained popularity as a method for increasing muscle mass and strength using resistance training loads as low as 20% 1RM. Traditional resistance training methods typically demand loads greater than 70% 1RM be used in order to trigger a muscle hypertrophy response, making BFR an appealing alternative. The use of BFR in musculoskeletal and clinical rehabilitation is rapidly becoming a critical part of gold standard care. To the authors knowledge there is currently no research exploring the use of BFR in the management of hip and groin injury, however, many of the core principles in the rehabilitation of these injuries indicate that BFR may be a useful strategy for several reasons.
Most of the research surrounding the use of BFR training has targeted the muscles directly beneath the cuff. For example, the application of BFR cuffs to the most proximal part of the thigh has consistently been shown to increase quadriceps muscle mass and strength when training the lower limb. However, as we learn more about BFR, we discover that the benefits of this form of training may be pertinent to other areas of the body. Recent research from Eric Bowman has demonstrated an increase in muscle strength and endurance capacity in muscles located above the cuff in both the lower (2019) and upper (2020) limb. In the lower limb this research demonstrated increase in muscle strength in hip extension and abduction with the cuff placement at the top of the thigh. Likewise, Constantinou et al (2022) demonstrated a significant increase in hip extensor strength following 4 weeks of BFR training, compared to traditional heavy resistance exercise in individuals suffering from patellofemoral joint pain. These findings suggest that BFR may be a viable strategy to improve the capacity of the tissues that surround the hip and lumbopelvic region and be a useful strategy in managing complex hip and groin injury.
The muscles surrounding the lumbo-pelvic-hip complex work synergistically to balance the pelvis and create movement. This region acts as a central hub for load transfer during all movements and is often subject to forces up to 15x body weight during high-intensity efforts such as sprinting and change of direction. There is good evidence to suggest that both the absolute strength of these muscles, along with their relative strength and balance across the pelvis is important in managing and rehabilitating hip and groin pain. For example, there is strong evidence that the relationship between hip adduction and abduction strength (referred to as the ADD:ABD ratio) is important in managing and preventing hip and groin pain. The precise desired ratio depends on the research and is likely influenced by the athlete population and the demands of the sport, however generally speaking to create balance across the pelvis the hip extensors should be the biggest producers of force across the hip closely followed by the hip flexors, and the hip adductors should be slightly stronger than the hip abductors. Depending on the nature of the injury will determine whether it is the more dominant or weaker structures that are subject to injury. Regardless, optimizing strength balance across the pelvis requires intelligent programming. In order to change the peak force generating capacity of a muscle, we typically require high-intensity resistance training methods which in conditions of hip and groin pathology can be highly provocative. While we currently lack evidence directly exploring the use of BFR in optimizing hip torque ratios and improving athlete outcomes in hip and groin rehabilitation, BFR training has been shown to improve the strength and capacity of the hip extensor, hip flexor and hip abductor muscle groups. By providing a low-cost alternative to traditional resistance training that may be better tolerated by injured athletes, BFR offers a training solution to expedite the desired improvements in maximum strength and hypertrophy of muscle that support the hip and pelvis. General guidelines for prescribing BFR training to achieve improvements in muscle strength and hypertrophy are outlined below. To achieve sustained improvement the program should be progressed based on how each individual presents clinically and their desired training outcome. See Figure 1 for some more ideas.
Many athletes managing hip and groin injury suffer from long-term chronic pain. Often the symptoms of hip and groin pain are not significant enough to remove the athlete from competition and symptoms are managed alongside training. In these cases, finding appropriate times to effectively load the muscles across the hip is limited, and the athlete risks further aggravation of symptoms and reductions in strength. Recent research suggests that performing light load blood flow restriction exercise may have a pain modulation effect. While there is growing evidence supporting the use of BFR in pain management, how and why it is effective remains speculative. Hughes et al. (2020) recently demonstrated that BFR may activate a hypoxia-dependent endocannabinoid pathway that plays a central role in exercise-induced hypoalgesia. Other proposed mechanisms include conditioned pain modulation and the preferential recruitment of high-threshold motor units. By temporarily relieving pain, the BFR stimulus might allow the athlete to complete more intensive traditional heavy resistance training methods pain free, or potentially train and compete in their sport with reduced pain levels. For more information on programming BFR for pain relief, check out our recent blog titled Blood Flow Restriction Training and the Athletic Knee.
