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  • Huw Darnell

Blood Flow Restriction Training for Rehab

Blood flow restriction (BFR) training has been one of the best additions to my rehabilitation tool box over the last 5 years.


I was first exposed to BFR through Selwyn Griffith and Matt Hass when working with the Brisbane Lions. The 1st generation cuffs from Chris Gaviglio have since been updated. I highly recommend the Sports Rehab Tourniquet for quality and ease of use. Chris also has a podcast that goes deep on BFR uses and practical applications which is worth checking out!


The responses due to increase in metabolic stress with BFR is similar to that of high load lifting. This is achieved by restricting the venous return of blood from your working muscles which causes the accumulation of blood pooling. The result is energy substrate supply for the working muscle being inhibited, oxygen balance of muscle cell disturbed and removal of metabolic by-products inhibited.


In a nutshell BFR training simulates a much higher training stress, at lower mechanical loads.

The proposed mechanisms by which BFR works are the following:

  1. Metabolite accumulation - lactate, phosphate

  2. Hormonal responses - HGH, IGF-1, testosterone

  3. Intramuscular Signalling - mTOR, myostatin

  4. Intracellular Swelling aka "The Pump"

  5. Muscle Fiber Recruitment


I will give you a few examples where I have used BFR with massive success.

  • Older athletes, weekend warriors. For those of your out there who have long term sporting injuries, degenerative joints and load compromised joints e.g. chondral defects. The ability to put a much higher training stress (metabolic, hormonal) on the body, at lower mechanical loads is great for promoting hypertrophy around these joints

  • Chronic injuries e.g. Tendinopathy, I have found getting extra volume in for movement patterns great for helping here. One really great example is higher volume sled drag finishers with the cuffs on for patella Tendinopathy

  • Those who have trouble feeling a muscle work. Using the cuffs can be enough of a neurological stimulus to help feel the muscle.

  • Those struggling with hypertrophy post injury/surgery. 30,15,15,15 protocol on the injured muscle. I like using something that has a minimal need for the individual to create stability e.g. leg extension or leg press to get extra volume into quads.

  • Post surgery - when you are immobilised post surgery there is evidence to suggest that using BFR results in a significant attenuation of muscle loss post surgery from an ACL (view paper here)




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