BFR and Bone Health: Muscle and Bone Interconnectivity
Bone, like muscle tissue, is subject to disuse atrophy and loss of structural integrity. Following fractures – particularly in regions that have poor vascular supply – impaired ability for the bone to form a soft/hard callus can lead to a troublesome recovery. Interesting enough, while low-loads haven’t been shown to induce preferential changes in bone tissue (either acutely or chronically to my knowledge), low-intensity BFR resistance exercise has been shown to upregulate markers associated with bone tissue formation and even in longitudinal studies preserving bone following ACL reconstruction (Lambert, 2019) along with mitigating muscle atrophy following surgery. Two for one special – BFR can increase muscle mass AND bone density, but how if it’s such low loads?
Like muscle, bone also has a relationship to myostatin (Elkaswary, 2011) such that myostatin is expressed locally in injured muscle and bone tissue and negatively impacts their healing rates (likely in an effort to temporarily reduce the local tissue capacity). Strategies to inhibit myostatin through low-load BFR training can therefore provide some rationale as to some of the potential mechanisms underlying these observed changes. This is particularly true in situations where there is widespread muscle and bone injury, leading to an overexpression of myostatin that inhibits the muscle/bone growth stimulus too much and ends up causing more long-term damage than good.
Another potential mechanism for inducing bone growth is through interstitial fluid flow. Sensors within the bone sense the changes in pressure gradient and ultimately increase the ratio of osteoblastic (bone creating) to osteoclastic (bone resorbing) activity.
Either way, the take home message is simple. There is a strong interconnectivity between muscle and bone. As the old saying goes, where there’s smoke, there’s fire and this is looking to be true with low-load BFR and muscle mass/bone changes with use during the early rehabilitation period.
Adapted from: https://www.instagram.com/p/CZUev5EOgAD/
****Remember, the decision to use BFR, or any treatment for that matter, should be based on the pillars of evidence-based practice.
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