Blood Flow Restriction article


(Eric - The patient needs to be patient!) #21

Visit this long thread for several people posting about BFR and BBS workouts. I’m one that posts there and I do BBS weekly and BFR for arms only, weekly if schedule allows.

Dr McGuff, the Body by Science author talks about recovery and how some people need 5,6, 7 days and even up to 10 for recovery. I’m not sure where I have read this or heard it but the younger you are and the healthier you are, metabolically, the shorter your recovery period “may” be.

I have discovered by adjusting mine up and down that 6 or 7 days are what I need. I’m 66 yo and still a little overweight and clearly metabolically deranged, but improving.

I was doing lower one day and upper the next and recently combined them into 6 exercises (2 lower because I can’t do leg presses because of a bad ankle).

  • Pulldown
  • Overhead
  • Seated chest press
  • Seated pull (aka vertically rowing)
  • Leg extensions
  • Leg curls

I add wrist curls somedays.

For Body by Science routines this book is a must-read:

Body by Science: A Research Based Program for Strength Training, Body buildin… via @amazon

This book is for after you read the one above and have a few weeks of BBS experience :

The Body By Science Question and Answer Book by Doug McGuff MD via @amazon

Dr. Doug McGuff (MD) did not invent this approach but he popularized it. There are videos on youtube that demonstrate the technique but the video quality is lacking in most cases.

This presentation by Dr. McGuff motivated the heck out of me. It is long (>1hr) and has some technical biochemistry in it but again it motivated me. Dr. McGuff is an emergency room trauma doctor and he talks about what we need to do to age in a healthy manner.

Hopefully, this info helps.


I liked the BBS read. I read it years ago and it did away with many misconceptions I had on fitness. Opens your eyes on why you feel “out of shape” and it has more to do with excess weight and lack of muscle more than it does “cardio” deficiency. You are out of breath due to amount of energy you are required to move, not because you don’t get up and run on the treadmill. Lose weight, build muscle, move easier. That’s why people that walk regularly has an easier time walking. They are building up walking muscles and it then requires less energy to do it.

(Joey) #23

@daddyoh Yes, it certainly does. Lots of great suggestions.

I’ve read the McGuff book, watched clips of him speak - but not that full length video link you’ve provided. Will make time to get to that soon.

I’ve also read a slew of HIIT-related books, many of which are contradictory with each other about specifics, even if directionally they head toward the same concepts.

And of course there are a range of research papers, most of which are quite informative - if the experimental “givens” are consistent with one’s own situation. As a guy in my early 60s, I appreciate that my body chemistry is not going to track too closely with a 20-30 yr old graduate student- (seemingly the most common experimental subject :wink:

You’re 66 and doing just grand based on what you’ve shared above. Keep it up … you’re inspiring the young’uns coming up behind you. :vulcan_salute:

(Bunny) #24

An interesting overview:

What is Blood Flow Restriction (BFR) Training?

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

How does it work?

  • Lack of venous return creates a swelling effect of the muscle.
  • Metabolites, such as lactate, accumulate and stimulate muscle growth.
  • Hypoxic environment promotes strength and muscle growth.
  • Direct muscle fatigue forces the nervous system to recruit the largest fast-twitch muscle fibers, which have the greatest capacity to grow.
  • Increase to Growth Hormone (GH) and Insulin Growth Factor 1 (IGF-1).

What are the benefits?

  • Increased muscle size (Hypertrophy)
  • Increased muscle strength
  • Increased cardiovascular capacity
  • Increased GH, IGF1 and maybe testosterone
  • Decreased joint/tissue stress
  • Little to no muscle damage
  • Little to no recovery needed
  • Little to no soreness or delayed onset muscular soreness (DOMS)
  • Low Intensity needed (resistance or cardio)

Who benefits?

  • Immobile or mobility-restricted populations:
  • Bed ridden
  • Casted
  • Post-operation rehabilitation patients
  • Elderly
  • Athletic populations:
  • Active recovery
  • Decrease joint/tissue loads
  • Isolated exercises for “weak link” region

What are the risks?

  • Injury resulting from this type of training is rare
  • Possibility with inappropriate implementation:
  • Subcutaneous hemorrhage
  • Numbness
  • Always consult your physician prior to any new exercise program …More


I did BFR for Tris and Biceps today. BBS for chest, legs, and shoulders. My son did squats using the bands. Glad I ran across the BFR training threads on here. I had no clue there was such a thing…

(Central Florida Bob ) #26

There’s a quote that graduate students are the best replacements for lab rats in any sort of study like this. That’s because (1) being rather more intelligent than a lab rat, grad students are easier to train and it’s easier to teach them what they’re supposed to do, (2) after the experiment there are none of those arguments about “but it’s a rat, how do we know the same mechanism exists in humans?”, (3) they’ll do just about anything for free meals, and (4) there are things that a rat’s ethical system won’t allow them to do!

