Blood Flow Restriction Training

Blood Flow Restriction Training

It is a training involving the use of cuffs placed around a limb during exercise, aiming a partial arterial occlusion.

The occlusion pressure used it is usually 40-80% for the Lower limb and 40-60% for the Upper Limb.

The 100% limb occlusion pressure is obtained using different methods such as auscultation, palpation or using a doppler ultrasound.

Blood Flow Restriction Training , provokes a local swelling of the muscle cells, improving the local neural function, also, it improves the central neural function through an increase cortical motor excitability. Moreover, the metabolite accumulation increases the muscle protein synthesis helping the muscle hypertrophy.

At the moment the evidence shows that  the best use for blood flow restriction training is when we require muscle strengthening and/or hypertrophy, but we cannot load the joint itself.


40-80% of the maximal occlusion pressure for the Lower limb and 40-60% for the Upper Limb. (higher pressures are associated with more discomfort but likely superior clinical outcomes).

Guidelines include 75 reps split in 4 sets(30-15-15-15), the load used should be between 15 and 30% of 1-RM.

  • First set: aim for voluntary failure at 30 repetitions at a rate of approximately 1 repetition every 2 to 4 seconds
  • Second to fourth sets: same weight as first set, 15 repetitions, 30 seconds of recovery between sets

Each bout of occlusion should last 5-7minuted, if multiple bouts of occlusion are performed, a Reperfusion time of 5 minute should be used at least.


  • Vascular compromise, clotting disorders or other elevated risk of embolism, renal compromise, hypertension (systolic blood pressure of 140 mmHg or greater)

Possible side effects:

embolism the worst one,  Local discomfort during the exercise and bruising, very few reports of serious adverse events when precautions have been followed.

Expect to see meaningful results after at least 4 weeks of training

Blood Flow Restriction Training can be useful tool in the Rehab environment and for who is looking for muscle gains.

In the Rehab environment it gives the possibility to contrast the muscle atrophy and the loss of strength in any conditions which doesn’t allow a joint loading and therefore, where heavy resistance training is not clinically indicated.

For who aims to get muscle gain, it could be a good variant to the normal routine or could be seen as part of the weight training in order to increase the metabolic work.

Other benefits of Blood Flow Restriction Training

  • Pain reduction
  • Increase in strength and hypertrophy using Low Loads
  • Improve muscle function


-Whiteley, R. (2019). Blood Flow Restriction Training in Rehabilitation: A Useful Adjunct or Lucy’s Latest Trick? Journal of Orthopaedic & Sports Physical Therapy,


-Ladlow et al.,(2018),Low-Load Resistance Training With Blood Flow Restriction Improves Clinical Outcomes in Musculoskeletal Rehabilitation: A Single-Blind Randomized Controlled Trial

doi: 10.3389/fphys.2018.01269

-Dephilippo N.N. et al(2018), Blood Flow Restriction Therapy After Knee Surgery: Indications, Safety Considerations, and Postoperative Protocol

doi: 10.1016/j.eats.2018.06.010



5 STAR CLINIC LTD has put in place several measures to assess and manage the risk of Covid-19 transmission.
Be aware that is not possible to completely eliminate this risk and that a face to face consultation will increase
the likelihood of you contracting COVID-19.

Full information here: 5 STAR CLINIC LTD COVID-19 POLICY



We are following the CSP chart “Virtual first”, therefore you will be required to have
a Video Consultation at first(15min FREE), where a Triage questionnaire will be also administered.

At the end of the Video Consultation, we will decide if is deemed necessary
a FACE to FACE appointment or if we need to proceed with a virtual consultation.





    Please DO NOT ATTEND:

    1. If you have you been in close contact (<1m for at least 15 minutes without any protection) with a confirmed case of COVD-19
    2. If are you in the list of clinically extremely vulnerable people, click here: VULNERABLE GROUP
    3. If either you or one of your household has been ill in the last two weeks
    4. If you are suffering from any of the below:
      • Shortness of breath.
      • New persistent cough.
      • Fever over 38 degrees C.
      • Change or loss of taste/smell.



    • We follow hand and hygiene practices throughout the meeting.
    • We provide hand sanitizing facilities and a surgical mask (Type IIR)
    • We minimise contact time closer than 2 metres and for less than 15 minutes
    • We keep at least 15min gap between patient for environment decontamination
    • We provide adequate air changes (average of 15min/hour with 4 to 6 air changes)
    • We provide cleaning and decontamination of equipment, surface and areas
      between each patient
    • Throughout the clinic are placed relevant posters to raise awareness and help in
      managing the risk of transmission
    • We follow safe removal and disposal of PPE in accordance with infection prevention
      and control during Covid-19 document
    • In the waiting area, a maximum of 2 people at a time at a distance>2m will be allowed.
      The patients know where to sit, as in the sitting area 2 chairs are provided only.
    • We follow Respiratory and cough hygiene – ‘Catch it, bin it, kill it’. Disposable, single-use tissues
      should be used to cover the nose and mouth when sneezing, coughing or wiping and blowing the nose,
      used tissues should be disposed of promptly in the nearest waste bin tissues. To be followed from hand hygiene.
    • We are only using disposable or washable material (such as couch covers, paper tissue, couch/pillow etc.)
      The therapist will be wearing PPE in line with government guidelines (disposable gloves, plastic apron,
      surgical mask (Type IIR), eye protection or Visor will be used if at risk of droplets)



    • To arrive on time for your appointment.
    • To do not arrive before or late to avoid crowding in the waiting area.
    • On arrival will be taken a contactless temperature reading.
    • To wear a surgical type mask during the waiting and the treatment*.
      a mask will need to be purchased at the clinic if you do not bring one.
    • To wash or clean the hands with hand sanitizer on the arrival and before.
      leaving and whenever may be needed to reduce the risk of contamination.
    • Please try not to use the toilet if possible and DO NOT USE self-service area.
    • On each face to face consultation, you will be required to fill and sign a Triage questionnaire.
    • Maintain 2 metres separation where possible, for instance, during the subjective examination.
    • To avoid cash payments preferably using contactless payments as much as possible), or online transfers.
    • To come alone unless strictly necessary to be accompanied. After entered the building, the companion will be allowed
      to enter only if strictly necessary (see below chaperone/translator).On the other hand, will be asked to leave and wait in the car.
    • In the case of chaperone/ translator is required will be asked to stay 2m apart of all the time from everyone, also they will need
      to complete a pre-screening questionnaire.
    • Follow Respiratory and cough hygiene – ‘Catch it, bin it, kill it’. Disposable, single-use tissues should be used to cover the nose
      and mouth when sneezing, coughing or wiping and blowing the nose, used tissues should be disposed of promptly in the nearest
      waste bin tissues. To be followed from hand hygiene.
    • Confirm contact details for the patient and each person accompanying the patient and inform them that these details may be used
      for contact tracing if required.
    • If possible, an electronic signature will be used on all of the document, if not a signature with a clean pen, after the hands have
      been sanitized


* Patient use of face masks

In clinical areas, common waiting areas or during face to face treatments patients is required to wear a surgical face mask.
The aim of this is to minimise the dispersal of respiratory secretions and reduce environmental contamination.
A surgical face mask should not be worn by patients if there is potential for their clinical care to be compromised (such as when receiving oxygen therapy).



For more detailed information Covid-19 policy click HERE.