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GUIDELINES ON WHEN TO INCLUDE BFR IN POST-OP ACL CLIENTS
When to include blood flow restriction in the plan of care of post-operative clients is one of the most common questions I get asked when I teach. Unfortunately - there are no real set guidelines on when to include BFR in any post-surgical case. This is why it is crucial to confer with the orthopedic surgeon on any post-operative cases! However...
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Hughes et al. (2019) provided the first real insight into when it may be appropriate to include blood flow restriction into the plan of care of individuals who underwent ACL reconstruction. This is the first study to have clinically appropriate inclusion criteria that clinicians can measure to ensure that their client is ready for BFR training.
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What are your thoughts on these prerequisites for BFR? If you've been performing BFR with your patients following anterior cruciate ligament reconstructions, what signs do you use to determine readiness for BFR?
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SOURCE: Hughes et al. (2019). Comparing the effectiveness of blood flow restriction and traditional heavy load resistance training in the post-surgery rehabilitation of anterior cruciate ligament reconstruction patients: A UK National Health Service randomised controlled trial.

Heading to #Italy in 2020 to help promote evidence-based unbiased #BFRTRAINING using the best automatic and non-automatic technology in the world. Thank you to @novaviaproject for your trust and to all the cuff sponsors for our workshops including @madup_training @hpluscuff @fitcuffs @modernmanualtherapy @smarttoolsusa. Thanks for creating an amazing experience for all our participants! BFR isn’t just blood flow restriction to us- its #betterforresults! So come learn what Forbes magazine describes as the next hottest trend in fitness (and rehab)! Hope to see you Italian #physios in March!

#Repost from @novaviaproject (@repost_media_app)
📣📣📣 NEWS 📣📣📣 NOVAVIA è lieta di annunciare l'arrivo in #Italia di una serie di Evidence-Based & " #unbiased" workshop sul BLOOD FLOW RESTRICTION Training (bit.ly/32YvlZj) in riabilitazione, per via della partnership in esclusiva con 'THE BFR PROS' dagli USA (@thebfrpros ) 🇺🇸
Qui la video-intervista di Physiotutors a NICHOLAS Rolnick @thehpm , docente per l'Italia, da loro invitato come "THE expert in the field of #BFR": bit.ly/31XnB8z. 🏅 Corsi per la #Certificazione "BFR Training Rehab Specialist" 📅 7 marzo 2020 - #Roma (ITA)
📅 8 marzo 2020 - #Parma (ITA)

Tutti i dettagli a breve 👉👉👉 www.novaviaproject.it
It's a #newway, anyway

#BFR #BloodFlowRestriction #thebfrpros

BLOOD FLOW RESTRICTION PRODUCES SIGNIFICANT PAIN RELIEF
Blood flow restriction has been shown in numerous studies (as well as anecdotally) to produce significant pain relief in clinical and non-clinical populations. This can have huge impact on rehabilitating injuries and accelerating performance & recovery.
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This recent article (2019) discusses 4 potential pathways through which low-load BFR exercise (20-30% 1 RM) may influence pain relief.
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1. Opioid and endocannibinoid systems - activation of group III-IV afferents through metabolic stress may interact with the central nervous system by changing the feedback from the working muscle by producing local pain/discomfort, triggering pathways that release these factors and produce pain relief.

2. Conditioned Pain Modulation - Think "pain blocks pain." BFR causes discomfort/pain during exercise (metabolites) and this creates a reduction in perception of other painful areas. This may also occur with just cell swelling/IPC protocols from hypoxia.

3. Early Type II Fiber Recruitment - BFR accelerates fatigue which recruits these high threshold motor units much earlier than work-matched controls. Higher intensity exercise has been shown to produce superior pain relief than lower-intensity exercise.

4. Descending Inhibitory Pathway - May be a result of the link between cardiovascular and pain modulation systems. Exercise-induced increases in blood pressure are controlled by similar brain regions that also control pain relief.
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More in-depth explanations coming in our e-mail list. Comment or DM us to be included! Can't miss discounts and deals!
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SOURCE: Hughes & Patterson, 2019. Low intensity blood flow restriction exercise: Rationale for a hypoalgesia effect.

THE SCIENCE BEHIND BLOOD FLOW RESTRICTION
Many people wonder how blood flow restriction can be so effective at loads as light as 20-40% 1 RM in producing similar gains in muscle mass and (to a lesser extent) strength as heavier load (60-70+% 1RM) protocols.
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It all comes down to understanding three main concepts: the force-velocity (FV) relationship, fatigue and the effect of fatigue on muscle activation patterns.
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The FV relationship describes how much force a muscle fiber can generate at different shortening speeds. The caveat here is that it only describes maximum effort attempts. Under this lens, low-load training is ineffective at building muscle mass because the muscle force per muscle fiber at very fast speeds is minimal. This will lead to negligible muscle protein synthesis signaling. However, when lifting heavy weights, you are unable to lift the weight very fast even with very high amounts of intent. This leads to high levels of muscle force and strong stimulation of muscle protein synthesis that will promote muscle growth (along with good nutrition).
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Fatigue can be described as central or peripheral in nature. For the purposes of this post, peripheral fatigue occurs when there is an inability of a muscle fiber to meet the force demands of the task causing more muscle fibers to be recruited. Only during light loads with high amounts of volume can enough peripheral fatigue accumulate to force these new muscle fibers to be recruited.
When new muscle fibers get recruited, it eventually leads to an increase in muscle activation as more of the higher threshold motor units become recruited to allow for continuation of the activity. Due to the fatigue, these muscle fibers can not move that weight at a very high speed, which allows for maximum force to be generated by each of the activated muscle fibers.
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This is why low-load blood flow restriction training works. It increases fatigue to ultimately increase muscle activation at slow shortening speeds to produce muscle growth with prolonged training.

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