Blood Flow Restriction Therapy

High load - high intensity training has been shown time and again to be one of the most successful ways to make significant strength gains and muscle hypertrophy. However, there are many conditions and pathologies (post-operative, osteoarthritis, chronic pain, etc.) that require strengthening, but are unable to tolerate the demands of a high load - high intensity workout in order to achieve the desired results. Blood Flow Restriction Therapy (BFRT) is a method of training that allows a person to make significant strength gains through low load training, thus reducing overall stress on the body.

BFRT utilizes pneumatic cuffs that are applied to the extremities and in turn provide external pressures occluding venous outflow while maintaining arterial blood flow. This leads to the release of hormones, hypoxia (reduction of oxygen to the muscles and ultimately leading to the production of lactate), and cellular swelling. Ultimately, these physiological effects lead to strength gains and muscle hypertrophy, which are all desired effects of high load -high intensity training, but accomplished through the completion of low load training. 

A typical BFRT workout includes 3-5 exercises at a training volume of 75 repetitions over 4 sets (30 reps, 15 reps, 15 reps, 15 reps) with a 30-60 second rest break between sets. As stated above, BFRT should be performed at a low load, with studies showing a load of 20-40% of an individual’s 1 repetition max being most efficient. The pneumatic cuffs should be left on for the entirety of the workout (maximum of 20 minutes at a time) in order to get the desired physiological effects. 

For more information about the effects, application, and safety of Blood Flow Restriction Therapy, CLICK HERE or contact us through our Ask A PT feature.

-Brian Collins, DPT

References:

• https://www.physio-pedia.com/Blood_Flow_Restriction_Training

• https://www.apta.org/patient-care/interventions/blood-flow-restriction/what-to-know-about-blood-flow-restriction-training

• Patterson SD, Hughes L, Warmington S, et al. Blood Flow Restriction Exercise: Considerations of Methodology, Application, and Safety [published correction appears in Front Physiol. 2019 Oct 22;10:1332]. Front Physiol. 2019;10:533. Published 2019 May 15. doi:10.3389/fphys.2019.00533

Anatomy 101: The Rotator Cuff

You’ve probably heard of the term “rotator cuff” before, but do you know what the rotator cuff is? More often than not, a thorough explanation is required when introducing the rotator cuff to individuals in physical therapy for shoulder pain. So what is it? The rotator cuff is simply a group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) that work collectively to stabilize the ball-and-socket structure that makes up the shoulder joint. By itself, the bones of the shoulder joint are not very stable, as the ball-and-socket structure is similar in composition to a golf ball sitting on a golf tee, with the golf ball being the humeral head and the golf tee being the glenoid. Inherently, a golf ball resting on a golf tee is not very stable, i.e. it is easy to knock the ball off of the tee. Physiologically, this would be rather problematic if this were the entire design of the human shoulder joint complex. Enter the rotator cuff, which helps hold the golf ball securely in the center of the golf tee. As you raise your arm overhead, the rotator cuff activates, pulling the humeral head down while it rolls upward in the glenoid. Without a healthy and efficient rotator cuff to provide the necessary counterforce, the golf ball would get dangerously close to rolling off the tee. This would not be an issue on a golf course, but could result in injury in the human body. In fact, many common aches and pains in the shoulder are the result of an injured or inefficient rotator cuff, which can result in an unstable shoulder joint, particularly with overhead activities such as swimming, rock climbing, and tennis. Shoulder impingement syndrome is a common diagnosis that involves a pinching of the supraspinatus tendon. Rotator cuff tears can involve any of the four rotator cuff muscles, but most often impact the suparspinatus. The good news is physical therapy can help strengthen the rotator cuff, in hopes of improving the stability and subsequent function of the shoulder joint. Here are a few therapeutic exercises used to strengthen the rotator cuff:

Band-Resisted Wall Crawl

Band-Resisted Shoulder External Rotation At Sides

Resisted Scaption

Quadruped Scaption

So, if you are experiencing nagging shoulder pain, you may benefit from having a physical therapist or other sports medicine specialist evaluate the health of your rotator cuff. Treatment can be rather effective and typically only takes between 6-8 weeks, the average time required to strengthen weak or dysfunctional muscles. Get started now!

-Grant Hennington, DPT