Impact of Blood Flow Restriction Training in Orthopedics: Know All

What Is Blood Flow Restriction Training?

Blood flow restriction training is a rehabilitation technique that helps with musculoskeletal injuries. It also helps sports persons to enhance their performance and strengthen their injured parts with less stress and load on the body. Blood flow restriction training is also known as occlusive training. This technique is used in building muscle faster with less load using a blood flow restriction band.

How Does Blood Flow Restriction Training Work?

Blood flow restriction training works by partially restricting the arterial inflow of blood and fully restricting the venous outflow in the muscles during workouts. It requires the use of elastic or pneumatic cuffs around the proximal side of the lower and upper extremities with the desired amount of compression to stop the circulation. The pressure applied by using the cuff on the limb restricts the blood flow, which causes the pooling of blood on the limbs and leads to hypertrophy of the muscles. This hypertrophy starts the muscle growth process and strengthens the muscles.

What Are the Types of Blood Flow Restriction Training?

Blood flow restriction training is performed with various exercises. The types of blood flow restriction training include:

• BFR-RE (Resistance Training) - This type of resistance training with blood flow restriction can be done only two to four times a week. Muscle hypertrophy can be observed in a shorter duration within three weeks.

• BFR-AE (Aerobic Training) - This type of blood flow restriction is applied while cycling or walking. This is used mainly by trained athletes.

• P-BFR (Passively Without Exercise) - Only blood flow restriction is applied in this type, and no exercises are performed. It is commonly used in reducing muscle atrophy after anterior cruciate ligament surgery.

What Are the Uses of Blood Flow Restriction Training?

• Blood flow restriction training is usually performed by a physical therapist and other healthcare providers.

• It is used to increase muscle mass, muscle strength, and muscle endurance.

• It is also used in the rehabilitation process after certain orthopedic surgeries.

• It is not only used in persons with injury but blood flow restriction training is also used by sports persons to enhance their performance by increasing muscle strength.

Some of the common benefits of blood flow restriction training in orthopedics include:

• Increased muscle mass.

• Improved healing.

• Increased strength.

• Improved aerobic capacity.

• It improved cardiovascular endurance.

• Improved bone density.

• Reduction in blood pressure.

• Reduction in pain.

• Less soreness of muscles after exertion.

• Enables quicker recovery.

• Increase the level of growth hormones.

• Increase muscle strength even during injury.

What Are the Impacts of Blood Flow Restriction Training in Orthopedics?

• The main aim of the blood flow restriction training is to simulate the effects of high-intensity exercise by applying less load by recreating the hypoxia in the muscles using the cuffs. Low-intensity exercises can be performed on the targeted muscle by placing the cuff proximally.

• Low-intensity blood flow restriction training helps to develop greater muscle circumference with normal exercise with low-intensity training.

• Low-intensity blood flow restriction training causes cell swelling; that is, it increases the water content of the cells of the muscles. It also helps in faster muscle twitching.

• Low-intensity blood flow restriction training done for four to six weeks has been very useful in increasing muscular strength. This increase in muscle strength is similar to the muscle gain obtained from a high-intensity exercise without blood flow restriction training.

In What Exercises Blood Flow Restriction Training Can Be Used?

The upper extremity exercises in which blood flow restriction can be used are:

• Push-up progression.

• Bicep curls.

• Limited wrist extension.

• Limited wrist flexion.

• Resisted external rotation.

The lower extremity exercises in which blood flow restriction can be used are:

• Quad set.

• Leg press.

• Squat variations.

• Heel raise.

• Stationary bike.

• Step up.

• Straight leg raise.

What Are the Indications of Blood Flow Restriction Training?

• It is most commonly used in the anterior cruciate ligament injury rehabilitation process.

• Knee arthroscopy.

• Age-related sarcopenia.

• Disuse atrophy.

• Cartilage repairs.

• Patellar tendinosis.

• Total knee arthroplasty.

What Are the Contraindications of Blood Flow Restriction Training?

Blood flow restriction training is contraindicated in persons with:

• Open fractures of the limb.

• Diabetes.

• Cancer.

• Varicose vein.

• Compromised peripheral circulation.

• Severe hypertension.

• Pregnancy.

• Active infection.

• Clotting disorders.

• Deep vein thrombosis.

• Obesity.

• Arterial calcification.

• Sickle cell anemia.

• Acidosis.

• Renal problems.

• Venous thromboembolism.

• Lymphadenopathy.

• Extremities infections.

What Are the Safety Implications of Blood Flow Restriction Training?

• BFR training partially restricts blood flow to the working muscles using cuffs or bands. This could potentially increase the risk of injury if not performed correctly or if the equipment is not properly applied.

• BFR training may temporarily reduce blood flow to the limbs, which could cause discomfort or exacerbate certain medical conditions like hypertension or vascular issues. It's essential to consult a healthcare professional before attempting BFR training, especially if you have any pre-existing health conditions.

• Improperly applied pressure during BFR training may cause nerve compression and lead to tingling, numbness, or more severe nerve-related issues.

• To ensure safety and effectiveness, it's crucial to have proper instruction and supervision when performing BFR training. Following appropriate guidelines and using suitable equipment is essential.

• Although the risk is low, there is a potential for blood clot formation during BFR training due to reduced blood flow. People with a history of clotting disorders should avoid BFR training or consult their healthcare provider before attempting it.

• The safety considerations in blood flow restriction training are mainly taken on pulmonary embolism, deep vein thrombosis, and muscle damage.

• The main effect that a person should consider before undergoing blood flow restriction training is blood-related complications.

• In addition to this, another major concern is muscle damage. Improper exercises with blood flow restriction may result in muscle damage and DOMS (delayed onset muscle soreness). Muscle damage may also be caused by high-load resistance exercise.

Conclusion

Blood flow restriction training is a technique that is used in orthopedics, mainly in the rehabilitation process after surgeries. The restriction of blood flow leads to muscle growth and increases muscle strength. There are various studies and research based on this technique. Even though I have achieved many benefits, blood flow restriction training needs a lot of work to overcome all the risks, complications, and disadvantages.