Most people know that going to Physical Therapy will require some form of exercise with an emphasis on building strength. Current guidelines from the American Academy of Sports Medicine (ACSM) suggest that resistance training greater than 65% of a one repetition maximum (1RM) is needed to improve strength and promote hypertrophy (increase in size of a muscle). However, due to injury and post-surgical precautions, this intensity of exercise can be not suitable for rehabilitation. That’s where BFR comes in. BFR uses a tourniquet system applied under the shoulder or hip, and involves performing low load (20-30% 1RM) exercises to promote hypertrophy of muscle while increasing strength. All while keeping joint compression relatively low to protect the healing process.
At Foothills Physical Therapy, our therapists are certified in Personalized BFR (PBFR) training through Owens Recovery Science (the premier company for research and implementation of PBFR). We hosted an in-house continuing education course in May of 2021, in which we learned the theory, methodology, and prescription of PBFR. Each clinic has a state-of-the-art BFR unit from Delfi. These units have an FDA approved doppler (class 1 medical device) that safely regulates limb occlusion pressure (LOP) and personalized tourniquet pressure (PTP) for our patients.
The primary reason why BFR is effective is by reducing blood flow to an exercising muscle, which places muscle tissue in a hypoxic state (lack of oxygen). This hypoxic stress is what drives cellular and hormonal responses, correlating to improvements in muscular strength and endurance. Other benefits include reduced pain, improved bone health, and improved tissue healing.
Based on current evidence, the typical upper extremity strength protocol includes performing 4 sets (repetitions of 30/15/15/15) 2-3x/week with 50% LOP. For the lower extremity strength protocol, we use the same 4 sets 2-3x/week, but with 80% LOP. BFR is a safe and very effective tool to help increase strength, and is best used under the direction of licensed and certified Physical Therapists. There are a few precautions and contraindications for using BFR training based on medical history. If you’re interested in trying BFR, contact us, or ask your current Physical Therapist to see if it is right for you.
Beau Lockmer, PT, DPT
Owens Recovery Science. Personalized Blood Flow Restriction Rehabilitation (PFBR) continuing education course. May 15, 2021. Foothills Physical Therapy. Boise, ID.