What is BFR
BFR is a type of strength training that has been around since the 1960s but has only really been studied for about the last 20 years. To keep it simple, we use a medical-grade pneumatic tourniquet that we inflate around either your arms or legs. Then we use an ultrasound to listen for your pulse. Once we find the right pressure we then reduce the pressure so blood continues to flow into your muscle but then we keep it there to help stimulate the muscle to work harder. Normally you need to lift heavy weights to build muscle. For example, if you can only lift 100 pounds once(your max) then in order to grow muscle, you’d have to lift 60-80 pounds 8-10 times to grow muscle through making microtears to the muscle that the body has to go back in and fix(this is what causes the high levels of soreness after a heavy lift). With BFR, we can grow that same muscle while only lifting 20-35 pounds while limiting the amount of soreness you have afterwards. This works really well if your doctor has placed you on weight lifting limitations(like after a surgery or if you are limited for worker’s comp). In this, it acts like a “muscle hack” because it stimulates your muscle to grow at lower loads even as light as just your arm or leg.
Who shouldn't use BFR
While our BFR Certified Therapists will take a thorough medical history including current vitals, the following are generally people that BFR is not right for:
History of DVT or deep vein thrombosis or PE or pulmonary embolism
Acute sickness or fever(meaning you’re actively sick)
Blood pressure > 180/100 mmHg
Early postoperative period meaning your sutures are still in or there is currently any drainage from your incision.
Higher class arrhythmia or heart rhythm issues or coronary ischemia(you are having chest pains or have had a recent heart attack).
We’ll also generally not use it if you are pregnant or trying to get pregnant though our BFR therapist is happy to guide you through what exercises are safe for you during pregnancy.
Has it been studied?
To date, it has hundreds of studies focusing first on safety including who should use it and who shouldn’t(for example, if you have a history of blood clots or an active blood clot or if your blood pressure is over 180, you shouldn’t do BFR). It has over 100 studies showing that it works to save muscle if you’re unable to move(like if you’re in a cast or your doctor said you can’t bear weight through a leg or arm) and grow muscle even if you’re unable to lift heavy weights. In addition, the studies say that the blood pressure used should be personalized to the patient which means that using things like floss bands or blood pressure cuffs and randomly picking a pressure would be less safe and not effective.
Is it safe?
At Body Mechanix, our therapists are specifically trained in BFR safety and use clinical guidelines to determine if using BFR is safe or not for you. Our therapists take a very thorough health history including your current vitals to determine if it is both safe and right for you. Generally speaking, if you have a history of blood clots, have super high blood pressure, or have heart rhythm issues, we generally will not use BFR. Even if you are dealing with those things, there is often lots that can be done to help, so we recommend scheduling your free BFR consult either way
What about blood clots?
As long as the BFR clinician is using personalized pressures, risk of clots is very low. Interestingly enough, when researchers tested the blood of people who’ve done BFR, they find that the body produces several chemicals, specifically TPA which is a clot buster and prevents clots from forming.
What if I can't put weight through a joint?
Are you non-weight bearing or partial-weight bearing after your surgery or are in an immobilizer. BFR can help and is used successfully days after the surgery to stop muscle loss and stimulate muscle growth. This way, the more muscle you have when you are allowed to bear weight the better base you have to start from.
What if I'm on weight lifting restrictions?
Has your doctor or surgeon told you that you have lifting restrictions for your injury? No problem, most BFR programs can save or grow muscle with no added weight.
How do you find the right pressure?
We use a doppler ultrasound which listens for your blood moving through your arteries. For your arm, we measure through an artery that is close to your thumb while for your legs we measure through an artery just behind your ankle. Once we find the right pressure through inflating the cuff, we then reduce the pressure in the cuffs to 50% for your arms and 80% for your legs. This means that the blood is NOT blocked(occluded) and so BFR is not occlusion training. This increases the safety for your blood vessels, nerves, and prevents muscle injuries.
Can't I just use a blood pressure cuff?
Usually a blood pressure cuff is too big to work for BFR for the arms and often can’t get the right pressure for the legs(and you have to use really high pressures that can damage nerves and blood vessels). Our medical grade cuffs and where we place them really reduce the chance of damage to nerves and blood vessels.
Can't I just use a Floss Band or Strap?
For the same reasons that a blood pressure cuff increases the risk of injury, a floss band generally can’t create the right pressures for effective BFR and you are unable to get the right amount of pressure for it to work well either.