Do I need the obligatory “that was a joke” disclaimer?

The on topic part of this is that I’ve been doing an experiment for the last few weeks with my BBS (or BBS-like) workouts. I’ve dropped the recovery time by one day, from 8 to 7 to 6 this week. So far I’ve seen no loss of progress and have actually increased my time under tension/load on all exercises. I have kept up my three-times a week, hour long bike rides throughout, but only my squats seem they could interact with the bike.

I turn 66 on Monday.

(Kenny Croxdale) #27

The Three Mechanisms of For Hypertophy

  1. Metabolic Stress

Blood Flow Restriction falls into this category.

Metabolic Stress is also referred to as “The Pump”.

As Arnold said, “You can’t grow without the burn”; that driven by a build up of lactate in the muscles. Lactate triggers an anabolic muscle growth in a similar way to…

Traditional Bodybuilding

The use of moderate to high repetition are used to elicit the same Hyperterphic Response…

This is elicited due to Venous Blood Flow back to the heart being restricted. The muscle contraction shut down Venous Blood Flow back to the heart.

Arterial Blood Flow to floods the muscle being worked.

This produce “The Pump”, blood is trapped in the muscles blowing them up like a balloon.

Blood Flow Restriction just take it a step farther.

  1. Mechanical Tension

This is another component that drive an increase in muscle mass. It involves the use of heavy loads for low repetitions.

  1. Muscle Damage

This is the the third component that promotes an increase in muscle mass.

It is obtained by infrequently pushing muscle to failure or near to it. It also occurs when muscle are place under a load in a fully stretched position; Full Squat or Dumbbell Bench Press, etc.

Physical Therapist

As you stated, very few Physical Therapist know about it. Part of my job is with PT’s. As with most things, they don’t “Prescribe” or use something that are not familiar with.

Blood Flow Restriction is rather uncomfortable, when performed correctly. As one PT told me, most people are already in pain when the visit him. The last thing they want is more pain.

Some Validity

For an individual who want to maximize muscle mass, as noted above, using heavy load is needed for optimal results.

Time Under Tension

Research has demonstrated that Fast Concentric Contraction and Fast Eccentric Action are more effective than Slower Time Under Tension Training.

Fast Concentric and Eccentric Movement innervate that "Super Fast Type IIb/x and Fast Type IIa Muscle Fiber.

These Fast Twitch Fiber larger and stronger; strength and size are increased when they are trained.

Heavy Loads

If you want to go slow, use heavy loads but try and blow them up as hard and fast as you can. That not going to happen with a heavy load.

However, research show that the “Intent” to do so, immediately innervates these Fast Twitch Muscle Fiber.

**Excellent Synopsis!

Great information.

Squat For Legs

Research has determined that Squat work for Legs but have virtually no carry over for doing something like building biceps.

Exercise are “Sight Specific”, only the muscle being worked grow in size and strength.

Blood Flow Restriction

It like a tool in your tool box. It’s effective for the right job.

(Eric - The patient needs to be patient!) #28

Is this true for Failure training? What research please? I follow Dr. McGuff’s recommendations and they are working for me in terms of strength. I care not about muscle size. For now I am no longer doing BFR training.

(Kenny Croxdale) #29

Speed kills: 2x the intended bar speed yields ~2x the bench press gains • Stronger by Science

(May 2014) study published in the European Journal of Sports Science

Approximately double the strength gains by lifting the bar with maximum speed each rep , as opposed to a slower cadence

  1. To produce more force, your body uses more muscle fibers (as opposed to each fiber just contracting harder to produce more force)

  2. The first fibers your body uses are the smallest, slow-twitch fibers . To produce more and more force , it recruits progressively larger and stronger fibers, with your largest, strongest fast twitch fibers being the last ones integrated into the movement. (This is called Henneman’s Size Principle )

  3. Recruiting these fibers isn’t based on the weight you’re using per se, but rather the amount of force you produce . Force = mass x acceleration, so all other things being equal, lifting a bar faster means you produced more force to lift it.

  4. Therefore, lifting the bar faster recruits more muscle fibers.

  5. The fast twitch muscle fibers – the last ones you recruit – are the ones most prone to hypertrophy , so lifting faster = more fast twitch fibers used = more strength and size gains.


24 men were recruited (4 dropped out), mostly in their early to mid 20s, and of normal height and weight (1.77 ± 0.08m, 70.9 ± 8.0kg). They were healthy and physically active, with 2-4 years “recreational” experience with the bench press. “Recreational” is a slippery term. Their 1rms averaged around 75kg to begin with – slightly more than 1x body weight. So it wasn’t the first time these guys had picked up a barbell, but they also weren’t elite athletes.


