Another BFR Success Story: Osteoarthritis
One of the themes here at The BFR Pros is that we never look at a patient and think, “How can I use BFR with this person?” Rather, we think, “Can BFR be a tool that can help this person get back to his/her specific goals?” This paradigm was foundational to the treatment of the gentleman featured in this BFR success story.
Today we have a 61-year-old male with left knee and left hip pain. Past medical history included testicular cancer in 2007 (treated successfully with surgery), non-Hodgkin’s lymphoma 2019 (treated successfully with immunotherapy), and a meniscectomy L knee in 2005. Recent X-rays of the left knee and hip were positive for osteoarthritis. He did not participate in any type of formal exercise, but was very active as a carpenter and loved doing yard work like cutting grass and chopping firewood. He also was extremely passionate about his role as a playful and actively involved grandfather to three grandchildren under the age of 3.
Physical examination findings included pain, weakness, atrophy, decreased walking tolerance, difficulty with standing after prolonged sitting, difficulty performing work duties as carpenter, and difficulty playing with and caring for his grandchildren. His main goals were to decrease pain, return to unrestricted work, and of course, return to babysitting and playing with his grandchildren.
Since this man was no stranger to physical work and muscle fatigue (carpenter, chopping firewood, etc.), I skipped Pillar 1 (passive BFR) and went right to Pillar 2 (aerobic training). This allowed him to get accustomed to the sensation and unique discomfort of BFR, while still getting a training and analgesic effect. In addition to a general strengthening program (squats, hip hinging, carries, etc.), we started with 5 minutes of low intensity cycling using the low end of recommended lower extremity LOP at 50%. We gradually progressed pressure to 60% along with intensity and duration. After two weeks, we transitioned to Pillar 3 (resistance exercise) and implemented 3x10 knee extensions without weight at 60% LOP about 3 reps shy of failure. We progressed load and proximity to failure and added leg presses and squats the following week. All was tolerated extremely well. He ended up returning to work and chasing after his grandchildren in no time!
Was BFR training the reason our rock star grandfather did so well? Of course not. Did BFR training play a key role in his ability to accelerate the healing process and improve strength without using heavy loads? You bet!
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****Remember, the use of BFR training should not be based solely on a success story. The decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.
