CategoriesExercise Technique muscle growth

Blood Flow Restriction: The Holy Grail of Gimmicks?

As this post goes live Lisa and I are en route to Australia. I’d like to sit here and say I’m doing something productive with 20 hours on a plane like reading a book, catching up on some writing, or, I don’t know, looking lovingly into my wife’s eyes.

But in reality I’m probably watching John Wick or something.

Anyway, I didn’t forget about everyone and I do have a bunch of great content prepared  for while I’m away. Today’s pinch writer is Baltimore, MD based trainer, Tim Hendren.

Let’s get jacked.

Copyright: piotrkt / 123RF Stock Photo

Blood Flow Restriction Training: The Holy Grail of Gimmicks?

The fitness world is usually full of shit.

What seems like every 30 seconds, a new product pops up in gyms or online that’s hailed as the next cutting-edge tool to take your training to the next level. From the thigh master to waist trainers to oxygen deprivation masks, bullshit peddlers have been taking advantage of the insecurities of fitness enthusiasts for decades.

Tell someone that it takes ten years of consistency with training and nutrition to achieve their desired results and you will struggle in the fitness space. Tell someone to strap a belt around their waist and magically lose 10 lbs. for three easy payments of 12.99 and you’re a millionaire.

Unfortunately, that’s where we’re at.

via GIPHY

I’m skeptical at this point when I see something gimmicky.

My stance is guilty before proven innocent for almost everything that doesn’t involve getting stronger using basic core lifts and eating the right amounts of the right foods for your goals.

When I saw blood flow restriction (BFR) for the first time, my brain immediately filed it in the category of useless shake weight’esque type nonsense.

Then I gave it a shot after I saw some trusted coaches (John Meadows, Ben Pakulski, and others) advocating it.

Ok, maybe there’s something to this.

I gave it a shot and the massive pump it provided my arms was undeniable.

Keeping blood trapped in the targeted muscle and reaching failure with an absurdly light weight had to have some legit benefits.

It was time to dig deeper.

What is BFR?

BFR refers to a training strategy that employs the use of cuffs, wraps, bands, or a BFR device placed strategically on the extremities to occlude venous blood flow away from the muscle while maintaining arterial flow into the muscle during an exercise.

In other words, blood goes into the muscle when it’s contracting and gets stuck there while you’re wrapped up.

When done properly and to failure, BFR is quite painful. Want to see someone humbled? Take the baddest dude at the gym, put him through a BFR exercise and watch him writhe in pain and hit failure with 20-35% of his 1 rep max.

To put that in perspective, that’s failing with a 60 lbs. squat when you max 315.

The duration of the exercise and total time with wraps on is under 4 minutes, light speed in terms of reaching muscular failure using a weight you typically warm up with.

What Does the Research Say?

This is all fine and dandy but who cares about the pump (I’m that guy with his hand raised) if it’s not producing any lasting results? When you take a closer look though, it turns out BFR isn’t just a tool for a bro to get a massive arm swell before he puts on his smedium t-shirt and hits the club.

In a recent meta-analysis of almost 50 studies (Lixandrão 2018) comparing traditional heavy load training and training using low loads with BFR, it was a wash with regards to muscle hypertrophy.

Think about that.

Almost 50 studies and the differences between traditional heavy training and light lifting with BFR were statistically insignificant when looking at muscle growth.

I guess this isn’t in the shake weight category after all.

via GIPHY

It must be stated that in the same meta-analysis, it was determined that differences in strength were in favor of the heavy load groups by a wide margin.

Training for specificity still reigns supreme, especially regarding maximal strength.

In another study (Takarada Y 2000), patients fresh from ACL surgery were observed.

One group was given traditionally loaded exercises for the quadriceps and another group were given low load exercises combined with BFR. The group using BFR showed markedly less atrophy in the quadriceps when compared with the traditional group and certainly what is typically seen in patients after an ACL repair.

Another win for BFR as a prehab/rehab tool!