The subjects maxed at the beginning and end of the program to assess strength gains. Also, bar speed of all of their warmup sets was recorded (both groups were instructed to lift the bar as fast as they possibly could on all of their warmup sets) to see whether training fast or slow affected their force production capabilities.

They split the subjects into two groups. Half of them trained at max velocity (MaxV – controlled eccentric, and explosive concentric), and half of them trained at half velocity (HalfV – controlled eccentric, and 1/2 maximum bar speed for the concentric).

bar speed - TUT
In every single category, MaxV saw basically twice the gains of HalfV

Bar speed - strength and velocityNotice – right around 2x the gains across the board
Breaking is all down:

So, lifting the bar faster means more gains , and it makes you more explosive with lighter weights too?

lifting faster may produce superior gains in maximal strength.

The biggest takeaway is that being able to pick up heavier things makes it easier for you to move lighter things faster.

Getting stronge r DOES he lp you produce more power , but it’s not highly specific. Lifting heavy things has a much higher carryover for lifting heavy things fast than it does for lifting light things fast.

So will you be able to throw a shot put further by increasing your bench , or be able to jump higher by increasing you squat ?

Absolutely! To a point…

…actually recorded average velocities and concentric time under tension . TUT has been preached by some as a driving force in strength and hypertrophy gains.

However, the HalfV protocol had substantially more TUT than the MaxV protocol , but it produced substantially worse results . Perhaps TUT should be amended from “time under tension” to “time under maximal tension”how much time you spend actually moving the weight with as much force as possible .

… there is a time and place for controlled concentrics – learning.


moving the bar as fast as possible probably produces better gains than intentionally slowing your rep speed

Moving heavy things as fast as possible improves your ability to move heavy things fast much more than it improves your ability to move light things fast.

use bar speed as an indicator of your strength day-to-day. You can use this knowledge to adapt a percentage-based program to fluctuations in strength day-to-day and (hopefully) improvements in strength over time without having to max in the gym regularly.

Short-term high- vs. low-velocity isokinetic lengthening training results in greater hypertrophy of the elbow flexors in young men

higher velocity (3.66 rad/s) isokinetic lengthening contractions are associated with greater muscular hypertrophy than slower (0.35 rad/s) velocity lengthening contractions.

We observed, despite a >10-fold lower mean torque-time integral (Fig. 6), a greater degree of hypertrophy (Fig. 3) with a training protocol that involved only high velocity lengthening contractions.

Fiber type-specific changes after eccentric training

Not every type of eccentric training causes preferential increases in type II muscle fiber area, and some types actually cause type I muscle fiber area to increase more!

#2. Preferential type I muscle fiber hypertrophy

…when slow eccentric phases are used during normal strength training, this causes increased type I muscle fiber size,

Slowing down an eccentric does not enhancement or recruitment so it is not "eccentric overload ". It only increases time under tension.

Research shows the slow negatives do not elicit the most effective response.

Slow Eccentrics For Growth?

Slow eccentrics for growth? - Dan Ogborn

Dan Osborne found that with eccentrics/negatives are…

  1. “…greater following high rather than slow velocity eccentric actions (29).”
  2. “…as far as strength was concerned, fast eccentric actions were superior.
  3. "… growth of type IIa and IIx fibres was greater with fast eccentric actions."

Negatives: You’re Doing Them Wrong](Negatives: You’re Doing Them Wrong | T Nation)

As per Chris Thibaudeau

  1. …“ going slower will not improve the stimulatory affect of the eccentric. …it won’t recruit and stimulate more fast-twitch fibers .”
  2. "The Essential Points : Focus on heavy and controlled, not on moderate weights lowered slowly."

Defining Fast Eccentric Time

A Fast Eccentric is defined as lowering the bar in approximately one (1) second. This innervates the Fast Twitch Muscle Fiber (“Super” Fast Type IIb/x and Fast Type IIa).

A greater muscle mass as well as maximum strength is achieved by training the Fast Twitch Muscle Fiber compared to the Slow Twitch Muscle Fiber

(Eric - The patient needs to be patient!) #30

Thanks. I need to read this in detail and look at the original paper. Much to think about.

(Stephen Judd) #31

You left out one point that is especially relevant to BBS training:

When not training to failure, moving the bar as fast as possible probably produces better gains than intentionally slowing your rep speed.

When you’re constantly training to failure, it may not matter quite as much. However, you DON’T constantly have to train to failure to get stronger.

BBS is predicated on training to momentary muscular failure. BFR is also typically taken to failure.

(Anthony) #32

I’ve been doing blood restriction training to improve muscle endurance, and strength for 6 months. The most prominent benefit of this training was my increase in stamina and better workout performance.

(Kenny Croxdale) #33

Occlusion Training

This method produces some increases in strength but not that much.

It is primarily for Hypertrophy, increasing muscle mass. Some endurance occurs with it, as well.

Kenny Croxdale