Blood Flow Restriction

man using blood flow restriction while lifting weights

Blood Flow Restriction (BFR) therapy is an extensively researched and heavily effective method of exercise with the use of a medical grade tourniquet to briefly and safely limit the amount of venous blood flow to the exercising limb while performing low load exercises. Research shows that limiting the amount of blood flow to the exercising limb can lead to increased muscle size, strength and endurance without having to load the region with excessive weight. This is key when recovering from injury as it allows the injured site to heal while preventing both atrophy and building muscle performance through the entire limb.

How BFR works

Normally when performing low load exercise, the body uses aerobic energy systems, using oxygen to provide energy. During more intense and higher load exercise, the body depends on anaerobic systems, which do not use oxygen in order to provide energy to the system. When BFR is applied, we are temporarily depriving the limb of oxygen, thus forcing the body to use anaerobic energy systems for weights/resistance that it would otherwise not have to. This way, the client is able to exercise at a lower intensity with decreased mechanical stress on tissue, while getting the effects of higher load strength training. Simply put, the use of the BFR device allows an individual to achieve significant strength training effects without having to use a lot of weight, which is safer for the tissue.

Our goal with using BFR is to improve muscle cell size and increased muscle fiber recruitment (bringing more muscle fibers into the exercise), which results in increased muscle strength and hypertrophy (size).

Who can benefit

BFR can be used with many of our clientele both for physical therapy and training purposes, and it is appropriate for:

  • People recovering from post-operative conditions including (but not limited to) ACL reconstruction, meniscectomy, meniscus repair, shoulder labral repair, Tommy John, and rotator cuff repair. Treatment can start as early as the first week depending on physician's discretion. Injuries include:
    • Ligamentous injuries (ACL sprain, MCL sprain, inversion and high ankle sprains, UCL, non-operative labral injuries in the shoulder, shoulder instability)
    • Tendinopathies (patellar tendon, achilles tendon, rotator cuff, tennis elbow, golfer’s elbow, etc.)
    • Muscle strains
  • All training and sports performance clients


Is Blood Flow Restriction safe?


Yes, BFR is safe to use. Our therapists are all trained on how to use the devices and how to screen clients for conditions that are contraindicated for the use of BFR.

What BFR device do you use?


In our Greenwich location, we use the Delphi unit, which is the gold standard unit for BFR. This continuously monitors pressure in the limb and adjusts as needed. This is the standard unit used by the Department of Defense for BFR research. Our other offices use the H+ cuff system, which is slightly different than the Delphi unit, but is just as safe/effective

What does it feel like?


You may experience a burning sensation in the exercising muscle, consistent with lactic acid accumulation in the muscle. The feeling is similar to a very intense work out, without the adverse feeling of pain or pressure within the joint. It is generally well tolerated.

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