Blood Flow Restriction Training

Why use it?

Blood Flow Restriction (BFR) Training is a safe and effective tool to promote gains in strength for individuals with limitations in their ability to complete traditional strength training due to injury or weight bearing restrictions. Traditional resistance training for strength often requires use of loads at 70% to 85% or greater of a one repetition maximum value to gain significant strength or increase muscle mass. Through use of BFR muscle strength and size can be increased without the requirement of extensive external load, exercises are completed at up to 30% of one repetition maximum levels and often are even body weight only.

What exactly is it?

BFR was originally introduced in the 1960’s in Japan and was known as “Kaatsu Training.” Over the past few decades more research has been done regarding safety and efficacy leading to better established training protocols and safe use for a variety of patients. BFR utilizes pneumatic cuffs, similar to those used to assess blood pressure, to restrict blood flow return from the extremity which it is applied to leading to increased buildup of metabolic byproducts, thus leading to greater muscle fatigue and eventually strength gains.

Is it safe?

Through proper patient screening and use of doppler ultrasound, BFR is very safe when applied and monitored by a trained clinician. BFR does not completely stop blood flow (occlusion) but only restricts return of blood from the limb. Prior to initiating BFR the treating physical therapist will ask you a series of questions regarding your medical history and assess your blood pressure, this will give the therapist the information needed to determine if you are a good candidate for BFR.

What is a training session like?

BFR can be used in isolation or as part of a larger training program for a variety of patients, athletes, and clients depending on the goals of use. At the start of the session the restriction cuffs will applied to the extremities to be trained and an occlusion pressure will be established, this is where blood flow into the limb is halted or significantly slowed. With use of doppler ultrasound the arterial flow in the limb will be monitored as the pressure is built up in the restriction cuff, once the arterial flow is halted or changed significantly the occlusion pressure will have been set. Training will occur at 50% of this established occlusion pressure in the upper extremity and 80% of the occlusion pressure in the lower extremity. A training session will typically include 4-6 exercises at repetition ranges of 15-30 for multiple sets.


BFR may be the tool you need to get back to your best or improve your overall performance. BFR is currently offered at Select Therapy’s Baxter clinic with supervision from Brett Kramer, DPT. Please call at 218-824-5027 or email us at with any questions!

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