As we previously discussed, the lumbo-pelvic-hip complex represents the central point of load transfer across the various kinetic chains within the body. Therefore, completing meaningful strength and power training sessions using traditional methods can often be problematic in athletes suffering from hip and groin pain, and other tissues within the body risk becoming deconditioned. While the research supporting BFR training in maximal muscle strength and hypertrophy is well recognized, BFR training may also be able to develop more high threshold training adaptations that are crucial to sporting performance. Eccentric strength is widely considered an essential physical quality in injury prevention and speed development. Changes in eccentric strength are typically reserved for training strategies that supersede an individual concentric 1RM such as the Nordic hamstring exercise. However, recent research from Jones et al. (2023) has demonstrated similar increases in eccentric hamstring strength using loads at 30%1RM + BFR when compared to 80%1RM eccentric training. Similarly, BFR training when combined with plyometric and speed training has been repeatedly shown to influence speed and power performance. When combined with practical BFR using elastic wraps 100m incremental runs led to a significant increase in 100m sprint time and isometric rate of force development performed on a leg press (Behringer et al 2010). Similarly, when combined with plyometric exercise, the application of BFR led to significant improvements in vertical jump performance, reactive strength and peak force at high contraction speeds in post-operative ACL patients (Demirci et al., 2020).
Athletic hip and groin pain is a complex and multi-factorial injury, making prevention, diagnosis and rehabilitation a significant challenge. Blood flow restriction training presents as a potential strategy to positively impact rehabilitation and management via three key mechanisms:
1 -Providing a low-cost method to optimize torque ratios between muscles that cross the hip and pelvis. This may be achieved by improving the absolute strength levels of individual muscle groups or by improving the balance of strength across the pelvis.
2 – Providing symptomatic pain relief for athletes as a pre-loading or pre-training strategy.
3 – By maintaining high-threshold physical qualities such eccentric strength and leg power during periods or relative unloading.
Whittaker, J. L., et al., Risk factors for groin injury in sport: an updated systematic review. British Journal of Sports Medicine, 2015. 49 (12): pp 803-809.
Szukics, P. F., et al., A Scoping Review of Injuries in Amateur and Professional Men’s Ice Hockey. Orthopedic Journal of Sports Medicine, 2022. 10 (4): pp 1-12.
Sherman, B., et al., Hip and Core Muscle Injuries in Soccer. American Journal of Orthopedics, 2018. 47 (10): pp 23-29.
Bowman, E. N., et al., Proximal, Distal, and Contralateral Effects of Blood Flow Restriction Training on the Lower Extremities: A Randomized Controlled Trial. Sports Health, 2019. 11 (2): pp 149-156.
Bowman, E. N., et al., Upper extremity blood flow restriction: the proximal, distal, and contralateral effects – A randomized controlled trial. Journal of Shoulder and Elbow Surgery, 2020. 29: pp 1267-1274.
Constantinou, A., et al., Comparing hip and knee focused exercises versus hip and knee focused exercises with the use of blood flow restriction training in adults with patellofemoral pain. European Journal of Physical and Rehabilitation Medicine, 2022. 58 (2): pp 225-235.
Hughes, L., et al., The effect of blood flow restriction exercise on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid mechanisms of pain modulation. Journal of Applied Physiology, 2020. 128: pp 914-924.
Jones, M. J., et al., Low Load With BFR vs. High Load Without BFR Eccentric Hamstring Training Have Similar Outcomes on Muscle Adaptation. Journal of Strength and Conditioning Research, 2023. 37 (1): pp 55-61.
Behringer, M., et al., Low-intensity Sprint Training With Blood Flow Restriction Improves 100-m Dash. Journal of Strength and Conditioning Research, 2010. 31 (9): pp 2462-2472.
Demirci, S., et al., The Effect of Plyometric Training with Blood Flow Restriction After Anterior Cruciate Ligament Reconstruction, 2020. 52: pp 798.]]>Chronic knee pain and acute or traumatic knee injury is a major cause of time loss in many competitive sports. A recent injury surveillance study identified knee injury as a leading cause of injury burden across all the top four professional sports codes in the United States and North America, including: basketball, baseball, football and ice hockey. Not surprisingly, the search for rehabilitation strategies that optimize knee health and improve performance remains a top priority within the sports medicine world. Blood flow restriction training is fast becoming a common part of gold-standard management in many different forms of knee injury rehabilitation including:
BFR is typically used as a strategy to improve skeletal muscle mass and strength in load compromised or injured individuals. However, research is emerging to demonstrate the proposed benefits may also apply to bone, tendon, cardiovascular health, cognitive function, neuromuscular performance and pain mitigation. The purpose of this blog is to explore the different ways in which BFR training is currently being used to improve clinical outcomes and athletic performance in acute and chronic knee injury.
