Blood Flow Restriction Training: What You Need to Know

Mihai Voinea
Medically reviewed by Mihai Voinea Doctor of Medicine (M.D.) — Research analysis by Alex Eriksson

There was a time when getting a good pump meant lifting really heavy weights, which are at least 80% of your one-rep-max. That was until blood flow restriction training or BFR training came into the limelight.

This revolutionary performance enhancing technique can help you reach your muscle building goals. Unfortunately, as popular as it is now, that doesn’t mean it’s well-understood by many.

Some people think that BFR training is too extreme or even dangerous and may cause muscle damage and high blood pressure. The other names given to it like hypoxic training, occlusion training, and KAATSU training as well as the equipment required like cuffs, bands, and ace bandages only save to make people think that it really is harmful.

In order to put an end to all those doubts against BFR, let’s dig deeper into the research studies that have been done to prove that when done right, this technique is potent and safe. The plan is to safely apply BFR into your personal physical goals.



Blood flow restriction (BFR) training is a training technique involving the use of wraps or cuffs placed around a limb during exercise, to maintain arterial inflow to the muscle while preventing venous return.

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Heart Blood Health

The Human Circulatory System and BFR

Knowing how the human circulatory system works is the first step in learning about BFR training. The arteries are the blood vessels that deliver oxygenated blood from your heart to the rest of your body while the veins are the blood vessels that deliver mostly deoxygenated blood from your body to your heart.

BFR training’s goal is to restrict the flow of blood via your veins while allowing blood flow via your arteries. This is done by wrapping a device such as a KAATSU device, pressure cuffs, or knee wraps around the top most portion of the limb you are working on.

When blood flow is restricted in the veins, blood pools into the muscle and stays trapped. Think of it like filling a water balloon.

When you bring all that blood into the working muscles, that’s when the ‘magic’ of BFR takes over.

First, you get a really good pump. It causes some swelling. Studies support that cellular swelling is what makes muscles grow.

Second, you’ll get that burn quickly. Remember that burning feeling when your muscles get tired during repeated lifting of weights? That’s called acidosis because the muscle is being deprived of oxygen and it’s unable to get rid of the waste materials (lactic acid) that are accumulating. This metabolic stress is another important factor in muscle growth.

BFR training can stimulate anabolic signaling and muscle protein synthesis which results in significant muscle growth increase even when the load involved is too low for promoting noticeable hypertrophy. This BFR-induced hypertrophy is being driven by metabolic stress.

One other key event which occurs during BFR training is that the slow-twitch muscle fibers that are oxygen-dependent tire much faster than usual. As a result your body immediately taps into the fast-twitch muscle fibers. These kinds of muscles have the most potential for growth.

Without employing BFR, these fast-twitch fibers aren’t normally hit unless you use moderately heavy weights and you lift explosively, or you use really heavy loads. With BFR, you can go fast-twitch with 50 percent of your one-rep max or even less.

A study supporting BFR showed that BFR training can increase the cross-sectional area of the muscle by using only 20 percent of your one-rep max. That means if you can bicep curl a 30-pound dumbbell only once, you only need 6 pounds to get the pump required for muscle growth when normally it will require around 25 pounds and above.

Hence, how does it benefit you? Through BFR training, you’ll be sparing those joints from the stresses of heavy weights. You don’t exhaust your central nervous system excessively because you’re only using light weights.

The arms and the legs are not the only beneficiaries with this type of workout. The nearby muscle groups like the shoulders, chest, and back show size and strength gains as well.


Fortunately, recent studies show that BFR is perfectly safe if all the precautions are taken and that proper wrapping protocols are followed.

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Is BFR Safe for You?

Like with other workout programs, you need to consult with your physician before including BFR training in your routine. The recommendations in this article are applicable only to healthy individuals who are already undergoing high-intensity resistance training in their regular routines.

Although it’s known that restricted blood flow can damage the veins, those who use BFR exhibit increased vasodilation and increased blood flow, compared to when only traditional resistance exercise is used.

Also, using heavy weights can increase arterial blood pressure more than two-folds and make the heart reach maximum rate levels. The low-intensity nature of BFR only increases the heart rate and blood pressure by 11 to 13 percent.


How Should I Wrap for BFR Training?

Some people would use knee or elbow wraps, ace bandages, and even hospital tourniquet. But if you want to be serious with BFR training, there are wraps specially made for this purpose. One such wrap is the PRO-X Edition BFR Bands.

When you’re working out your upper body, you just need to wrap below your shoulder at the top of your upper arm. The wrap will be nestling in the armpit if done correctly.

For your lower body, you should wrap below your gluteal fold at the back and below the hip flexor at the front.

The tightness should be at the right level. Else, you risk injury if it’s too tight and you lose the benefits of BFR if it’s too loose. In a tightness level of 1 to 10, 10 being the tightest possible, it should be around 7.

There shouldn’t be any feeling of numbness or tingling sensation. Else, that would mean you’re wrapping the limb too tight. A tight wrap restricts arterial flow so blood won’t be pooling into the muscle, defeating the whole purpose of BFR. It’s better to err on the looser side than the tighter side, especially if you’re a beginner.

Once you get it right, you’ll get the best pump you’ve ever felt in those muscles. If you feel uneasy, you can always remove the wraps and wrap it again a bit looser the next time. You’ll need to learn what is comfortable to you.


Other Safety Measures

Blood flow restriction training should not be done on its own. You should incorporate regular strength training as well using moderate to heavy weights.

Also, this technique is not recommended for those who have been diagnosed with high blood pressure. Keep a close eye on your blood pressure if you want to undergo BFR training.

Finally, taking supplements and natural foods that are categorized as vasodilators could significantly help if you’re undergoing blood flow restriction training. Vasolidators help your blood vessels expand and allow for more blood to flow through.


author
Alex Eriksson (Research Analysis)

Alex Eriksson is the founder of Anabolic Health, a men’s health blog dedicated to providing honest and research-backed advice for optimal male hormonal health. Anabolic Health aspires to become a trusted resource where men can come and learn how to fix their hormonal problems naturally, without pharmaceuticals.

author
Mihai Voinea (Editor)

Mihai is a medical doctor and entrepreneur with a burning obsession for performance and health. Mihai is also an IronMan, ultramarathon runner, and co-founder of Marsilian, which owns two e-learning platforms for future medical students and doctors.





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