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BFR Basics
BFR entails occluding circulation of the working muscle. This is
accomplished by wrapping a restrictive implement around the limb(s) while
carrying out dynamic exercise. The objective of BFR is to occlude venous
flow without significantly affecting arterial circulation. In this way, blood
goes into the muscle but can't escape.
Research on the hypertrophic effects of BFR is compelling. Studies show that
simply occluding blood flow to bedridden patients can prevent atrophy and
weakness, without performing any training at all (1)!
Moreover, walking with blood flow restricted to the legs not exactly your
classic muscle-building activity has been found to significantly increase
muscle strength and size (2). But the real hypertrophic benefits of BFR occur
when it's applied in concert with resistance exercise.
Numerous studies show substantial increases in muscle growth when low-
load lifting (~20-30% 1RM) is combined with flow restriction (3). Gains are
often on par with traditional heavy-load training during early-stage training,
sometimes even greater.
How Does BFR Increase Hypertrophy
What is the "magic" behind BFR? The exact hypertrophic mechanisms aren't
entirely clear but it's believed that metabolic stress plays an important role
in the process. Simply stated, metabolic stress is the buildup of training
byproducts called metabolites, and is particularly prevalent when training is
carried out in an oxygen-limited state, as is seen when circulation is
restricted. Metabolites implicated in promoting a hypertrophic response
include lactate, inorganic phosphate, and hydrogen ions.
These byproducts are theorized to enhance anabolism by a variety of
mechanisms, including mediating the release of growth factors, reactive
oxygen species, and cell swelling, and/or systemic agents. Alone or in
combination, the production of metabolites drive cellular signaling in a
manner that enhances protein synthesis and satellite cell activation key
elements needed for muscle growth (4).
It's also important to keep the limbs continually restricted for the duration of
the exercise. Research shows that untying the wraps between sets
significantly reduces metabolic stress, thereby inhibiting the growth
stimulus (8). Remove the wraps only after you've finished the final BFR set.
Do it right and you'll get a skin-splitting pump like you've never experienced
in your life.
At least some of your sets should be taken to the point of muscular failure.
Understand, however, that going to failure in BFR requires a different
mindset than during traditional resistance exercise.
With BFR your limbs get heavier with each successive rep. After a point,
you'll feel as though they simply can't move. This is where mental fortitude
comes into play. Because the loads are so light, you can will yourself to push
through the sensation and pump out a few additional reps. Dig deep and
squeeze out every last rep possible. Ultimately this is how you maximize
metabolite accumulation and its associated anabolic response.
Final Thoughts
Integrating BFR into your training can really ramp up your muscular gains.
With continued implementation into a well-designed resistance training
program, it may well be the strategy that takes your muscular development
to new heights.
References
Kubota A, Sakuraba K, Sawaki K, Sumide T, Tamura Y. Prevention of disuse
muscular weakness by restriction of blood flow. Med Sci Sports Exerc. 2008
Mar;40(3):529-34.
Abe T, Kearns CF, Sato Y. Muscle size and strength are increased following
walk training with restricted venous blood flow from the leg muscle, kaatsu-
walk training. J Appl Physiol. 2006 May;100(5):1460-6.
Loenneke JP, Wilson JM, Marin PJ, Zourdos MC, Bemben MG. Low intensity
blood flow restriction training: A meta-analysis. Eur J Appl Physiol. 2011 Sep
16.
Schoenfeld BJ. Potential mechanisms for a role of metabolic stress in
hypertrophic adaptations to resistance training. Sports Med. 2013
Mar;43(3):179-94.
Wilson JM, Lowery RP, Joy JM, Loenneke JP, Naimo MA. Practical blood flow
restriction training increases acute determinants of hypertrophy without
increasing indices of muscle damage. J Strength Cond Res. 2013 Feb 26.
Loenneke JP, Fahs CA, Rossow LM, Sherk VD, Thiebaud RS, Abe T, et al.
Effects of cuff width on arterial occlusion: Implications for blood flow
restricted exercise. Eur J Appl Physiol. 2011 Dec 6.
Kacin A, Strazar K. Frequent low-load ischemic resistance exercise to failure
enhances muscle oxygen delivery and endurance capacity. Scand J Med Sci
Sports. 2011 Dec;21(6):e231-41.
Suga T, Okita K, Takada S, Omokawa M, Kadoguchi T, Yokota T, et al. Effect
of multiple set on intramuscular metabolic stress during low-intensity
resistance exercise with blood flow restriction. Eur J Appl Physiol. 2012
Nov;112(11):3915-20.