Nearly 60 years ago, while meditating on a traditional Japanese tatami mat, Yoshiaki Sato felt his legs go numb. Little did anyone realize that precise moment would be the catalyst for the latest fitness trend called blood flow restriction training or BFR training. 

In his moment of circulatory constriction, Sato was seated in a position called “seiza,” in which the legs are folded underneath the body, with the tops of the feet on the floor, and the buttocks resting on the heels. Anybody not used to the seiza position would likely experience numbness in the lower extremities after just a few minutes. But Sato, being immersed in traditional Japanese culture, knew that the lack of blood flow to his lower legs was not normal. 

Sato set out to work. Decades of experimentation led him to devise and perfect blood flow restriction technology. Today, world-class athletes and rehab patients alike are benefitting from Dr. Sato’s ingenuity and steadfastness. 

At the 2021 Tokyo Olympics, the gold-medal-winning U.S. swimmer Michael Andrew and his fellow countryman, marathon runner Galen Rupp, a silver medalist in the 2012 London games, were seen wearing devices that resemble blood pressure cuffs around their extremities. If the 2016 Olympic Games in Rio brought cupping therapy into the limelight thanks to Michael Phelps, the Tokyo Games popularized BFR training. Only the cuffs that Andrew and Rupp modeled have come a long way from the bicycle tire innertubes that Sato experimented with a half-century ago. 

What Is Blood Flow Restriction (BFR) Training?

The cuffs worn by Andrew and Rupp in the Olympics are pressurized bands. Worn around the arms or legs, the bands slow blood flow to the muscles during training.

The effects of this diminished blood flow are the perfect solution for anybody who detests doing vigorous exercise. BFR training can be done at a low intensity. And research shows it’s more effective at building muscle mass and enhancing recovery than a regular high-intensity workout. 

How Does Blood Flow Restriction Work? 

Essentially, BFR works like a tourniquet. The pneumatic cuffs limit the amount of blood that can flow in and out of a particular area (usually the arms or legs). When the cuff inflates, an increase in pressure is placed on the blood vessels beneath the cuff. This makes it harder for blood to flow through. The blood does in fact reach the exercising muscle via the brachial (arm) or femoral (leg) artery. 

However, the cuff chokes off the return of blood from the veins. 

How is this a good thing? It’s one thing to apply a medical tourniquet to choke off blood flow when blood is profusely spewing from an artery. But why would you want to make it harder for blood to flow through veins? And how is it a good thing that the muscles you’re working out during a BFR training session aren’t receiving as much oxygen? 

The short answer is that you feel an incredible pump without having to heave heavy weights. You see, your muscles become fully engorged with blood. As the muscle nears exhaustion, more musculoskeletal fibers are recruited to help perform the task. This means that more muscle tissue is activated. The end result is that this method of occlusion training (choking off blood flow) causes the muscles to undergo hypertrophy, or increase in size. 

Legendary bodybuilders such as Arnold Schwarzeneger and Franco Columbu used early iterations of Sato’s blood flow restriction cuffs in the early 1980s. 

But it’s not only bodybuilders who may benefit from blood flow resistance training bands. A 2019 study published in Frontiers in Physiology says that BFR training “results in beneficial adaptations to skeletal muscle and bones in various populations,” including old, young, trained and untrained. 

Other Benefits Of Blood Flow Restriction Resistance Bands 

According to the University of Mississippi, BFR can promote quicker healing, decreased levels of pain and soreness (in comparison to traditional exercise), as well as improved cardiovascular endurance and increased bone density. 

In addition, sports medicine physical therapist Trent Nessler, says that BFR training increases the number of breaths taken per minute (respiratory rate), and stimulates the release of growth hormone (GH) and insulin growth factor (IGF), the latter of which helps to reduce blood sugar levels. 

BFR Resistance Bands For Muscle Growth

The main selling point about BFR is how relatively little effort it takes to experience an increase in GH and IGH. In a traditional weightlifting session, lifting at least 80% of your one-repetition maximum would require you to experience the same GH and IGH results using BFR, which only requires 20% to 30% of 1 repetition maximum. 

In other words, if you can squat 300 pounds, you would need to squat at least 240 pounds in order to achieve a full release of growth hormone from the pituitary gland. But when doing a blood flow restriction workout with resistance bands, you’d only have to squat 90 pounds. And the cherry on top: your quads and hamstrings would get bigger than they would if you were normally bending the bar. 

But it’s not just the size of the muscles. BFR training also leads to increases in muscular strength, the researchers writing in the Frontiers in Physiology study suggest. The researchers add that these findings aren’t exclusive to bodybuilders “Populations in need of rehabilitation” also experience similar results. 

Moreover, the feel-the-burn pump effect of BFR training isn’t a temporary out-out-brief-candle moment, signifying nothing. Rather, “improvements are still observed between 2 and 10 days post-training,” conclude the researchers.

BFR for Cardiovascular Health 

More and more physical therapists are using BFR training as “an innovative rehabilitation tool,” according to a peer-reviewed chapter in Contemporary Advances in Sports Science.  

The positive effects of BFR training achieved at a lower exercise intensity, “could be a promising type of exercise for high-risk groups of patients,” such as cardiovascular disease patients,” the researchers conclude. 

BFR For Calming The Nervous System

Less than a year ago, the effect of BFR training on the autonomic nervous system of patients with hypertension (high blood pressure) had not yet been evaluated. An April 2022 study published in Frontiers in Physiology was the first to observe that BFR could effectively decrease systolic pressure and regulate the autonomic nervous system function in patients with high blood pressure. 

Perhaps BFR will prove to be therapeutic for people seeking to overcome emotional trauma or who are always tired

BFR To Support Cognition and Neurological Function

A 2022 study published in the Journal of Physical Therapy Science said that “training at lower intensities using BFR has the potential to be an important intervention for people with neurologic conditions as it can be easier to tolerate than higher intensity training while still resulting in similar physiological and performance gains.” 

The researchers noted that preliminary evidence supports the safety and feasibility of exercise training with BFR in people with certain neurologic conditions such as cerebral palsy, inflammatory myopathies, multiple sclerosis, Parkinson’s disease, and spinal cord injury. 

Because of the relatively easy intensity of BFR training, the modality may be an effective adjunct for regenerative medicine

Innovative Medicine Podcast On Blood Flow Restriction

As for Dr. Sato, his pioneering work on blood flow resistance led him to develop KAATSU, the leading brand of blood flow resistance bands. Tune into the Innovative Medicine podcast, where Dr. Caspar Szulc, founder of the New York Center for Innovative Medicine, interviews Steve Munatones, CEO of KAATSU. 


Disclaimer: The statements made in this article have not been evaluated by the Food and Drug Administration. Any products or treatments mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please consult a licensed medical practitioner for medical advice.

At Innovative Medicine, we believe in transparency. We want you to know that we may participate in affiliate advertising programs pertaining to products mentioned herein.

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Meet the Author

Judd Handler

Judd Handler is an Encinitas, CA-based natural health writer and a graduate of Functional Diagnostic Nutrition (FDN) and a certified Metabolic Typing Advisor.
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