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physical therapist discussing blood flow restriction with patient

What's Blood Flow Restriction? New PT Technique Strengthens Muscles with Lighter Loads

After an injury or surgery, patients are often anxious to work on strengthening – so they can get back to normal. But they have to wait because injured tissue requires a certain amount of time before it is safe to do resistance strengthening exercises such as lifting weights.

For example, an athlete recovering from a meniscus repair typically has to wait six to eight weeks before putting full weight (load) on the leg. While physical therapists can activate muscles, we are not able to work on strengthening because it may hinder recovery and even further damage the repair.

Unfortunately, during this time the athlete can experience loss of muscle (atrophy).

About Blood Flow Restriction

Now with a technique called blood flow restriction (BFR), physical therapists can help patients not only prevent loss of strength, but actually actively strengthen muscle tissues during the early phases of physical therapy.

The BFR Technique Works Like This:

  • A specialized tourniquet system is applied to the arm or leg.
  • The tourniquet system is inflated to a personalized and specific pressure to reduce blood flow.
  • Application is brief, typically about 6 minutes per exercise, but can last up to 30 minutes.

While the tourniquet is applied, the physical therapist has the patient perform strengthening exercises with lighter weights (load).

Why is the Blood Flow Restriction Technique Important?

The activity allows the patient to gain muscle cells and strength at a rate that’s similar to lifting heavy loads for multiple repetitions1 without damaging muscle tissues. Basically, it’s a way to safely gain strength using lighter loads.

The blood flow restriction technique can also be used with older patients who have pain or arthritis. They often find it difficult to lift heavy loads, which is unfortunate because people with arthritis benefit greatly from increased strength.

Benefits of Blood Flow Restriction

With BFR, we can get the same strength gains with lighter weights while decreasing stress on joints and tissues. One study found that with BFR, older adults can lift three times less weight for the exact same gain.

Whether you are an early post-operative patient or a person who is experiencing pain while lifting heavy loads, BFR is a safe option for you.

Instead of simply attempting to prevent strength loss during tissue healing and early recovery times, why not strengthen instead? Talk to your physical therapist about using BFR to get more strength with less load.

For more information, reach out the CHI Health St. Mary's PT team. 


1Bowman EN,Elshaar R,Milligan H,Jue G,Mohr K,Brown P,Watanabe DM5,Limpisvasti O Proximal, Distal, and Contralateral Effects of Blood Flow Restriction Training on the Lower Extremities: A Randomized Controlled Trial. Sports Health.2019 Jan 14

2Park S1Kim JKChoi HMKim HGBeekley MDNho H. Increase in maximal oxygen uptake following 2-week walk training with blood flow occlusion in athletes. Eur J Appl Physiol. 2010.

Laura Ortinau, et. al., Comparisons between low-intensity resistance training with blood flow restriction and high-intensity resistance training on quadriceps muscle mass and strength in elderly. The Journal of Strength & Conditioning Research 2014

Originally Published: May 2020. Updated: February 2023. 

Brant Loose, PT, DPT, TPI-M3-J2-F2, FMS, SFMA, YSAS
Brant Loose, PT, DPT, TPI-M3-J2-F2, FMS, SFMA, YSAS

Brant Loose is a physical therapy provider at CHI Health.

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