Blood Flow Restriction

Sep24th 2019

I recently attended a class to be certified in Blood Flow Restriction Training or BFRT because I have heard a lot of talk about this treatment being utilized in the rehab and strength setting.   I went into this class with some knowledge but I was blown away with the number of applications BFRT and how it can be applied.  It can be adapted to the patient’s tolerance to improve outcomes in therapy as well as accelerating the healing process and return to a high quality of life. BFRT is ideal for people who have limitations to high mechanical load due to casting, bracing or non-weight bearing.  BFR has been shown to improve angiogenesis (development of new blood vessels) and circulation to the limbs, increase VO2 max, and reduce pain! So much has been researched in the last 10 years, over 820 peer reviewed articles!! I’m excited to bring this to Rocky Mountain Physical Therapy.

What is BFR? 

BFR is the brief and intermittent occlusion or restriction of arterial and venous blood flow that is performed by applying a tourniquet to the upper or lower extremity.  The wrapping restricts blood flow from the veins of the working muscles to the heart and limits the amount of blood flow to the limbs from the arteries.  The restrictions results in physiological changes that mimic high intensity exercise.  BFRT has been found to improve systemic ( or whole body) changes and cardiovascular benefits while at rest, with low intensity endurance exercises or low load resistance training. By restricting the blood flow, higher levels of metabolic stress is created by putting the tissue in a hypoxic (lack of oxygen) state and tricking the body into building muscle mass and strength.  Exercises can be performed with low-load resistance training and achieve the same, if not better results than traditional strength training.

Significant atrophy (decreased muscle mass) of muscle or injury can prevent people from loading joints and muscle without pain or risk of re-injury.  Patients coming into the clinic post-operation are limited and unable to strengthen muscles for several weeks during the initial healing phase.  BFRT allows them to accelerate their recovery and even exceed that.  This technology can allow us to get the patient active and keep them active even with their injury.   BFRT also has a systemic effect which means a patient can achieve global gains in strength for those who are deconditioned in more than one area.  Bone will adapt to the load in which is placed on it. With BFR, the patient has the ability to accelerate bone healing and help improve bone density and its ability to regenerate after injury when used correctly.

Who Could Benefit?

  • Bed ridden/Casted/Braced
  • Pre/Post-operative
  • Elderly
  • Athletic populations

You’re probably saying to yourself, “Great, where do I sign up??…..but wait, is it safe?”  Every patient in the clinic is assessed for the appropriate level of restriction.  Once the patient has been cleared for BFR, limb occlusion pressure or LOP is taken using a specialized Doppler which allows the therapist to determine exactly when full blood flow occlusion has been attained and a treatment protocol will be put in place.  In studies, BFR has not been to show blood clots; in fact studies concluded that BFRT can produce the release of anti-coagulating hormone when the cuff is released.  BFR is not recommended for those with uncontrolled blood pressure. It is safe to use on most patients from the elderly to post-operative to athletes, or those who want to see faster results.  It is recommended to use BFR under the supervision of a practitioner, as limb occlusion pressure will be assessed and need to be checked regularly.  A detailed exercise program and protocol will also be designed for the patient to ensure the most effective outcome. 

BFR Benefits

  • Preserve Muscle Mass + Strength during Forced Inactivity (Bed rest, Casting, and Prolonged Bracing)
  • Improve Bone Density + Function
  • Increase Muscle Size + Strength
  • Improve Aerobic Capacity

If you have any question about BFR and how you can benefit from it, you can email me at

Jason Dooley, PTA

Level 1 BFR Certification

Rock Mountain Physical Therapy-Central

Fort Collins, Colorado

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