Practical Uses

When programming BFR into your training sessions, it’s important to keep in mind that its efficacy is limited to the biceps, triceps, quads, hamstrings, and calves due to the location of the occlusion sites. Sorry folks, it doesn’t matter where you put those wraps, you aren’t occluding your glutes or pecs.

Another limitation is its reluctancy to produce strength gains.

Based on the available research, while BFR hasn’t shown to increase maximal strength anywhere close to traditional lifting, it could be an effective way to maintain strength when dealing with an injury or joint issue that inhibits the trainee from lifting with heavy weight.

Other Scenarios Where BFR is Useful

1. Golfer’s or Tennis Elbow

The dreaded medial or lateral epicondylitis has provided quite a roadblock for arm gains.

There is nothing quite like attempting an overhead triceps extension with an inflamed elbow and the searing pain that follows. One of the more effective strategies I’ve found personally and with clients is taking the weight down, applying the cuffs, and pumping away pain free.

Typically, under these conditions, if the weight is light enough, you can get away with performing the exercise.

Add in the pillow-like effect of blood pooling around the joint due to BFR, and you’ve created an anabolic environment for the muscle minus the pain and risk for more inflammation.

2. Knee Issues

Whether it’s arthritis or simply cranky knees from heavy compound lifts, BFR can be a great way to hammer the quads and hamstrings without placing more stress on the knees. The same concept from #1, your inflamed knees will appreciate the low loads and allow the targeted muscles to reach failure without pain in a full range of motion.

3. Added Frequency

When working with heavier weights in a strength phase, it may be helpful to limit the load of isolation work for arms and legs. Training with BFR can provide an intense stimulus to the targeted muscles without anywhere close to the amount of muscle damage or joint stress from high loads. Furthermore, if you are using low loads and BFR, you can do the isolation lifts more frequently without sacrificing performance in the heavy lifts.

4. In-Home or On-the-Road

If you are training at home or in a hotel gym working with weights that resemble “My First Weight Set” by Fisher-Price, BFR can be a great way to jack up the intensity and train closer to failure regardless of load.

We’ve all been burned by bullshit online hotel gym pictures. You book the room thinking it’s an acceptable gym then show up to lift and they don’t have any dumbbells over 25 lbs. Infuriating.

Pack your wraps or cuffs just in case.

5. Prehab or Rehab

As stated earlier, the resulting atrophy from an injury or operation can be mitigated with low loads and BFR.

6. During a Deload

Taking a week off to recover from an intense training block? Sprinkle in BFR to provide the muscles a stimulus that won’t require much recovery or tax the central nervous system.

7. When You Need a Sick Pump Without Sacrificing Recovery from Programmed Training

Don’t act like you haven’t done this.

You’re about to head to the pool or beach and need to catch a quick arm swell.

You have exactly 2 ½ minutes to bang out 12,000 reps of curls and close grip push-ups to get the arms poppin’.

Wrap up, use BFR, and ensure that swell lasts well into the outing. You’d hate to lose that pump if someone starts snapping poolside pics for the gram’.

 

View this post on Instagram

 

Finally a pool day!! Happy summer.

A post shared by Dr. Lisa Lewis (@drlewisconsulting) on

Note From TG: No BFR was done prior to the snapping of this pic…;o)

Get the pump you need without digging into your recovery from programmed training.

How to Wrap Up Safely and Effectively

Upper body: Place the wraps, cuffs, or BFR device directly under the deltoid tuberosity located at the attachment of the deltoid and humerus. Wrap your arms with a perceived tightness of 7/10 as this will provide enough pressure to occlude the cephalic vein but ensure you are still allowing arterial flow.

Check for a distal radial pulse after you are wrapped to make sure you didn’t go too tight. Do not perform the exercise if you can’t find your pulse.

Lower Body: Place the wraps, cuffs, or BFR device as far up your thigh as you can. Wrap your thigh with the same 7/10 tightness as upper body. Make sure the wrap, cuff, or device is lying flat and not wrinkled or bunched up. The goal here is to occlude the deep vein and femoral vein.