The use of BFR methods in acute knee injury dates back more than 20 years when Takarada and colleagues demonstrated that the use of BFR as a passive strategy had the capacity to diminish muscle atrophy following ACL
reconstruction surgery. Since then, more than 50 publications have explored the use of BFR both passively, and in combination with low-intensity exercise in multiple forms of knee injury. A recent review from Hughes et al (2018) described the use of BFR following ACL surgery and identified four key phases through which BFR may be implemented.
The objective of this phase is preventing muscle disuse atrophy and strength loss, minimising joint effusion and pain management. Passive application of BFR can stimulate muscle protein synthesis and has been shown to minimise muscle atrophy when applied as soon as 2-days post ACLR surgery. The most common protocol is 5 sets of 5 minutes occlusion with 2-3 minutes of rest. Higher occlusion pressures, perhaps full limb occlusion (100% LOP) may be required to provide a sufficient stimulus to trigger muscle adaptation. Combining passive BFR with voluntary muscle contraction or neuromuscular electrical stimulation has also been demonstrated as an effective strategy to promote muscle hypertrophy and optimize early stage return of muscle function post traumatic knee injury.
The objective of this phase is to further prevent muscle atrophy, normalize gait patterns and improve quadriceps muscle function. Combining BFR with walking and low-intensity cycling has been shown to increase muscle size, strength and function. BFR application may also promote muscle deoxygenation and enhance aerobic and strength endurance adaptations. When using BFR in conjunction with aerobic exercise higher pressures between 60-80% LOP are typically required to optimize improvements in strength. Anecdotally there is often concerns that using BFR can exacerbate joint effusion. However, evidence from Hughes et al (2019) demonstrated that the application of BFR in post-operative ACL reconstruction can reduce joint effusion and reduce pain during this stage of rehabilitation.
During the phase the application of BFR to low-intensity resistance exercise is commonly used to maximize muscle hypertrophy. The benefits of BFR combined with resistance exercise are well documented, with improvements in muscle hypertrophy being comparable to heavy traditional resistance exercise, and improvements in strength superior to an exercise matched control. Programming within this phase should be consistent with principles of progressive overload and specificity. Metabolic stress and mechanical load should be systematically increased through changes in limb occlusion pressure/time under occlusion and intensity respectively. Training loads between 20-40% 1RM combined with cuff pressures between 40-80% LOP are recommended for improvements in muscle strength and hypertrophy.
The end goal of any rehabilitation program it to progress athletes to be able to tolerate high intensity strength and plyometric training. Heavy strength training is more effective than low-load BFR at improving maximal muscle strength, and plyometric training is essential at re-training leg power and reactive strength qualities. During this phase traditional high-intensity training methods can be supplemented with on-going to continue to target improvements in muscle hypertrophy with a low-cost training intervention.
Chronic and degenerative knee conditions such as patellofemoral joint pain or patella tendinopathy have the potential to cause pain for many years. Experimental pain studies have demonstrated that localized joint pain leads to a decrease in muscle function, impaired motor control and fear avoidance behavioural patterns (avoiding painful activities). Movement strategies that avoid loading the painful knee may trigger a vicious spiralling decline in physical function characterised by progressive muscle weakness and decreased joint stability, which may in-turn expose the athlete to more significant injuries. While traditional resistance exercise is commonly considered the most effective rehabilitation strategy this form of training has the potential to increase load through the injured area and potentially aggravate symptoms
Recent research has shown that performing light BFR exercise may have a pain modulation effect. A landmark study from Korakakis (2018) demonstrated that subjective pain scores while performing functional tasks (single leg squat and step down) were reduced by more than 60% following BFR exercise in subjects with anterior knee pain. Hughes et al (2019) speculated that there may be several mechanisms by which BFR might influence pain:
The simplest way to describe conditioned pain modulation is with the expression 'pain cures pain'. Within the conditioned pain modulation paradigm, a painful conditioning stimulus, may inhibit the perceived pain of a secondary stimulus. While BFR is characterised by low-intensity training, perceptions of pain and discomfort comparable to high intensity exercise are consistently reported in the literature.
