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

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