Make sure you have a posterior tibial pulse before you perform the exercise.

For a more detailed description, head to Dr. Mario Novo’s guide to everything BFR.

Programming

The best exercises to use with BFR are isolation movements such as leg extensions, leg curls, bicep curls, and triceps extensions. Play around and find your favorite variations.

The most heavily utilized and researched rep/set scheme of 30-15-15-15 is considered the gold standard by practitioners.

Set 1: 30 reps

Set 2: 15 reps

Set 3: 15 reps

Set 4: 15 reps

Take :30 rest between each set. Unwrap after set 4. Breathe.

Perform BFR up to 2-3x per week per muscle group for best results.

About the Author

Tim is an exercise science graduate and CSCS who has been training in Baltimore MD since 2004. While his specialty is body composition, he has extensive experience working with clients from young athletes to cardiac rehabilitation patients. Tim has been published in a variety of fitness publications and writes for his blog when he isn’t helping clients get stronger, leaner, and generally more awesome in person.

Earlier this year, Tim published his first book “Ignition Protocol”, available on Amazon.

Being a former fat boy, Tim developed a deep seeded passion for training and nutrition in his teenage years after a major body transformation. This passion is what drives him to seek the best results for his clients and readers. Tim combines a knowledge base earned from years of practice in the field, research, and time spent under the bar with practical advice to help his clients accomplish their goals.

You can find Tim on Instagram HERE or his blog HERE.

CategoriesRehab/Prehab Strength Training

Sleep and Training: The Ultimate Balancing Act

Whenever a client or athlete grows frustrated from their lack of progress in the gym it can almost always be attributed to sleep…or lack thereof.

I often say the best “supplement” you can invest in isn’t protein powder, pre-work energy drinks, or something like Acai Boost,1 but rather…

…a solid night’s sleep.

Today’s guest post by Baltimore based personal trainer/coach, Tim Hendren, reverberates my sentiments on the topic.

Which is….go to freakin bed.

Copyright: nilswey / 123RF Stock Photo

Sleep and Training: The Ultimate Balancing Act

At this point it’s common knowledge that the “experts” online have hijacked the attention of the public.

While conflicting and generally poor fitness advice has flooded the internet to confuse the public, one area that even sound coaches and trainers talk out of both sides of their mouths is the relationship between training and sleep.

On many occasions, I have heard live coaches (myself included) or coaches I follow online give the “wake up earlier to get the work done” speech and then five minutes later hit the same person with the “well you aren’t getting enough sleep” speech to explain lack of progress, chronic fatigue, or generally feeling like shit at the gym and beyond.

Most people can’t do both.

If a coach spews this advice at a parent of an infant or toddler or an accountant trying to meet a deadline during the peak of tax season, you can bet it’s going to fall on deaf ears.

Getting nine hours of uninterrupted sleep and getting up at 5am to get a workout in is about as likely as Tracy Anderson entering a powerlifting meet, it isn’t happening, and even if it does, that training session won’t be pretty.

Sleep is important, getting the work done is important. It takes balance. The best program ever written is a total waste of time if you can’t recover from it.

As usual, the answer is in the grey area. If you aren’t getting enough sleep, training needs to be scaled back in terms of volume, intensity, or frequency. If you are especially sleep deprived, dialing back two of those three variables may be necessary to optimize your results until you are able to get more shut-eye.

Even if you are getting the required nutrition to support your frequent and intense bouts of training, you WILL be stuck in neutral if you aren’t getting sufficient sleep.

The Importance of Sleep        

We know that as Americans, we simply don’t sleep enough. In fact, according to a Gallup poll from a few years back, 40% of Americans are sleeping less than 7 hours per night.

While busy lifestyles, work schedules, and raising kids contribute to this lack of ZZZs, two underrated factors may be:

  • The brilliant Netflix feature that rolls the end of an episode directly into the next one in 5 seconds.
  • The graphics, sound, and online capabilities of the Call of Duty franchise has gotten totally insane.