BFR exercise causes an increase in metabolites such as lactate within the muscle. These metabolites stimulate the production of opioids and endocannabinoids. Opioids are a family of neuropeptides produced within the nervous system. Specifically, beta-endorphine is thought to play a key role in exercise-induced pain relief. Recent evidence from Hughes et al (2020) demonstrated an increase in beta-endorphine and 2-arachidonoylglycerol levels following high-pressure BFR exercise, and that these changes were associated with increased post-exercise pain relief.
While the evidence supporting BFR as a pain relief strategy is relatively new, the implications for states of chronic knee pain are significant. Not only does BFR have the potential to alleviate pain which may allow for more traditional rehabilitation loading strategies, evidence indicates a moderate effect of BFR exercise on increasing muscle strength in individuals suffering musculoskeletal weakness. This mean BFR exercise can target changes in function, pathology and pain, the three hallmark symptoms of chronic knee injury. There are three primary use cases by which BFR is currently being implemented:
1 – Pre-loading strategy: Heavy resistance training is still viewed as the gold standard rehabilitation strategy in multi-factorial anterior knee pain; however, pain often contraindicates many people from being able to lift sufficient loads. Pre-loading with BFR exercise may enable individuals to successfully complete high-intensity resistance exercises to improve muscle strength. Hughes et al. (2020) demonstrated that the pain-relieving effects of BFR can last up to 24 hours and are likely dependent on the intensity of the BFR stimulus. It appears higher occlusion pressures up to 80% LOP may provide the most potent pain relief strategy.
2 – Pre-competition strategy: While higher occlusion pressures may optimize pain relief, using such a fatiguing stimulus prior to competition may not be desirable. Occlusion pressures as low as 40% LOP have been shown to be effective at providing significant pain relief, while also providing an effective post-exercise potentiation stimulus (Zheng et al 2022).
The capacity to relieve pain and improve leg power performance makes the use of BFR prior to training or competition a desirable strategy.
3 – A stand-alone rehabilitation tool: BFR in combination with resistance exercise has the capacity to increase skeletal muscle strength, increase bone cell turnover, stimulate changes in tendon morphology, and improve conditions of chronic pain in individuals with complex anterior knee pain. When using BFR as an isolated rehabilitation tool it should be noted that BFR is not able to increase muscle strength to the same extent as traditional heavy resistance training. Users are encouraged to systematically increase mechanical load as a part of their progressive overload protocols.
Blood flow restriction training is typically used in combination with low-intensity resistance exercise or cardiovascular training. It involves the application of a pneumatic cuff device to limit arterial blood flow to a limb, while fully restricting venous outflow in working muscles. By modifying blood flow in this way, users can train at remarkably low intensities, and achieve comparable training results as more traditional resistance training methods.
The Suji Device: AI-Powered, BFR Training Equipment
While BFR was conceived as a passive strategy, it is most commonly used to increase muscle mass and strength in combination with low-intensity resistance training. Current guidelines from the American College of Sports Medicine suggest that in order to increase muscle mass and strength an individual is required to train 2 to 3 days per week at 70% of a 1 repetition maximum (1RM). However, when combined with BFR, significant increases in muscle mass and strength have been achieved with a training intensity of as little as 20% 1RM (Takarada et al. 2002). Early research achieved a 10% increase in strength and a 5% increase in thigh muscle mass with only 5x2 min bouts of treadmill walking when combined with BFR (Abe et al. 2006). The benefits of BFR training also likely apply to tendons, bones, and the cardiorespiratory system, however, these pathways will be explored in future blogs.
Using a low-intensity training stimulus such as walking and light resistance exercise exposes users to a low mechanical load. This means less force going through bones, tendons, muscles, and joints. This means that people who are typically considered contraindicated to high-intensity exercise, such as those who are injured, the elderly, or those in poor health, may still be able to benefit from rigorous physical activity. Within the current literature, blood-flow restriction training is currently being explored in over 25 conditions of clinical disease and musculoskeletal rehabilitation. A recent survey of practitioners currently using BFR revealed that the most common objectives of BFR exercise were to induce muscle hypertrophy, followed by use during injury rehabilitation. Universities and elite or professional sporting teams are the most frequented users of BFR, with the age bracket of 21-30 years being the most common age bracket (Patterson et al. 2017).
In this series of blogs, we will explore how to use BFR training safely and effectively. We will also look at how it is being used to improve performance, rehabilitate injury and treat diseases worldwide.