Who Better Than Us?
Adapted from: https://www.instagram.com/p/CfjdE-NOh2J/
The research on blood flow restriction is continuing to accelerate at a rapid, near exponential rate because it is effective at not only increasing muscle mass/strength with light loads in less time, but it is also extremely effective at improving cardiovascular endurance at very low intensities (Park, 2010), producing significant post-exercise hypoalgesia (pain relief) (Hughes, 2020,2021), producing similar morphological tendon changes as heavy load strength training (Centner, 2019, 2021), and even preserving post-surgical bone mass following ACL reconstruction where traditional approaches have failed to do so (Jack, III, 2022).
It just so happens that the indications for blood flow restriction include an inability to tolerate heavy loads or the presence of significant muscle/joint pain (Rolnick, 2021) – two huge areas that perfectly align within the scope of practice of physical therapists – something that the APTA recognized in 2018.
Since 2018, hundreds of more papers have been produced that have now expanded the findings to clinical populations…all of which have been extremely well tolerated even in very at risk populations such as those with chronic kidney disease (Rolnick, 2022). In fact, multiple publications have been produced to help the clinician reduce the potential for adverse events with BFR training (Patterson, 2019; Rolnick, 2021; Nascimento, 2022).
So when someone tells you that physical therapists should not be allowed to do blood flow restriction – I ask – then who is better positioned to take on this modality to get people back to the activities they love as quickly as possible?
References:
Centner C, Lauber B, Seynnes OR, Jerger S, Sohnius T, Gollhofer A, König D. Low-load blood flow restriction training induces similar morphological and mechanical Achilles tendon adaptations compared with high-load resistance training. J Appl Physiol (1985). 2019 Dec 1;127(6):1660-1667. doi: 10.1152/japplphysiol.00602.2019. Epub 2019 Nov 14. PMID: 31725362.
Centner C, Jerger S, Lauber B, Seynnes O, Friedrich T, Lolli D, Gollhofer A, König D. Low-Load Blood Flow Restriction and High-Load Resistance Training Induce Comparable Changes in Patellar Tendon Properties. Med Sci Sports Exerc. 2022 Apr 1;54(4):582-589. doi: 10.1249/MSS.0000000000002824. PMID: 34772900.
Hughes L, Patterson SD. The effect of blood flow restriction exercise on exercise-induced hypoalgesia and endogenous opioid and endocannabinoid mechanisms of pain modulation. J Appl Physiol (1985). 2020 Apr 1;128(4):914-924. doi: 10.1152/japplphysiol.00768.2019. Epub 2020 Feb 27. PMID: 32105522.
Hughes L, Grant I, Patterson SD. Aerobic exercise with blood flow restriction causes local and systemic hypoalgesia and increases circulating opioid and endocannabinoid levels. J Appl Physiol (1985). 2021 Nov 1;131(5):1460-1468. doi: 10.1152/japplphysiol.00543.2021. Epub 2021 Sep 9. PMID: 34498944.
Jack RA, Lambert BS, Hedt CA, Delgado D, Goble H, McCulloch PC. Blood Flow Restriction Therapy Preserves Lower Extremity Bone and Muscle Mass After ACL Reconstruction. Sports Health. June 2022. doi:10.1177/19417381221101006
Park S, Kim JK, Choi HM, Kim HG, Beekley MD, Nho H. Increase in maximal oxygen uptake following 2-week walk training with blood flow occlusion in athletes. Eur J Appl Physiol. 2010 Jul;109(4):591-600. doi: 10.1007/s00421-010-1377-y. Epub 2010 Feb 21. PMID: 20544348.
Rolnick N, Kimbrell K, Cerqueira MS, Weatherford B and Brandner C (2021) Perceived Barriers to Blood Flow Restriction Training. Front. Rehabilit. Sci. 2:697082. doi: 10.3389/fresc.2021.697082
Rolnick N, de Sousa Neto IV, da Fonseca EF, Neves RVP, Rosa TDS, Nascimento DDC. Potential implications of blood flow restriction exercise on patients with chronic kidney disease: a brief review. J Exerc Rehabil. 2022 Apr 26;18(2):81-95. doi: 10.12965/jer.2244082.041. PMID: 35582687; PMCID: PMC9081410.
****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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