Regardless of the root of the issue, this lack of sleep will wreak havoc on your production in the gym especially if your training sessions are frequent and intense.

Sleep deprivation will not only sap energy from your lifts, it will negatively impact you on a hormonal level by decreasing the release of testosterone (1) and increasing cortisol (2), an especially nasty combo when trying to gain strength, muscle mass, or lose body fat and even worse for males interested in having sex past the age of 35.

Furthermore, if you add quality sleep, you’ll have a much better chance at performing optimally in the gym (3). We know we need more sleep, but how?

How Do We Sleep for More Muscle?

A general rule of thumb is getting 7-9 hours of sleep per night to recover from training and support your effort in the weight room.

It’s important to note, however, that not everyone is going to be able to follow that advice 100% of the time.

Sometimes you are simply in a period of life (new baby, starting a new business, etc.) that doesn’t lend itself to a lot of sleep. While training is still encouraged under these circumstances, going balls to the wall with exercise is going to end up wasting time, effort, or causing injury.

Want a more restful night of sleep? Try implementing a couple of these tips to take advantage of all the benefits a great night of rest can provide.

1. Go to Bed Earlier

Common sense? Absolutely.

It’s also the easiest tip to implement and will yield the best results. I bet if there were some snazzy Instagram videos of shredded guys and girls going to bed at 9:30 on a Friday night, it would be a more popular thing to do.

2. Put Down the Screens an Hour or Two Before Bed Time (but after you finish this article).

This includes TVs, phones, laptops, iPads, and video games. The blue light from these popular devices is used to keep us alert and engaged. Helpful when writing a thesis, not so much when scrolling social media directly prior to bed. Blue light at night will completely disrupt the human body’s natural circadian rhythm hampering our ability to get a good night’s sleep. Put devices down a few hours before bed (out of arms reach), dim the lights, and read an actual paper book or magazine. Yeah, those still exist.

3. Stay Away From Caffeine in the Afternoon

Caffeine is glorious.

Its awakening effect has helped mankind move mountains, part seas, and beat deadlines. If it’s ingested too late however, it may affect sleep. Caffeine can stay in our system for up to 6 hours (4) so nix the 3pm cup of coffee used to finish strong at work.

Be careful of sneaky caffeinated items such as chocolate, soda (diet or regular), and even decaf coffee.

4. Avoid Alcohol

While this tip won’t win me a popularity contest, it simply must be stated. That glass or four of wine in the evening may help you cope with the shitty day you had and help you fall asleep faster (read: pass out), but it isn’t doing anything for your quality of sleep .(5)

With alcohol on board, it’s a good bet that the later stages of sleep most crucial for recovery from tough training will be disrupted. As usual, alcohol and progress in the gym simply don’t mix, use sparingly.

5. Your Bed is For Humans

Maybe it’s cold-hearted but the cats and dogs need to get kicked out of your bed.

How many times have you been woken up by your pet?

Think about it this way, every single time they move or nudge you, waking you up, you’re starting at square one of the sleep cycle. How are you going to reach the restorative stages of sleep if every 20 minutes Fido shoves his ass in your face?

If that doesn’t get you to train your pet to sleep in their own designated bed, ask yourself this question: would you let your spouse walk around outside all day on their bare feet and then climb into your clean bed with no bath or shower?

Doubtful!

About the Author

Tim is an exercise science graduate and CSCS who has been training in Baltimore MD for over 14 years. While his specialty is body composition, he has extensive experience working with clients from young athletes to cardiac rehabilitation patients. Tim has been published in a variety of fitness publications and writes for his blog when he isn’t helping clients in person.

Being a former fat boy, Tim developed a deep seeded passion for training and nutrition in his teenage years after a major body transformation. This passion is what drives him to seek the best results for his clients and readers. Tim combines a knowledge base earned from years of practice in the field, research, and time spent under the bar with practical advice to get his clients to the next level.

You can find Tim on Instagram (HERE) or his blog (HERE).