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OTL: Hustle with less flow

Blood Flow Restriction Rehabilitation at Atrium Physical Therapy

You’re probably immediately thinking: “Blood Flow Restriction? How could restricting my blood flow actually be good for me?”

This is a bit complicated, but we’re going to try to break it down so it makes sense.  Blood flow restriction rehab, or BFR, has been around for a long time, but recently the evidence for it’s use in the rehab world has started to emerge, and many physical therapists are realizing that this is a game-changer when in comes to increasing muscle strength and muscle size.    One of the issues in the rehab world is that we often have difficulty increasing strength in muscle groups because we can’t work the muscles hard enough.  Enter BFR, which allows us to increase muscle size (hypertrophy) and muscle strength when we work the muscle as a low load. 

 

How Does BFR Work?

BFR is not an exact science and is not currently utilized during traditional rehabilitation or training sessions. One theory of how it might work states that the decrease in blood flow during exercise can lead to a hypoxic state (decreased oxygen) and force the muscle to recruit and use the fast twitch (type 2) muscle fibers which produce high power output and strength. These fibers are normally recruited and utilized by a muscle when the muscle is burning stored energy fuel (glycogen) and not relying on oxygen for its fuel source. High intensity exercise such as resistance training with heavy loads has been the standard way to recruit and develop these muscle fibers. Recently, researchers and some healthcare providers have utilized the BFR to get similar results.   The major difference in training principles of the BFR vs standard training is that BFR uses low loads and high repetitions to get the desired results.  Another effect of blood flow restricted training is that is allows for a greater synthesis of proteins needed to build and repair muscles and other tissues.

According to the latest research, if the proper blood flow restriction therapy protocols are used, the benefits of the training are equivalent to those seen when using 70 percent of a person’s maximal load, while using as little as 20 to 30 percent of the individual’s maximum load. The key is that restricted blood flow allows a therapist to create a localized area of anaerobic training. What exactly does that mean? All of our muscles are made from different types of fibers, including type 1 that are slow to twitch and rely on oxygen to contract, and type 2, which are fast-twitch fibers and the ones we are trying to recruit with BFR training. By limiting the blood flow, we create an environment in the muscle group that forces the recruitment of more type 2 fibers. Because these type 2 fibers generally can produce more force, greater strength gains are a result.

The use of BFR shows promise in rehabilitation and many Physical Therapists will most likely incorporate it into their treatment protocols in the future. The use of low loads makes it possible for almost anyone with any condition to be able to perform the exercise routine and develop a larger, stronger muscle mass. Patients that have arthritic joints, severe weakness due to disease or age will be able to develop strength but spare the joint structures from further damage. The use of heavy resistance is not an option in some of the patient populations because they are too frail and weak to move this type of resistance, but can handle the low loads that are associated with BFR.

From a strength training perspective these are all great things, but from a rehabilitation perspective they give us an amazing advantage. Many times after an injury or surgery the amount of load that an area can handle is decreased as we wait for the tissue to heal. As a result, we often see large decreases in strength simply because the affected limb needs to heal before it can handle the resistance needed to build strength. With the ability to use blood flow restriction training in rehab, we can minimize that muscle loss and speed up healing and recovery, all while placing a minimal load on the injury or surgical site.

 

Is It Safe?

Now you may be thinking that that sounds great, but is this really safe? The short answer is yes, but as with any other rehab technique, there are protocols that need to be followed. We definitely don’t recommend that people tie bands around themselves and do this on their own. In the clinic we use specific devices to know exactly how much occlusion we are getting and can monitor it as you train. Atrium Physical Therapy uses the gold-standard in BFR -Delfi Medical Innovations’s state-of-the-art PTS Personalized Tourniquet System for Blood Flow Restriction. The Delfi unit has been specifically designed to safely regulate and control tourniquet pressure for Blood Flow Restriction applications, and is the only FDA approved device for this purpose.  The PTS Personalized Tourniquet System for Blood Flow Restriction device can only be purchased by medical providers who are certified in it’s use.  At the time of this writing Atrium Physical Therapy is the only medical provider in the State of Mexico to be certified in the use of the Delfi system.

At Atrium Physical Therapy we are always looking for the best ways to allow our patients to achieve their goals as fast as possible, and we are very excited to be able to add Blood Flow Restriction Therapy to our “toolbox”.

If you would like to learn if you are a candidate for BFR as part of your rehabilitation, please call us and schedule a Discovery Visit today.