Within the last few years, studies have been conducted on the practice of blood flow restriction therapy in athletes that have suffered an injury. The findings are fascinating, indicating that blood flow restriction (BFR) can substantially increase myogenic stem cells and overall muscle hypertrophy. One study compared males that underwent similar exercise protocols, 12 with the BFR protocol and 8 for control. Typical BFR training consists of short‐term low‐load resistance exercises performed with partial blood flow restriction. Blood flow is carefully regulated via a cuff around the appendage doing the work. At the end of a 3 week period, the BFR group underwent a significant increase in maximal isometric voluntary contraction strength and myogenic stem cells as comparable to that gained from heavy-load resistance training. (Nielsen et al. 2012).
The concept behind the effectiveness of BFR is that. The compression cuff restricts 50-80% of blood flow to the limb, creating a local hypoxic event. This temporary anaerobic environment causes an increase in cell signalling, leading to increased anabolic growth factors, fast twitch fiber recruitment, and muscle protein synthesis. Ultimately, this leads to overall muscle hypertrophy in shorter periods of time with less stress from high-weight exercises. (DePhillipo et al., 2018).
There are however some risks to blood flow restriction training. At risk populations include older adults and individuals with compromised cardiovascular systems. If it is performed incorrectly by a provider who is not well versed in the technology, it can cause muscle, nerve, and cardiovascular damage. (DePhillipo et al., 2018).
On the flip side, who might benefit from it? The most interesting application of this type of training lies in physical therapy post-injury. In patients who are load-compromised post-injury or post-surgery, BFR has been effective in accelerating recovery and minimizing pain. It can also be used during rehabilitation cycles of healthy athletes to prevent atrophy during periods of rest. (Buckthorpe et al., 2019).
The potential for this technology could be enormous, however there is a disparity among researchers and physicians, some of whom support the therapy entirely and others who doubt its usefulness. While more research is definitely required, the mechanisms behind blood flow restriction therapy is intriguing.
Buckthorpe, M., La Rosa, G., & Villa, F. D. (2019). RESTORING KNEE EXTENSOR STRENGTH AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A CLINICAL COMMENTARY. International journal of sports physical therapy, 14(1), 159–172.
DePhillipo, N. N., Kennedy, M. I., Aman, Z. S., Bernhardson, A. S., O'Brien, L., & LaPrade, R. F. (2018). Blood Flow Restriction Therapy After Knee Surgery: Indications, Safety Considerations, and Postoperative Protocol. Arthroscopy techniques, 7(10), e1037–e1043. doi:10.1016/j.eats.2018.06.010
Nielsen, J.L., Aagaard, P., Bech, R.D., Nygaard, T., Hvid, L.G., Wernbom, M., Suetta, C. and Frandsen, U. (2012), Proliferation of myogenic stem cells in human skeletal muscle in response to low‐load resistance training with blood flow restriction. The Journal of Physiology, 590: 4351-4361. doi:10.1113/jphysiol.2012.237008
That is very interesting concept, being able to make strength gains under less weight and putting lower stress on limbs would be very beneficial. That would be awesome to see blood flow restriction therapy used in practice for physical therapist and see if they notice an increased recovery. I saw an article that also talked about BFRT being used for the elderly. The blood flow restriction stimulates mTORC1 and this increases protein synthesis which would be beneficial as people start to loose skeletal muscle mass with age. I hope that there is continued research because BFRT because it seems like something that could be utilized for a lot of different things.
ReplyDeleteFry, Christopher S., et al. “Blood Flow Restriction Exercise Stimulates mTORC1 Signaling and Muscle Protein Synthesis in Older Men.” Journal of Applied Physiology, vol. 108, no. 5, 2010, pp. 1199–1209., doi:10.1152/japplphysiol.01266.2009.