Blood Flow Restriction Training: Getting stronger despite injury and a break from climbing?

Blood Flow Restriction Training (BFRT) is a training method that uses pressure cuffs to reduce blood flow. The effect: muscle growth and strength increase despite low training intensity. A type of training that can be particularly interesting during injury-related breaks in climbing and in the rehabilitation phase.

A contribution by Philipp Mathis and Simon Deussen from PhysioVision Zurich - With the support of Minimum Bouldering and Saga Fitness

Finger injuries are among the most common injuries in climbing. The injury is often accompanied by a break from climbing, during which the hard-earned strength is lost again. The promise of the BFRT training method sounds tempting: Thanks to the low intensity, you can actively train the climbing-specific muscles even during acute or sub-acute injury breaks without endangering the ligaments or tendons.

You will learn that in this article

• What is Blood Flow Restriction Training?
• How does the training method work?
• BFRT in climbing?
• Risks, pros and cons of BFRT

That's what Blood Flow Restriction Training is all about

During Blood Flow Restriction Training, pneumatic pressure cuffs ensure that the venous blood flow is reduced. Train with low resistance at an intensity of 10 to 30 percent of the 1-rep max. At this intensity, comparable effects in terms of muscle growth and increase in strength can be achieved with BFRT as with classic hypertrophy training. These effects have been confirmed by several scientific meta-analyses (Hughes et al., 2017).

What is hypertrophy training?

Muscle hypertrophy is colloquially defined as muscle growth. In classic hypertrophy training, the intensity is between 70 and 85 percent. Traditionally, you train in three sets of eight to twelve repetitions.

How does BFRT training work?

In order to explain the mechanism of action of the BFRT, a detour into the physiology of hypertrophy training is required. Muscle mass growth occurs from three different measures:

1. Lifting heavy weights or performing fast movements creates mechanical tension in the muscle. This tires the fast muscle fibers.
2. The high training intensity causes microtraumas in our smallest muscle fibers, the so-called sarcomeres.
3. As a reaction to training, a lack of oxygen and an accumulation of metabolites and specific growth factors in the trained muscle can be observed.

All of these physiological mechanisms of action result in muscle cross-sectional thickening, referred to as muscle hypertrophy (Low, 2020).

With BFRT, the venous system is closed with the cuffs, while the arterial supply of the muscle is always guaranteed. As a result, mechanisms of action that lead to hypertrophy are set in motion.

According to an article by Loenneke et al. (2010), the following mechanisms are the most important:

• The accumulation of metabolic products leads to the accumulation of growth factors such as growth hormone (GH) (Takarada, Nakamura, et al., 2000)
• The recruitment of fast muscle fibers (Takarada, Takazawa, Sato, et al., 2000)
• Increased mammalian target of rapamycin (mTOR) activity boosts protein synthesis (Takano et al., 2005)

Blood flow restriction training in climbing

Finger injuries are the most common climbing injuries. It is precisely these that can be trained very well with BFRT in an acute or sub-acute injury phase. For example, you can hang from the finger board with your feet on the ground, i.e. with only a percentage of your body weight.

This principle can also be applied to a tendon complaint (tendinitis) without additionally irritating the painful tendons. Likewise, in the case of knee injuries, one can prevent the thigh muscles from shrinking. All promising possibilities that can be decisive in the rehabilitation phase of athletes.

If muscle atrophy can be prevented in the early phase of rehabilitation, the entire rehabilitation process will be shorter due to the shorter build-up phase.

Risks, pros and cons of BFRT

Blood flow restriction training is not recommended in the case of existing cardiovascular diseases such as high blood pressure, vascular diseases or heart failure (Spranger et al., 2015). In a review by Minniti et al., 2020, the safety of a BFRT in musculoskeletal knee problems was examined.

The result showed that strengthening using BFRT seems safe. However, long-term studies will be needed in the cardiovascular field to further confirm this.

Conclusion

On the one hand, the BFRT trains our active structures, namely the muscles, more gently and, on the other hand, the load on the passive structures of our body such as cruciate ligaments, menisci or annular ligaments is much lower.

This is exactly where you can start in the rehab setting and with the BFRT you can maintain muscle mass and strength to a certain extent without overloading the injured structures. After the rest phase, the BFRT should only serve as a supplement to hypertrophy training.

The aerobic climbing capacity can be trained much more gently with the BFRT. The shorter recovery times make it very attractive for competitive athletes because the training volume can be increased.

People with cardiovascular disease should stay away from it until more long-term studies are done. In conclusion, BFRT is an exciting and effective way to train that is well worth trying.

product and courses

dr Sato introduced the first Blood Flow Restriction Training product in 2005. In recent years, numerous companies have joined, including Saga Fitness.

After our own research and testing of various products, we decided to PhysioVision opted for the SAGA product. The price, the application and the quality of the app and the tapes are really good. We have ordered a large margin of ribbons and let you benefit from them

PhysioVision will be available in the first quarter of 2023 (initially in Minimum on Flüelastrasse) offer courses on BFRT. The course consists of two sessions, the theoretical background, the application and usability, additional to your normal training. The second session is for feedback and solving all practical applications. 

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Credits: Cover picture Simon Deussen