Dr. John Rusin describes what blood flow restriction training is, the benefits of adding it into your workouts, and how to implement it into your plan!
Blood flow restriction (BFR) training is nothing new in the world of muscle and strength.
However, recent application of this training method in clinical and rehabilitation settings has begun to catch the eye of coaches and practitioners alike for one simple reason.
When programmed properly, executed pristinely, and used with the right type of client, BFR training can be a game changer for training around injuries while getting bigger and stronger in the process.
Lifters get beat up, there’s no other way to say it. And some of the areas responsible for chronic injuries are the elbows and knees.
Well, BFR is here to save the day, and your knees and elbows in the process!
Blood flow restriction training sounds too good to be true, right? Well, I’ll be the first to tell you that this technique lives up to the hype.
It may even provide you with some of the most impactful joint sparing ways to train with brutal intensity while not tearing down your body in the process.
But before we get into exactly how to implement this method, lets review the basics of blood flow restriction training.
By restricting or occluding the return of venous blood flow back into central circulation from a limb or region of the body, BRF exercises can increase the metabolic environments of the tissues being occluded. This will elicit a mega pump effect, driving blood into the targeted tissues of an exercise, and keeping it there to trigger an anabolic response.
There are a few key programming parameters when implementing BFR training into your routine, so review each of these closely to ensure that BFR training stays safe and effective in the process:
1. 7/10 tightness rule- Use cuffs, bands or other occlusion tools around specific aspects of the limb with a perceived 7/10 tightness, where level 10 is as tight as you can possibly tie off an extremity. This will be different for everyone, but ensure that the cuff is not too tight, occluding the musculature fully, which can cause impairments.
2. Lower the intensity- Work at lower relative intensities in terms of the loads you are choosing for each movement where BFR training is being utilized. The sources vary, but staying within 25-40% of a one-rep max for a movement will keep the loads low enough to trigger the response that you are seeking with this method.
You should be able to execute these reps perfectly with these loads, placing emphasis on the movement itself, but more on that in a bit.
3. Up the volume- Utilize higher metabolically demanding set and rep schemes such as multiple sets of 15-20 reps per set with minimal rest periods between. Anywhere from 15-45 seconds rest between sets of BFR is appropriate. These are not grinder reps, but pristine form with perfect tempo to pump as much blood into the active tissues as possible.
4. Concentrated reps- The movement quality is key, so use a constant tension through the targeted musculature at all times, peaking each concentric contraction, and not pausing at the top or bottom or the range of motion. Tap into your mind muscle connection and “feel” these movements working the muscles, not the other way around!
5. Finish your sets- Lastly, once the cuffs are placed on BOTH extremities, keep them on until the end of the last programmed set. If at anytime your hands, feet, legs or other parts of the extremities start to go numb, stop the sets and take the cuffs off. Blood will flow back into the region and normalize within a few minutes.
I’ll say this again, keep the cuffs on for the duration of a set scheme, and that includes between each set in the rest periods.
While this method can technically be used for any movement in your training arsenal (including compound work of the upper and lower body such as pressing, pulling, deadlifting, squatting and lunging), I have found the most benefit, escpecially for lifters new to BFR, training in the extremities.
Below I have broken down the top three areas to start implementing BFR into your training. This includes arm training, quadriceps and hamstring work, along with the always-stubborn lower legs. Enjoy and be sure to review the video tutorials where I explain how to place the bands on your arms and legs for maximal comfort and effectiveness of the technique.
If you’ve been lifting long and heavy enough, the elbows and shoulders are a common pain point for many lifters. One of the reasons for tender elbows and shoddy shoulders is the incomplete inclusion of arm training into a routine.
While arm training is absolutely functional in my eyes, putting long levered stress through the acute structure of the biceps, triceps and forearms with near maximal strength and hypertrophy loading can reek havoc on the local soft tissues.
By bringing down the training loads to 40% of a one-rep max while utilizing BFR style occlusion of the upper limbs, we can create a huge and nasty pump through the arms. Not only that, but it minimizes the joint stresses which will allow you to train like a madman, letting your non-contractile tissues (like your joints and tendons) take a break from getting beat up.
While the cuff and bands are far more tedious to place high into your groin and gluteal fold, this is still an effective tool for beat up lifters dealing with aching knees and nagging hip problems.
By placing the cuff as high into your groin as possible and tightening it down again to a 7/10 perceived tightness, you can now train isolation work for the quads and hamstrings ( leg extensions and curls) at a submaximal load while reaping the benefits of a metabolic pump that will elicit muscle growth.
When placing the band, realize that you have some pretty large soft tissues to get through including the adductor group, hamstrings and of course the quads. To occlude effectively, you may need to tension the cuff more than you would compared to the arm occlusion techniques above.
If you are a minimalist and believe strongly in the power of compound movement, BFR is still a highly viable option for you! With the same cuff placement, completing movements like the squat, hinge, and single leg movements can tap into that highly electric metabolic environment created by the occlusion.
One of the nastiest BFR movements I routinely program for my clients is the split squat at higher rep ranges. With slow and deliberate full range of motion execution, this will create one of the most novel training effects of your lifting career. Fight the urge to speed up your reps or rest at the top or bottom, and reap the pump of your life.
Finally, the lower leg is notoriously a troubled area for many lifters. Naturally, most will gravitate towards big, heavy compound work and lack the focus for isolation work, especially in highly specialized areas such as the calves.
While strength and hypertrophy work creates the foundation for strengthening and building muscle in the lower leg, you can take your calf training to the next level by implementing some metabolically directed sets into the tail end of your calf training using BFR.
You can choose to occlude the calves below the knee. Although, my preferred method is to place the band or cuff above the knee for comfort’s sake. Again, focus on higher rep ranges here and really get a pump going.
Remember, take your bodyweight into account here when you are thinking about calculating 40% of one-rep max, so this may end up being bodyweight movements for the most part which is fine.
Give these a shot and focus on the quality of movement, especially in the calf raise. Peak each contraction and make sure you are tapping into your mind muscle connection and “feeling” each rep.
The BFR calf training above all others is usually in need of a great post-set stretch, so spend 30 seconds or so stretching out the calves after you finish up the BFR block of training.