Blood flow restriction is a training technique that seems to divide opinion among gym goers, some sing its praises, while others are more cautious.
They either dislike the idea of it, or doubt its effectiveness. But both sides tend to suffer from a lack of knowledge about how to correctly utilise blood flow restriction training, and what benefits it offers.
This article will look into what blood flow restriction is, what the benefits and drawbacks are, how to perform it, and when.
What is Blood Flow Restriction Training?
Blood flow restriction training uses a tourniquet to stop circulation around the muscles, allowing the blood to pool in the muscles and preventing it from escaping.
According to Dr Brad Schoenfeld, as you exercise metabolic stress increases as metabolites (lactate, inorganic phosphate, and hydrogen atoms) build up. The tourniquet prevents the metabolites from leaving the muscles and they instead stay in the muscles and promote anabolism .
A 2012 study by Loenneke et al theorised that the most likely mechanism for blood flow restriction increasing hypertrophy was cell swelling, it also stated that coupling cell swelling with higher metabolic accumulation (mentioned earlier) produced even greater results .
Studies seem to indicate that the best form of training with blood flow restriction is to train at low intensity for high reps. So using very light weights will lead to better hypertrophy results .
What are the Benefits?
Blood flow restriction training is used to build both strength and hypertrophy, and has been scientifically proven to be an effective method for doing so.
Some people believe that blood flow restriction training is complicated and expensive, but this cannot be further from the truth.
It’s not complicated, just wrap some elastic knee wraps around the limb you are training (thanks to Brad Schoenfeld for this advice) and perform high rep/low weight sets.
It can also be very cheap – provided you use the aforementioned elastic knee wraps rather than the expensive cuffs (though if you have the money, these are excellent products).
Are There any Downsides?
The main issue that a lot of people have with blood flow restriction training is whether it is safe or not.
No matter how many times someone tells you it is perfectly safe, there is something about creating a tourniquet that can be quite scary.
In 2011 a meta-analysis looked at several studies to ascertain whether blood flow restriction was safe, the study found lots of evidence that it was completely safe to perform and that people responded to it in the same way they would with regular training .
The study did note however that there needed to be more long-term studies before they could declare it completely risk free. Don’t let this worry you though, as 1) Any form of exercise has some risk attached, but the benefits far outweigh them, and 2) You don’t need to use blood flow restriction long-term. You can add it to your training for 8-12 weeks and then drop it.
Another common misconception is that blood flow restriction could cause blood clots or strokes. Without going into too much detail, this is incredibly unlikely as you are not restricting arterial blood flow, nor does blood flow restriction cause coagulation.
Where to Place the Wraps?
There are only two places that are suitable for wraps, the tops of your arms (near the shoulder) and the tops of your legs (near your hips). Nowhere else should be used.
You want to keep the wraps tight, but not aggressively so, Jacob Wilson (writing for bodybuilding.com) recommends tightening them to a 7 on a scale of 1-10 for tightness .
How to Integrate Blood Flow Restriction into your Training
When you look at the science, it is often the case that blood flow restriction was the sole form of exercise used in each study.
This makes sense when you are trying to prove/disprove its effectiveness, but it just isn’t practical for your average gym goer.
In fact, it wouldn’t be practical for an elite athlete either!
Instead of using blood flow restriction for each and every exercise you should instead use it strategically.
Let’s say you’re training chest and triceps in a session. You could perform a flat bench for 3 sets of 6-8 reps, then some weighted dips.
Finally you could finish off the chest with 3 sets of 15-20 reps of incline bench press using blood flow restriction.
Afterwards you would move to triceps, performing 2-3 tricep exercises and using blood flow restriction for the final one.
Dumbbell Bench Press (flat): 3 sets x 6-8 reps
Weighted Dips: 3 x 10
Incline Barbell Bench Press: 3 x 15-20 (BFR)
Dumbbell Skull Crushers: 3 x 6-8
Cable Tricep Pushdown: 3 x 15-20 (BFR)
You can train to failure rather than hitting that 15-20 rep range if you want, but don’t overdo this.
Blood flow restriction training is a very demanding form of exercise anyway. It can cause a high degree of muscle damage. This is kind of the point, you want muscle damage as it is from this that muscle protein synthesis occurs.
But too much can be counter-productive. If you plan on training 5 times per week, but overdo it during session one, then you’ll be behind schedule (as you won’t be able to train as frequently).
Combining blood flow restriction with high intensity resistance training, has been shown to be the most effective form of training for hypertrophy , so sprinkling in a couple of bfr exercises into a high intensity hypertrophy training session is perfect.
Blood flow restriction training is an excellent tool provided it is not overused.
Planning it into your program at strategic intervals, performing high rep, low weight sets, and wrapping your upper arms and legs (and nothing else) correctly, will ensure fantastic results.
Blood flow restriction is not something to be scared of, but it is something to be treated with a healthy respect.
It’s safe when performed correctly, and will really help you to build bigger muscles in record time.
 Loenneke, J., Fahs, C., Rossow, L., Abe, T., Bemben, M. 2012. The anabolic benefits of venous blood flow restriction training may be induced by cell swelling. Medical Hypotheses 78(1): 151-154
 Loenneke, J., Wilson, J., Marin, P., Zourdos, M., Bemben, M. 2012. Low intensity blood flow restriction training: a meta analysis. European Journal of Applied Physiology 112(5): 1849-1859
 Loenneke, J., Wilson, J., Wilson, G., Pujol, T., Bemben, M. 2011. Potential safety issues with blood flow restriction training. Scandinavian Journal of Medicine & Science in Sports 21(4): 510-518
 Yasuda, T., Ogasawara, R., Sakamaki, M., Ozaki, H., Sato, Y., Abe, T. 2011. Combined effects of low-intensity blood flow restriction training and high-intensity resistance training on muscle strength and science. European Journal of Applied Physiology 111(10): 2525-2533