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Pritchard: Is blood flow restriction training — is it for real? (column)

Jimmy Pritchard
Better Version of You

An increasingly popular training modality in today’s fitness landscape is blood flow restriction training, or BFR.

If you are unfamiliar with this method, it is simply a pressurized cuff that is placed proximally on either the upper or lower extremities to reduce arterial blood inflow and occlude venous return.

Why in the world would one do this when resistance training, you may ask? Proponents of this method believe that it creates a hypoxic environment in working musculature and enhances metabolic buildup which ultimately induces positive stress responses to drive increased muscular hypertrophy.



While the literature yields mixed reviews, there appears to be a place for including this method into ones training program, however, context is key.

Is the hype real?

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Before employing BFR strategies, it is essential to understand the efficacy and practicality behind its use.

A great deal of literature has been published discussing this topic, including a meta-analysis in 2011 conducted by the European Journal of Applied Physiology exploring BFR interventions and their effect on hypertrophy gain. Within this meta-analysis, there were 11 research studies included, varying from subjects completing 4-5 days of weekly walking while blood flow restricted, or two to three days of weekly resistance training using loads between 20-30% 1RM.

Upon conclusion of each respective study, the resistance trained groups displayed both significantly greater muscular strength and hypertrophy. This demonstrated that results can be seen with BFR because in normal training interventions using such low training loads are unlikely to stimulate significant hypertrophy whereas they did in this case. No research studies were included comparing test subjects doing training without BFR, which could easily be considered a hole in this meta-analysis, but there does appear to be some benefit to its use.

Anecdotally speaking, I have used it with many athletes/clients and seen positive benefits, so too have the majority of my colleagues.

Better than standard resistance training?

Understanding the mechanisms underlying BFR assist with its application. BFR training is recommended to be used only in low intensity resistance training situations, approximately 20-40% 1RM. By employing this method, one is seeking to increase muscular hypertrophy, not necessarily strength, therefore higher loads with lower volume are not optimal and could pose injury risk.

The ideal populations for using BFR training are injured or rehabilitating athletes. A major issue many athletes or individuals in this situation have is the inability to load themselves with adequate weight to stimulate muscular hypertrophy, much less maintain what they already have. If BFR is appropriately applied, it can allow individuals within this population to load themselves in a safe manner potentially keeping the muscle atrophy process at bay, even increasing muscular hypertrophy in some cases.

It is important to use proper loading schemes and understand that BFR is ultimately a tool in resistance training, much like everything else. Always consult your physician prior to employing this method, as high blood pressure could pose an inherent risk when doubled with this method. Thanks for reading!

Jimmy Pritchard has a BSc in exercise science from Colorado Mesa University and is a certified strength and conditioning specialist through the National Strength and Conditioning Association. He is the director of strength & conditioning at Ski & Snowboard Club Vail. Contact him at 970-331-3513 or jpritchard@skiclubvail.org. Check out his website pritchardperformance.com.


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