Blood Flow Restricted Training

  • Sacramento Spine & Physical Therapy
  • Sacramento Spine & Physical Therapy
  • Sacramento Spine & Physical Therapy
  • Sacramento Spine & Physical Therapy
  • Sacramento Spine & Physical Therapy

What is Blood Flow Restriction (BFR)?

BFR training is a system very low load exercise performed while blocking the venous return of blood out of the arm or leg all while allowing the arterial flow of blood to reach the muscles in that extremity. Heavily researched at Brooks Army Medical Center to assist wounded service members rebuild strength and function and avoid amputations of limbs, this system is literally the future of extremity rehabilitation.

How does BFR work?

With 2-3 sessions per week, a tourniquet is placed on the proximal portion of the arm or leg and the pressure is specifically increased with the assistance of vascular doppler scanning to make sure the occlusion is correct. Then low load and even non weight bearing exercise are performed typically about 6 minutes per exercise but can last up to 30 minutes based on the specific protocol. Incredibly producing the same physiologic benefits as training with heavy loads.

Typically, to increase strength and hypertrophy a person would need to lift a significant amount of weight (60% of a 1 Repetition maximum or greater). With BFR you can create significant strength and hypertrophy gains with loads as low as 20% 1RM.

Post operative patients can begin almost immediately post-operatively following surgery with research showing virtually NO operative limb atrophy.


  • Diminish atrophy and loss of strength from disuse and non-weight bearing after injuries Increase strength with only 30% loads
  • Increase hypertrophy with only 30% loads
  • Improve muscle endurance in 1/3 the time
  • Improve muscle protein synthesis
  • Improve strength and hypertrophy after surgery Improve muscle activation
  • Increase systemic growth hormone responses

BFR Candidates

BFR training is appropriate for all post-operative knee, ankle, foot, shoulder, elbow, wrist, hand patients. As well as non-operative patients with extremity involvement. Anyone that needs to gain strength but is not a good candidate for the mechanical stress that is produced with higher level exercise.

Click here for our patient handout

Helpful Links

  1. Dr. Walt Lowe and Dwight Howard ESPN video:
  2. Recent research:
  3. The efficacy of blood flow restricted exercise: A systematic review & meta-analysis:
  4. Military rehabilitation setting on severely compromised patients:

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