by Pete Geloso, DPT, January 13, 2020
Physical Therapy is a constantly growing profession. Research continues to be done to support the application of various treatment techniques, exercises, and modalities. Some of this research disproves old theories and emphasizes discontinuing their use. While other research is being performed to support the use of new treatments to help treat our patients. Some of these include but are not limited to treatments such as dry needling, laser therapy, and blood flow restriction therapy. More often than not, therapies such as these are not for everyone, but when applied appropriately to the right patient, it can yield fantastic results. This article will be focusing on Blood Flow Restriction therapy (BFR).
What is BFR?
BFR applies a specialized blood pressure cuff around either the arm or the leg to safely restrict blood flow by a desired percentage to increase oxygen demand to those muscle groups while performing very light resistance exercises. This stresses the body to a similar degree of working at very heavy resistance workloads, and in a sense, tricks the body into thinking it worked harder than it actually did. This creates a physiological response to where the body then repairs itself and builds muscle mass as if you were exercising at a much higher intensity.
Why is this important?
This is relevant in a clinical setting because often times we treat patients that need to build muscle mass and strengthen particular muscles, but because of their pain levels or other comorbidities they are unable to perform exercises at the required intensities to achieve these neuromuscular adaptations. It allows a patient to gain a muscle contraction which will produce increased size and strength without overloading the joints, ligaments, or tendons.
Who should use BFR?
BFR can be used across a variety of patient populations, age groups, and ability levels.
- Post-surgical patients (Total Knee Replacement, ACL Repair, Achilles Tendon Repair, Carpal Tunnel Release)
- It can also be an important part of PREHAB, or preoperative rehabilitation (for more information on PREHAB check out this article
- Arthritic Changes such as knee or hip degenerative joint disease
- Tendonitis (Achilles Tendinitis, Patellar Tendinitis, Biceps Tendinitis)
- Athletes Attempting to Return to Sports following sprains/strains to the ankle, knee, elbow, and shoulder
A good example of this is someone with advanced osteoarthritic changes of the knee. To strengthen their quadricep and other lower extremity muscles it usually requires functional weightbearing exercises such as squats, lunges, and step-ups. However, these are often too painful to perform and the non-weightbearing table exercises do not provide enough strengthening adaptions to result in any significant change.
The application of BFR while performing these simpler and less painful non-weightbearing table exercises can yield greater strength gains which less patient effort. This can then allow that patient to eventually progress to tolerating more challenging weightbearing strengthening exercises to help improve their overall function and quality of life.
Peter Geloso, DPT is a physical therapist at Amity Physical Therapy in the Woodbridge office. He received both his Bachelors in Exercise and Sport Science and Doctorate of Physical Therapy from Elon University. He is a licensed Physical Therapist in the State of Connecticut and treats patients of all ages and ability levels with special interest in cycling and cross training injuries. If you think you may benefit from blood flow restriction therapy, or have further questions regarding its use, please feel free to contact him with any questions at (203) 389-4593. Thank you.