Blood Flow Restriction Therapy Builds Strength, Promotes Healing

Increasing blood flow to help heal an injury. Building muscle strength for those unable to tolerate weight or resistance on a limb. Improving cardiovascular fitness and reducing pain. These are some of the applications of blood flow restriction (BFR) outpatient physical therapy offered at Good Shepherd Rehabilitation.

BFR therapy uses a tourniquet as a brief or intermittent restriction of blood flow to an extremity to increase muscle adaptation in a limb and can have systemic whole-body changes. It tricks the body into thinking it’s working harder than it is.

BFR is more well-known and utilized in the athletic population, but it can be used clinically — which people don’t always realize.

“Resistance training is successful in improving muscle strength and increasing muscle size. But for some patients, muscle strengthening with high-intensity exercises is not yet appropriate,” said Physical Therapist Samantha Partington, PT, DPT, who manages Good Shepherd’s Kutztown and Fogelsville outpatient sites. “For those patients, we may be able to use BFR to help them gain strength in injured or weak muscles while reducing the stress placed on the recovering limb.”

How does BFR work?

A special tourniquet system, with a cuff similar to a blood pressure cuff, is used to provide a precise amount of pressure to a patient’s arm or leg while exercising the muscle. The amount of pressure to restrict blood flow varies among patients and is calculated each session based on age, heart rate and blood pressure to ensure safety while using the cuffs. The goal is to maintain blood flow into the muscle while preventing outflow, thus maximizing strength gains while minimizing stress on muscles and joints.

The pressure will tire the muscles in the targeted area and help the body with healing and muscle growth in response to the metabolic stress and muscle tension.

BFR provides supplemental benefits to pain reduction and cardiovascular fitness since reducing blood flow to limbs increases VO2 max (the maximum amount of oxygen a person can use during exercise). 

BFR therapy works best with a frequency of three to four times a week, and results can speed up recovery time (depending on the injury or issue).

What are the benefits of BFR therapy?

• Increased strength
• Increased hypertrophy (muscle size)
• Decreased atrophy (loss of muscle size)
• Aid in recovery and healing
• Improved cardiovascular function

While some high-level athletes use BFR to build muscle, it is used in the therapy setting for patients whose bodies are unable to tolerate or who are not yet appropriate for strengthening and are limited to simple range of motion exercises due to pain or a post-surgical protocol. BFR can quicken healing and recovery, reduce pain, improve some cardiovascular issues and decrease muscle loss (atrophy). It can be used in pre-operative and post-operative rehabilitation.

For what conditions is BFR used?

BFR can be used for:

• Patients who need rehabilitation following an injury, such as a fracture, torn rotator cuff or torn anterior cruciate ligament (ACL).
• Patients who are pre-operative or post-operative for various illnesses, injuries and conditions.
• Bedridden and older patients who have muscle atrophy
• Patients with some cardiovascular issues

“For a rotator cuff injury, for example, we can put the tourniquet on a leg and have them exercise on a bicycle, which increases blood flow to the entire body and helps to promote healing in the shoulder through the increase of vascular endothelial growth factor (VEGF), which is responsible for nutrient delivery in our body during healing,” said Partington. “Then, with approval from the physician, we eventually put the tourniquet on the arm to continue strengthening.”

Is BFR safe?

Yes, BFR is safe when it is provided by a BFR specialist like Partington, who completed specialized training in the therapy. Good Shepherd’s therapists use an assessment to check for contraindications before starting BFR with a patient.

“If there is more risk than reward, the patient is not a candidate for BFR,” Partington said. “Once we know the patient can safely tolerate BFR, we provide a lot of education on the therapy. We also closely monitor every patient undergoing BFR therapy.”

BFR therapy is relatively new, so not a lot of clinicians know about it, Partington said.

“But Good Shepherd is successfully using this proven therapy to decrease the stress placed on the patient’s joints while advancing strength and healing,” she said.

For more information on Blood Flow Restriction Therapy and how to get started, call 1-888-447-3422 (44-REHAB).